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Dy SM, Waldfogel JM, Sloan DH, et al. Integrating Palliative Care in Ambulatory Care of Noncancer Serious Chronic Illness [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Feb. (Comparative Effectiveness Review, No. 237.)

Cover of Integrating Palliative Care in Ambulatory Care of Noncancer Serious Chronic Illness

Integrating Palliative Care in Ambulatory Care of Noncancer Serious Chronic Illness [Internet].

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Appendix DEvidence Tables

Table D-1. Study design characteristics for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 55K)

Table D-2. Study design characteristics for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 57K)

Table D-3. Study design Characteristics for qualitative studies implementing palliative care interventions for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 61K)

Table D-4. Patient characteristics for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 59K)

Table D-5. Patient characteristics for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 67K)

Table D-6. Participant characteristics for qualitative studies implementing palliative care interventions for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 60K)

Table D-7. Interventions for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 60K)

Table D-8. Interventions for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 71K)

Table D-9. Qualitative Studies: How have palliative care intervention components for patients with serious life-threatening chronic illness or conditions in ambulatory settings been implemented? (MS Word, 65K)

Table D-10. Anxiety symptom continuous outcomes for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 55K)

Table D-11. Concordance between preference and care received categorical outcomes for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 55K)

Table D-12. Depression continuous outcomes for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 55K)

Table D-13. Health-related quality of life continuous outcomes for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 54K)

Table D-14. Patient satisfaction continuous outcomes for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 55K)

Table D-15. Caregiver satisfaction continuous outcomes for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 57K)

Table D-16. Advance directive documentation categorical outcomes for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 57K)

Table D-17. Dropout categorical outcomes for studies comparing effectiveness of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 56K)

Table D-18. Anxiety symptoms continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 60K)

Table D-19. Depression symptoms continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 64K)

Table D-20. Dyspnea continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 58K)

Table D-21. Fatigue continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 55K)

Table D-22. Health-related quality of life continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 67K)

Table D-23. Pain continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 61K)

Table D-24. Patient satisfaction continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 56K)

Table D-25. Psychological well-being continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 60K)

Table D-26. Concordance between preference and care received categorical outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 57K)

Table D-27. Caregiver reported anxiety continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 56K)

Table D-28. Caregiver reported caregiver burden continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 55K)

Table D-29. Caregiver reported depression continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 55K)

Table D-30. Caregiver reported psychological continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 54K)

Table D-31. Caregiver reported quality of life continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 57K)

Table D-32. Advance directive documentation continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 54K)

Table D-33. Advance directive documentation categorical outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 62K)

Table D-34. Cost and resource use continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 68K)

Table D-35. Hospitalization continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 58K)

Table D-36. Hospitalization categorical outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 57K)

Table D-37. Use and length of hospice care continuous outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 58K)

Table D-38. Use and length of hospice care categorical outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 57K)

Table D-39. Dropouts categorical outcomes for studies comparing effectiveness of models or multimodal interventions for integrating palliative care for patients with serious life-threatening chronic illness or conditions in ambulatory settings (MS Word, 54K)

Table D-40. Summary of study characteristics for qualitative review (MS Word, 57K)

Table D-41. Results for qualitative review (MS Word, 72K)

Table D-42. Risk of bias assessment of randomized controlled trials (MS Word, 66K)

Table D-43. Risk of bias assessment of non-randomized studies using Cochrane ROBINS-I (MS Word, 57K)

Table D-44. Strength of evidence of studies that evaluate the effects of palliative care shared decision-making tools for patients with serious life-threatening chronic illness or conditions in ambulatory settings and their caregivers (MS Word, 57K)

Table D-45. Strength of evidence of studies that evaluate the effects of palliative care models or multimodal interventions (MS Word, 57K)

Table D-46. Joanna Briggs Institute qualitative critical appraisal (MS Word, 61K)

Table D-47. Percentage of studies meeting criteria using the Joanna Briggs Institute quality assessment (MS Word, 56K)

References

1.
Au DH, Udris EM, Engelberg RA, et al. A randomized trial to improve communication about end-of-life care among patients with COPD. CHEST. 2012;141(3):726–35. doi: 10.1378/chest.11-0362. PMID: 108167078. Language: English. Entry Date: 20120518. Revision Date: 20170601. Publication Type: journal article. [PMC free article: PMC3415164] [PubMed: 21940765] [CrossRef]
2.
Curtis JR, Downey L, Back AL, et al. Effect of a Patient and Clinician Communication-Priming Intervention on Patient-Reported Goals-of-Care Discussions Between Patients With Serious Illness and Clinicians: A Randomized Clinical Trial. JAMA Intern Med. 2018 Jul 1;178(7):930–40. doi: 10.1001/jamainternmed.2018.2317. PMID: 29802770. [PMC free article: PMC6145723] [PubMed: 29802770] [CrossRef]
3.
Doorenbos AZ, Levy WC, Curtis JR, et al. An Intervention to Enhance Goals-of-Care Communication Between Heart Failure Patients and Heart Failure Providers. J Pain Symptom Manage. 2016 Sep;52(3):353–60. doi: 10.1016/j.jpainsymman.2016.03.018. PMID: 27401505. [PMC free article: PMC5545129] [PubMed: 27401505] [CrossRef]
4.
Kirchhoff KT, Hammes BJ, Kehl KA, et al. Effect of a disease-specific advance care planning intervention on end-of-life care. J Am Geriatr Soc. 2012 May;60(5):946–50. doi: 10.1111/j.1532-5415.2012.03917.x. PMID: 22458336. [PMC free article: PMC3354033] [PubMed: 22458336] [CrossRef]
5.
Perry E, Swartz J, Brown S, et al. Peer mentoring: a culturally sensitive approach to end-of-life planning for long-term dialysis patients. Am J Kidney Dis. 2005 Jul;46(1):111–9. doi: 10.1053/j.ajkd.2005.03.018. PMID: 15983964. [PubMed: 15983964] [CrossRef]
6.
Song MK, Ward SE, Happ MB, et al. Randomized controlled trial of SPIRIT: an effective approach to preparing African-American dialysis patients and families for end of life. Res Nurs Health. 2009 Jun;32(3):260–73. doi: 10.1002/nur.20320. PMID: 19205027. [PMC free article: PMC2719959] [PubMed: 19205027] [CrossRef]
7.
Bekelman DB, Plomondon ME, Carey EP, et al. Primary Results of the Patient-Centered Disease Management (PCDM) for Heart Failure Study: A Randomized Clinical Trial. JAMA Intern Med. 2015 May;175(5):725–32. doi: 10.1001/jamainternmed.2015.0315. PMID: 25822284. [PubMed: 25822284] [CrossRef]
8.
Bekelman DB, Allen LA, McBryde CF, et al. Effect of a Collaborative Care Intervention vs Usual Care on Health Status of Patients With Chronic Heart Failure: The CASA Randomized Clinical Trial. JAMA Intern Med. 2018 Apr 1;178(4):511–9. doi: 10.1001/jamainternmed.2017.8667. PMID: 29482218. [PMC free article: PMC5876807] [PubMed: 29482218] [CrossRef]
9.
Dionne-Odom JN, Ejem DB, Wells R, et al. Effects of a Telehealth Early Palliative Care Intervention for Family Caregivers of Persons With Advanced Heart Failure: The ENABLE CHF-PC Randomized Clinical Trial. JAMA Netw Open. 2020 Apr 1;3(4):e202583. doi: 10.1001/jamanetworkopen.2020.2583. PMID: 32282044. [PMC free article: PMC7154802] [PubMed: 32282044] [CrossRef]
10.
Engelhardt JB, McClive-Reed KP, Toseland RW, et al. Effects of a program for coordinated care of advanced illness on patients, surrogates, and healthcare costs: a randomized trial. Am J Manag Care. 2006 Feb;12(2):93–100. PMID: 16464138. [PubMed: 16464138]
11.
Engelhardt JB, Rizzo VM, Della Penna RD, et al. Effectiveness of care coordination and health counseling in advancing illness. Am J Manag Care. 2009 Nov;15(11):817–25. PMID: 19895186. [PubMed: 19895186]
12.
Feely MA, Swetz KM, Zavaleta K, et al. Reengineering Dialysis: The Role of Palliative Medicine. J Palliat Med. 2016 Jun;19(6):652–5. doi: 10.1089/jpm.2015.0181. PMID: 26991732. [PubMed: 26991732] [CrossRef]
13.
Goldstein NE, Mather H, McKendrick K, et al. Improving Communication in Heart Failure Patient Care. Journal of the American College of Cardiology. 2019;74(13):1682–92. doi: 10.1016/j.jacc.2019.07.058. PMID: CN-01988597. [PMC free article: PMC7000126] [PubMed: 31558252] [CrossRef]
14.
Kluger BM, Miyasaki J, Katz M, et al. Comparison of Integrated Outpatient Palliative Care with Standard Care in Patients with Parkinson Disease and Related Disorders: a Randomized Clinical Trial. 2020. [PMC free article: PMC7042842] [PubMed: 32040141]
15.
Lakin JR, Koritsanszky LA, Cunningham R, et al. A Systematic Intervention To Improve Serious Illness Communication In Primary Care. Health Aff (Millwood). 2017 Jul 1;36(7):1258–64. doi: 10.1377/hlthaff.2017.0219. PMID: 28679813. [PubMed: 28679813] [CrossRef]
16.
Lakin JR, Robinson MG, Obermeyer Z, et al. Prioritizing Primary Care Patients for a Communication Intervention Using the “Surprise Question”: a Prospective Cohort Study. J Gen Intern Med. 2019 Aug;34(8):1467–74. doi: 10.1007/s11606-019-05094-4. PMID: 31190257. [PMC free article: PMC6667512] [PubMed: 31190257] [CrossRef]
17.
Lakin JR, Neal BJ, Maloney FL, et al. A systematic intervention to improve serious illness communication in primary care: Effect on expenses at the end of life. [PubMed: 32553522]
18.
O’Donnell AE, Schaefer KG, Stevenson LW, et al. Social Worker-Aided Palliative Care Intervention in High-risk Patients With Heart Failure (SWAP-HF): A Pilot Randomized Clinical Trial. JAMA Cardiol. 2018 Jun 1;3(6):516–9. doi: 10.1001/jamacardio.2018.0589. PMID: 29641819. [PMC free article: PMC6128511] [PubMed: 29641819] [CrossRef]
19.
O’Riordan DL, Rathfon MA, Joseph DM, et al. Feasibility of Implementing a Palliative CareIntervention for People with Heart Failure:Learnings from a Pilot Randomized Clinical Trial. Journal of Palliative Medicine. 2019;22doi: 10.1089/jpm.2018.0633. [PubMed: 31099698] [CrossRef]
20.
Owens D, Eby K, Burson S, et al. Primary palliative care clinic pilot project demonstrates benefits of a nurse practitioner-directed clinic providing primary and palliative care. J Am Acad Nurse Pract. 2012 Jan;24(1):52–8. doi: 10.1111/j.1745-7599.2011.00664.x. PMID: 22243681. [PubMed: 22243681] [CrossRef]
21.
Rabow MW, Dibble SL, Pantilat SZ, et al. The comprehensive care team: a controlled trial of outpatient palliative medicine consultation. Arch Intern Med. 2004 Jan 12;164(1):83–91. doi: 10.1001/archinte.164.1.83. PMID: 14718327. [PubMed: 14718327] [CrossRef]
22.
Rabow MW, Petersen J, Schanche K, et al. The comprehensive care team: a description of a controlled trial of care at the beginning of the end of life. J Palliat Med. 2003 Jun;6(3):489–99. doi: 10.1089/109662103322144862. PMID: 14509498. [PubMed: 14509498] [CrossRef]
23.
Rogers JG, Patel CB, Mentz RJ, et al. Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial. J Am Coll Cardiol. 2017 Jul 18;70(3):331–41. doi: 10.1016/j.jacc.2017.05.030. PMID: 28705314. [PMC free article: PMC5664956] [PubMed: 28705314] [CrossRef]
24.
Bekelman DB, Hooker S, Nowels CT, et al. Feasibility and acceptability of a collaborative care intervention to improve symptoms and quality of life in chronic heart failure: mixed methods pilot trial. J Palliat Med. 2014 Feb;17(2):145–51. doi: 10.1089/jpm.2013.0143. PMID: 24329424. [PMC free article: PMC3924799] [PubMed: 24329424] [CrossRef]
25.
Bekelman DB, Rabin BA, Nowels CT, et al. Barriers and Facilitators to Scaling Up Outpatient Palliative Care. J Palliat Med. 2016 Apr;19(4):456–9. doi: 10.1089/jpm.2015.0280. PMID: 26974489. [PubMed: 26974489] [CrossRef]
26.
Dillon E, Chuang J, Gupta A, et al. Provider Perspectives on Advance Care Planning Documentation in the Electronic Health Record: The Experience of Primary Care Providers and Specialists Using Advance Health-Care Directives and Physician Orders for Life-Sustaining Treatment. American Journal of Hospice & Palliative Medicine. 2017;34(10):918–24. doi: 10.1177/1049909117693578. PMID: 126084089. Language: English. Entry Date: 20171117. Revision Date: 20171117. Publication Type: Article. [PMC free article: PMC6668349] [PubMed: 28196448] [CrossRef]
27.
Goff SL, Unruh ML, Klingensmith J, et al. Advance care planning with patients on hemodialysis: an implementation study. BMC Palliat Care. 2019 Jul 26;18(1):64. doi: 10.1186/s12904-019-0437-2. PMID: 31349844. [PMC free article: PMC6659207] [PubMed: 31349844] [CrossRef]
28.
Hobler MR, Engelberg RA, Curtis JR, et al. Exploring Opportunities for Primary Outpatient Palliative Care for Adults with Cystic Fibrosis: A Mixed-Methods Study of Patients’ Needs. Journal of Palliative Medicine. 2018;21(4):513–21. doi: 10.1089/jpm.2017.0259. PMID: 128755020. Language: English. Entry Date: 20180402. Revision Date: 20190401. Publication Type: Article. [PMC free article: PMC5915258] [PubMed: 29298400] [CrossRef]
29.
Lakin JR, Benotti E, Paladino J, et al. Interprofessional Work in Serious Illness Communication in Primary Care: A Qualitative Study. Journal of Palliative Medicine. 2019;22(7):751–63. doi: 10.1089/jpm.2018.0471. PMID: 137304823. Language: English. Entry Date: 20190706. Revision Date: 20190827. Publication Type: Article. Journal Subset: Biomedical. [PubMed: 30688549] [CrossRef]
30.
Bronwyn Long M, Bekelman DB, Make B. Improving Quality of Life in Chronic Obstructive Pulmonary Disease by Integrating Palliative Approaches to Dyspnea, Anxiety, and Depression. Journal of Hospice & Palliative Nursing. 2014;16(8):514–20. doi: 10.1097/NJH.0000000000000111. PMID: 107840242. Language: English. Entry Date: 20141205. Revision Date: 20150712. Publication Type: Journal Article. [CrossRef]
31.
Metzger M, Song MK, Devane-Johnson S. LVAD patients’ and surrogates’ perspectives on SPIRIT-HF: An advance care planning discussion. Heart Lung. 2016 Jul–Aug;45(4):305–10. doi: 10.1016/j.hrtlng.2016.05.033. PMID: 27377333. [PubMed: 27377333] [CrossRef]
32.
Nowels D, Jones J, Nowels CT, et al. Perspectives of Primary Care Providers Toward Palliative Care for Their Patients. J Am Board Fam Med. 2016 Nov 12;29(6):748–58. doi: 10.3122/jabfm.2016.06.160054. PMID: 28076258. [PubMed: 28076258] [CrossRef]
33.
Paladino J, Kilpatrick L, O’Connor N, et al. Training Clinicians in Serious Illness Communication Using a Structured Guide: Evaluation of a Training Program in Three Health Systems. J Palliat Med. 2019 Sep 17doi: 10.1089/jpm.2019.0334. PMID: 31503520. [PubMed: 31503520] [CrossRef]
34.
Rabow MW, Schanche K, Petersen J, et al. Patient perceptions of an outpatient palliative care intervention: “It had been on my mind before, but I did not know how to start talking about death…”. Journal of Pain & Symptom Management. 2003;26(5):1010–5. PMID: 106746971. Language: English. Entry Date: 20040618. Revision Date: 20190920. Publication Type: journal article. [PubMed: 14585552]
35.
Scherer JS, Wright R, Blaum CS, et al. Building an Outpatient Kidney Palliative Care Clinical Program. J Pain Symptom Manage. 2018 Jan;55(1):108–16.e2. doi: 10.1016/j.jpainsymman.2017.08.005. PMID: 28803081. [PubMed: 28803081] [CrossRef]
36.
Song MK, Metzger M, Ward SE. Process and impact of an advance care planning intervention evaluated by bereaved surrogate decision-makers of dialysis patients. Palliat Med. 2017 Mar;31(3):267–74. doi: 10.1177/0269216316652012. PMID: 27272317. [PubMed: 27272317] [CrossRef]
37.
Uhler LM, Perez Figueroa RE, Dickson M, et al. InformedTogether: Usability Evaluation of a Web-Based Decision Aid to Facilitate Shared Advance Care Planning for Severe Chronic Obstructive Pulmonary Disease. JMIR Hum Factors. 2015 Feb 25;2(1):e2. doi: 10.2196/humanfactors.3842. PMID: 27025896. [PMC free article: PMC4797670] [PubMed: 27025896] [CrossRef]
38.
Nursing news. Nursing Leadership (1910-622X). 2013;26(2):8–13. PMID: 109864135. Language: English. Entry Date: 20140228. Revision Date: 20150923. Publication Type: Journal Article.
39.
O’Hare AM, Szarka J, McFarland LV, et al. Provider Perspectives on Advance Care Planning for Patients with Kidney Disease: Whose Job Is It Anyway? Clin J Am Soc Nephrol. 2016 May 6;11(5):855–66. doi: 10.2215/cjn.11351015. PMID: 27084877. [PMC free article: PMC4858488] [PubMed: 27084877] [CrossRef]
40.
Bekelman DB, Nowels CT, Retrum JH, et al. Giving voice to patients’ and family caregivers’ needs in chronic heart failure: implications for palliative care programs. J Palliat Med. 2011 Dec;14(12):1317–24. doi: 10.1089/jpm.2011.0179. PMID: 22107107. [PMC free article: PMC3532000] [PubMed: 22107107] [CrossRef]
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