• Palliative medicine · Sep 2021

    Virtual models of care for people with palliative care needs living in their own home: A systematic meta-review and narrative synthesis.

    • Domenica Disalvo, Meera Agar, Gideon Caplan, Fliss Em Murtagh, Tim Luckett, Nicole Heneka, Louise Hickman, Irina Kinchin, Susan Trethewie, Caitlin Sheehan, Kat Urban, Joshua Cohen, Janeane Harlum, Brian Long, Tricia Parker, Isabelle Schaefer, and Jane Phillips.
    • IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, NSW, Australia.
    • Palliat Med. 2021 Sep 1; 35 (8): 1385-1406.

    BackgroundAccess to palliative care in the community enables people to live in their preferred place of care, which is often home. Community palliative care services struggle to provide timely 24-h services to patients and family. This has resulted in calls for 'accessible and flexible' models of care that are 'responsive' to peoples' changing palliative care needs. Digital health technologies provide opportunities to meet these requirements 24-h a day.AimTo identify digital health technologies that have been evaluated for supporting timely assessment and management of people living at home with palliative care needs and/or their carer(s), and the evidence-base for each.DesignA systematic review of systematic reviews ('meta-review'). Systematic reviews evaluating evidence for virtual models of palliative or end-of-life care using one or more digital health technologies were included. Systematic reviews were evaluated using the Risk of Bias Tool for Systematic Reviews. A narrative approach was used to synthesise results.Data SourcesMedline, Embase, Web of Science, CINAHL and Cochrane Database of systematic reviews were searched for English-language reviews published between 2015 and 2020.ResultsThe search yielded 2266 articles, of which 12 systematic reviews met criteria. Sixteen reviews were included in total, after four reviews were found via handsearching. Other than scheduled telehealth, video-conferencing, or after-hours telephone support, little evidence was found for digital health technologies used to deliver virtual models of palliative care.ConclusionsThere are opportunities to test new models of virtual care, beyond telehealth and/or video conferencing, such as 24-h command centres, and rapid response teams.Systematic Review Registration NumberProspero CRD42020200266.

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