• J Pain Symptom Manage · Nov 2024

    Review

    Enhancing End-of-Life Care with Home-Based Palliative Interventions: A Systematic Review.

    • Diana Rodrigues Feliciano and Paulo Reis-Pina.
    • Faculty of Medicine (D.R.F., P.R.P.), University of Lisbon, Lisboa, Portugal.
    • J Pain Symptom Manage. 2024 Nov 1; 68 (5): e356e372e356-e372.

    ContextHome-Based Palliative Care (HPC) interventions have emerged as a promising approach to deliver patient-centered care in familiar surroundings, aligning with patients' preferences and improving quality of life (QOL).ObjectivesThis review aimed to systematically assess the impact of HPC interventions on symptom management, QOL, healthcare resource utilization and place of death among patients with severe, progressive illnesses requiring end-of-life care.MethodsA comprehensive search was conducted across PubMed, Cochrane, and Scopus databases to identify relevant studies published between January 1, 2013, and December 31, 2023. Eligible studies included randomized controlled trials and clinical studies evaluating the effectiveness of HPC interventions compared to usual care. Risk of bias assessment was performed using Cochrane tools.ResultsNine publications meeting inclusion criteria were identified. Findings indicate that HPC interventions, delivered by specialized teams or integrated care approaches, significantly improve QOL and increase the likelihood of patients dying at home. Moreover, HPC is associated with reduced healthcare utilization, including fewer hospital admissions, emergency department visits, and shorter hospital stays. No significant differences were observed in symptom management.ConclusionHPC interventions demonstrate significant benefits in addressing the complex needs of patients with advanced illnesses. These findings underscore the importance of integrating HPC into healthcare systems to optimize outcomes and promote quality end-of-life care. Future research should focus on expanding access to HPC services, enhancing interdisciplinary collaboration, and incorporating patient preferences to further improve care delivery in this vulnerable population.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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