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Impact of informational and relational continuity for people with palliative care needs: a mixed methods rapid review
  1. Briony F Hudson1,2,
  2. Sabine Best1,
  3. Patrick Stone2,
  4. Thomas (Bill) Noble3
  1. 1 Marie Curie, London, UK
  2. 2 Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
  3. 3 Academic Unit of Supportive Care, University of Sheffield, Sheffield, UK
  1. Correspondence to Dr Briony F Hudson; b.hudson{at}ucl.ac.uk

Abstract

Objective To identify and synthesise existing literature exploring the impact of relational and informational continuity of care on preferred place of death, hospital admissions and satisfaction for palliative care patients in qualitative, quantitative and mixed methods literature.

Design A mixed methods rapid review.

Methods PUBMED, PsychINFO, CINAHL were searched from June 2008 to June 2018 in order to identify original peer reviewed, primary qualitative, quantitative or mixed methods research exploring the impact of continuity of care for people receiving palliative care. Synthesis methods as outlined by the Cochrane Qualitative and Implementation Methods Group were applied to qualitative studies while meta-analyses for quantitative data were planned.

Outcomes The impact of interventions designed to promote continuity of care for people receiving palliative care on the following outcomes was explored: achieving preferred place of death, satisfaction with care and avoidable hospital admissions.

Results 18 eligible papers were identified (11 qualitative, 6 quantitative and 1 mixed methods papers). In all, 1951 patients and 190 family caregivers were recruited across included studies. Meta-analyses were not possible due to heterogeneity in outcome measures and tools used. Two studies described positive impact on facilitating preferred place of death. Four described a reduction in avoidable hospital admissions. No negative impacts of interventions designed to promote continuity were reported. Patient satisfaction was not assessed in quantitative studies. Participants described a significant impact on their experiences as a result of the lack of informational and relational continuity.

Conclusions This rapid review highlights the impact that continuity of care can have on the experiences of patients receiving palliative care. The evidence for the impact of continuity on place of death and hospital admissions is limited. Methods for enhancing, and recording continuity should be considered in the design and development of future healthcare interventions to support people receiving palliative care.

  • palliative care
  • continuity of patient care
  • systematic review
  • qualitative research

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors BFH, BN and SB conceptualised the study. BFH designed the search strategy. BFH ran the search strategy. BFH screened the articles, extracted data, analysed the results and drafted the manuscript. BN reviewed eligible articles. BFH, BN, SB and PS critically reviewed several drafts of the manuscript and approved the final draft.

  • Funding BFH, SB and BN’s role were supported by Marie Curie. PS’s role was supported by the Marie Curie Chair’s grant. PS is supported by the UCLH NIHR Biomedical Research Centre.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available for this manuscript.

  • Patient consent for publication Not required.

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