Impact of palliative care consult service in inpatient hospital setting: a systematic literature review

BMJ Support Palliat Care. 2021 Dec;11(4):351-360. doi: 10.1136/bmjspcare-2020-002291. Epub 2020 Sep 21.

Abstract

Objectives: Despite a number of studies on effectiveness of palliative care, there is a lack of complex updated review of the impact of in-hospital palliative care consult service. The objective is to update information on the impact of palliative care consult service in inpatient hospital setting.

Methods: This study was a systematic literature review, following the standard protocols (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Joanna Briggs Institute tools) to ensure the transparent and robust review procedure. The effect of palliative care consult service was classified as being associated with improvement, no difference, deterioration or mixed results in specific outcomes. PubMed, Scopus, Academic Search Ultimate and SocINDEX were systematically searched up to February 2020. Studies were included if they focused on the impact of palliative care consult service caring for adult palliative care patients and their families in inpatient hospital setting.

Results: After removing duplicates, 959 citations were screened of which 49 full-text articles were retained. A total of 28 different outcome variables were extracted. 18 of them showed positive effects within patient, family, staff and healthcare system domains. No difference was observed in patient survival and depression. Inconclusive results represented patient social support and staff satisfaction with care.

Conclusions: Palliative care consult service has a number of positive effects for patients, families, staff and healthcare system. More research is needed on factors such as patient spiritual well-being, social support, performance, family understanding of patient diagnosis or staff stress.

Keywords: clinical assessment; communication; hospital care; quality of life; service evaluation; symptoms and symptom management.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Hospice and Palliative Care Nursing*
  • Hospitals
  • Humans
  • Inpatients
  • Palliative Care*
  • Referral and Consultation