Systematic Literature review concerning out of hours admissions close to the end of life
Background
Out-of-hours hospital admissions for end-of-life care patients are a common cause for concern to patients, families, clinicians and policy makers. It is unclear what issues, or combinations of issues, lead out-of-hours clinicians to initiate hospital care for these patients.
Project aims
To investigate the circumstances, processes and mechanisms of UK out-of-hours services-initiated end-of-life care hospital admissions.
Project activity
- Eight electronic databases were searched from inception to December 2019 supplemented by hand-searching of BJGP. Key search terms included: out-of-hours services, hospital admission and end-of-life care.
- Two reviewers independently screened and selected papers and undertook quality appraisal using Gough’s Weight of Evidence Framework.
- Data was analysed using narrative synthesis and reported following PRISMA Complex Intervention Guidance.
Findings
- Searches identified 20,227 unique citations, 25 of which met the inclusion criteria.
- Few studies had a primary focus on the review questions.
- Admissions were instigated primarily to address clinical needs, caregiver and/or patient distress and discontinuity or unavailability of care provision and were arranged by a range of out-of-hours providers.
- Reported frequencies of end-of-life care patients being admitted to hospital varied greatly; most evidence related to cancer patients.
Papers published
Papavasiliou E, Hoare S, Bowers B, Kelly M, Kuhn I, Barclay S. (June 2021)
“Out-of-hours end-of-life hospital admissions. A complex intervention systematic review and narrative synthesis”.
British Journal of General Practice: e 780 - 786. doi.org/10.3399/BJGP.2021.0194
Who is involved
Principle Investigator: Stephen Barclay, University of Cambridge (UoC)
- Evie Papavasiliou (UoC)
- Sarah Hoare (UoC)
- Mike Kelly (UoC)
- Isla Kuhn (UoC)
Contact us
Stephen Barclay (UoC)
Email: sigb2@medschl.cam.ac.uk