Home palliative care services increase the chance of adults with advanced illness dying at home and reduce symptom burden without impact on caregiver grief

摘要

Implications for practice and research: 1.This review found evidence of the benefits of providing home-based palliative care, supporting people to die at home, particularly those with advanced cancer. 2.It is possible for service planners to calculate the levels of service required and project future need; however, planning is complex and multifactorial. 3.Further meta-analytic studies are required on cost-effectiveness, care-giver grief, symptom burden and other aspects of care. Context: Even though most people would prefer to die at home, institutional death is increasingly more common in many countries. In reviewing all known studies, this review by Gomes and colleagues highlights the impact home-based palliative care provision has on whether the death occurs at home, while also considering the impact it has on the management of symptom burden as well as carer distress. This review has gone further than previous studies, to include patients with any malignant or non-malignant advanced illness and to specifically address effectiveness and cost-effectiveness of home care services.