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The role and response of palliative care and hospice services in epidemics and pandemics: a rapid review to inform practice during the COVID-19 pandemic

Identifieur interne : 000953 ( Pmc/Curation ); précédent : 000952; suivant : 000954

The role and response of palliative care and hospice services in epidemics and pandemics: a rapid review to inform practice during the COVID-19 pandemic

Auteurs : Simon N. Etkind ; Anna E. Bone ; Natasha Lovell ; Rachel L. Cripps ; Richard Harding ; Irene J. Higginson ; Katherine E. Sleeman

Source :

RBID : PMC:7141635

Abstract

Cases of COVID-19 are escalating rapidly across the globe, with the mortality risk being especially high among those with existing illness and multimorbidity. This study aimed to synthesise evidence for the role and response of palliative care and hospice teams to viral epi/pandemics, to inform the COVID-19 pandemic response. We conducted a rapid systematic review according to PRISMA guidelines in five databases. Of 3094 papers identified, ten were included in this narrative synthesis. Included studies were from West Africa, Taiwan, Hong Kong, Singapore, the United States and Italy. All had an observational design. Findings were synthesised using a previously proposed framework according to ‘systems’ (policies, training and protocols, communication and coordination, data), ‘staff’ (deployment, skill mix, resilience), ‘space’ (community provision, use of technology) and ‘stuff’ (medicines and equipment, personal protective equipment). We conclude that hospice and palliative services have an essential role in the response to COVID-19 by: 1) responding rapidly and flexibly; 2) ensuring protocols for symptom management are available, and training non-specialists in their use; 3) being involved in triage; 4) considering shifting resources into the community; 5) considering redeploying volunteers to provide psychosocial and bereavement care; 6) facilitating camaraderie among staff and adopt measures to deal with stress; 7) using technology to communicate with patients and carers; 8) adopting standardised data collection systems to inform operational changes and improve care.


Url:
DOI: 10.1016/j.jpainsymman.2020.03.029
PubMed: 32278097
PubMed Central: 7141635

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Simon N. Etkind
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Anna E. Bone
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Natasha Lovell
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Rachel L. Cripps
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Richard Harding
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Irene J. Higginson
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Katherine E. Sleeman
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<contrib contrib-type="author" id="au1">
<name>
<surname>Etkind</surname>
<given-names>Simon N.</given-names>
</name>
<degrees>MB BChir BA MRCP DTMH</degrees>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author" id="au2">
<name>
<surname>Bone</surname>
<given-names>Anna E.</given-names>
</name>
<degrees>PhD MPH BA</degrees>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author" id="au3">
<name>
<surname>Lovell</surname>
<given-names>Natasha</given-names>
</name>
<degrees>MBChB BSc MRCP</degrees>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author" id="au4">
<name>
<surname>Cripps</surname>
<given-names>Rachel L.</given-names>
</name>
<degrees>MSc BSc</degrees>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author" id="au5">
<name>
<surname>Harding</surname>
<given-names>Richard</given-names>
</name>
<degrees>BSc MSc DipSW PhD</degrees>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author" id="au6">
<name>
<surname>Higginson</surname>
<given-names>Irene J.</given-names>
</name>
<degrees>OBE BMedSci BMBS PhD FMedSci FRCP FFPHM</degrees>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author" id="au7">
<name>
<surname>Sleeman</surname>
<given-names>Katherine E.</given-names>
</name>
<degrees>BSc MBBS MRCP PhD</degrees>
<email>Katherine.Sleeman@kcl.ac.uk</email>
<xref rid="aff1" ref-type="aff">1</xref>
<xref rid="cor1" ref-type="corresp"></xref>
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King’s College London, Cicely Saunders Institute, Bessemer Road, London, SE5 9PJ</aff>
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Corresponding Author: Dr Katherine E Sleeman, King’s College London, Cicely Saunders Institute, Bessemer Road, London, SE5 9PJ.
<email>Katherine.Sleeman@kcl.ac.uk</email>
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<day>8</day>
<month>4</month>
<year>2020</year>
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<pub-date pub-type="epub">
<day>8</day>
<month>4</month>
<year>2020</year>
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<history>
<date date-type="received">
<day>26</day>
<month>3</month>
<year>2020</year>
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<date date-type="accepted">
<day>27</day>
<month>3</month>
<year>2020</year>
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<copyright-statement>© 2020 Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.</copyright-statement>
<copyright-year>2020</copyright-year>
<copyright-holder></copyright-holder>
<license>
<license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
<abstract id="abs0010">
<p>Cases of COVID-19 are escalating rapidly across the globe, with the mortality risk being especially high among those with existing illness and multimorbidity. This study aimed to synthesise evidence for the role and response of palliative care and hospice teams to viral epi/pandemics, to inform the COVID-19 pandemic response. We conducted a rapid systematic review according to PRISMA guidelines in five databases. Of 3094 papers identified, ten were included in this narrative synthesis. Included studies were from West Africa, Taiwan, Hong Kong, Singapore, the United States and Italy. All had an observational design. Findings were synthesised using a previously proposed framework according to ‘systems’ (policies, training and protocols, communication and coordination, data), ‘staff’ (deployment, skill mix, resilience), ‘space’ (community provision, use of technology) and ‘stuff’ (medicines and equipment, personal protective equipment). We conclude that hospice and palliative services have an essential role in the response to COVID-19 by: 1) responding rapidly and flexibly; 2) ensuring protocols for symptom management are available, and training non-specialists in their use; 3) being involved in triage; 4) considering shifting resources into the community; 5) considering redeploying volunteers to provide psychosocial and bereavement care; 6) facilitating camaraderie among staff and adopt measures to deal with stress; 7) using technology to communicate with patients and carers; 8) adopting standardised data collection systems to inform operational changes and improve care.</p>
</abstract>
<kwd-group id="kwrds0010">
<title>Key words</title>
<kwd>COVID-19</kwd>
<kwd>coronavirus</kwd>
<kwd>pandemic</kwd>
<kwd>palliative care</kwd>
<kwd>hospice</kwd>
<kwd>end of life</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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