Nursing and interdisciplinary interventions to support people with advanced cancer at the end of life in emergency departments: A systematic review.

BACKGROUND

People with advanced cancer at the end of life may visit emergency departments (ED) due to worsening symptoms or unmet needs. The impact of ED-initiated palliative care interventions remains unclear for this population.

MAIN PURPOSE: To synthesize evidence on the impact of ED-initiated palliative care interventions on quality of life and symptom burden, perceptions, and service-related outcomes for people with advanced cancer.

METHODS

Systematic searches were conducted in five databases.

DISCUSSION: Five studies (n = 2,166; two randomized trials) involving interdisciplinary teams including nurses were included. One trial reported improved quality of life at 12 weeks (FACT-G) following an ED-initiated specialist palliative care consultation vs. usual care. In two studies, there were no between-group differences in depressive symptoms. Four studies indicated that ED-initiated referral or screening pathways increased access to palliative care consultations.

CONCLUSION

ED-initiated palliative care may improve quality of life and facilitate access to palliative care but remains underexplored.