The following lists palliative care research primarily conducted by Australian research groups. The list is based on application of the CareSearch search filter for palliative care to identify articles held within the PubMed database and corresponding to the strongest evidence. Articles have been selected based on relevance and new articles are added on a weekly basis.
Whilst not an exhaustive list, the aim is to keep the community informed by providing a snapshot of recent research findings and planned studies in the Australian setting.
Elvidge N, Carter HE, Rolfe M, Smith K, Phillips JL.
Context: Many individuals receiving specialist community palliative care experience unplanned hospitalisations or emergency department presentations. Understanding the reasons for this is essential to developing person-centred solutions.
Objectives: To identify the reasons for unplanned hospitalisations among people receiving specialist community palliative care.
Methods: A PROSPERO (CRD42024495016) registered scoping review reported according to the PRISMA extension for scoping reviews. A search of CINAHL, PubMed, Embase, and Scopus was undertaken for studies published from 2014 to 2025. Two reviewers completed title, abstract and full text screening and data extraction. Extracted reasons for hospitalisation were inductively coded using a content analysis approach, allowing for a descriptive summary of findings.
Results: Thirteen of the 2482 studies identified met the inclusion criteria. Six categories of hospitalisation reason were generated: (1) unrelieved symptoms (16 subcategories), (2) acute event (five subcategories) (3) signs of deterioration, (4) patient or carer distress/fatigue, (5) misunderstanding of the goals of care and (6) other/unknown. Of the sub-categories, dyspnoea (n = 11 studies, 85%), pain (n = 9, 69%), gastrointestinal symptoms (n = 9, 69%) and infection (n = 7, 54%) were the most frequently reported reasons for hospitalisation. Comparative studies (n = 5) of specialist versus usual or no palliative care showed mixed hospitalisation outcomes, with limited statistical detail.
Conclusion: This scoping review provides insight into patterns of hospitalisation, despite variability in data collection methods. This approach provides a foundation for developing targeted service improvements aimed at supporting individuals to stay at home for more extended periods in the last year of life.
Hutchison A, Spooner A, Parker D, Yates P.
Background: Internationally, the ageing population is driving increased demand for palliative care across primary, aged, and healthcare sectors. Quality indicators for palliative care have been extensively researched, with systematic reviews synthesising these indicators for older populations across various care settings.
Aim: To identify a comprehensive set of quality indicators for palliative care for older people.
Design: A research protocol was developed following Joanna Briggs Institute's umbrella review methodology and registered with PROSPERO. Included reviews were assessed using the Joanna Briggs Institute's Critical Appraisal Instrument for Systematic Reviews and Research Synthesis. Identified quality indicators were mapped to Donabedian's quality model (structure, process, outcome) and aligned with the Australian Commission on Safety and Quality's essential elements for safe, high-quality end-of-life care.
Data sources: MEDLINE, CINAHL, EMBASE, Scopus, and Cochrane were searched from January 2000 to May 2025.
Results: A total of 1272 records were identified, after removing duplicates 719 were screened by title and for eligibility. Four articles met the criteria, yielding 1071 quality indicators, of which 658 were unique. Among these, 402 (61%) related to the process of care, 179 (27%) to care outcomes, and 77 (12%) to structure.
Conclusion: This review highlights a critical gap in quality indicators related to structure, including the physical and organisational settings of healthcare delivery. Indicators often emphasised a biomedical approach, overlooking the psychological, social, cultural, and spiritual aspects essential to high-quality palliative care. Further work is needed to develop a comprehensive, practical set of quality indicators that can be used across care settings.
Kahawita T, Fischer A, Webb L, Good P.
Backgound: With an ageing population, there is an increasing demand for home-based palliative care to improve end-of-life care. Funding models can impact service utilisation and patient outcomes.
Aims: To compare two funding models to assess the effects on service utilisation, hospital admission, home death rates and concordance between preferred and actual place of death.
Methods: A single-centre, prospective cohort study compared the first 12 months of two funding models. Eligible patients accessing a private health insurance-funded palliative care programme were included. Each funding model had different eligibility criteria: the capitation model (May 2020-April 2021) required a ≤3-month prognosis and preference for home death, while the fee-for-service model (December 2022-November 2023) had a ≤6-month prognosis with no preference.
Results: The capitation cohort had fewer hospital admissions (27% vs. 64%) in the last 4 weeks of life, and a higher rate in home or a residential aged care facility (78% vs. 31%). Concordance with preferred place of death was similar across cohorts (91% vs. 76%). Except for assistants in nursing, the fee-for-service cohort accessed more services, with utilisation increasing near death. In the final 4 weeks, the capitation cohort had higher service use (median 14 vs. 7) and more involvement of assistants in nursing (40% vs. 5%) and medical practitioners (60% vs. 35%).
Conclusions: This is one of the first studies to look into funding models and how funding mechanisms influence service utilisation, intensity and timing. While trends emerged, cohort differences led to variability and limited interpretation.
Lock K, Zhi Yan Lee L, Goh A, Gerber K, Lim WK, Tropea J, et al.
Background: The challenges of implementing evidence-based palliative care in residential aged care are widely acknowledged. Facilitation is often cited as an effective implementation strategy to address these challenges. However, there is limited guidance on how this strategy applies specifically to this context.
Aim: To understand the contextual factors and causal processes (mechanisms) that influence the facilitation of interventions designed to improve palliative care in residential aged care, and to develop a realist programme theory that explains how best to support their implementation.
Design: Realist review guided by the RAMESES standards. Protocol is registered on PROSPERO (CRD42023447043).
Data sources: MEDLINE, CINAHL and PsycINFO databases were searched for studies on palliative care interventions in residential aged care that used facilitation, published between 2000 and 2024. Data extraction and synthesis followed realist principles to identify context-mechanism-outcome configurations.
Results: Twenty-three articles describing 16 palliative care interventions were included in the review. Facilitation was found to be effective when it fostered a shared understanding of the intervention, tailored its components to fit staff workflow and built trust among stakeholders. These processes contributed to normalisation of the intervention and transition of ownership of both the intervention and facilitation process. Proactive support from the facilitator in addition to action learning was most effective at developing learning systems and staff comfort and confidence.
Conclusions: The realist programme theory developed in this study provides a foundation for ongoing testing and refinement, with the aim of accelerating evidence uptake by residential aged care staff and ultimately improving palliative care outcomes for residents.
Schupak I, Chao M, Guerrieri M, Ho H, Udovicich C, Ong WL, et al.
Backgound and purpose: Stereotactic ablative body radiotherapy (SABR) for oligometastatic prostate cancer (omPC) has proven a topic of emerging interest in the paradigm shift from palliative androgen deprivation therapy (ADT) to metastasis-directed therapy. In this study, we aim to evaluate and report on biochemical and clinical outcomes for omPC patients treated with SABR.
Methods and materials: This was a multi-centre, retrospective case series of patients undergoing SABR for omPC from 2015 to 2019 inclusive, staged with PSMA-PET/CT. Concurrent ADT was permitted. Patients with synchronous metastatic disease receiving radiotherapy to primary within 12 months of SABR were excluded. The primary endpoint was biochemical failure-free survival (BCFFS). Secondary endpoints included: PSA response at 6 months, clinical failure-free survival (CFFS), defined by a 2nd course of SABR, commencing ADT, palliative radiotherapy, systemic therapy or changing current line of therapy; ADT-free survival (FS) was calculated in the SABR only cohort.
Results: 213 patients were included for analysis. 41.3 % of SABR was delivered to bone and 49.3 % to nodal metastases, with 28 patients (13.1 %) having SABR together with ADT. Median follow-up was 57.6 months (IQR 45.8-72.6). BCFFS at 12, 24 and 36 months was: 45.6 % (95 %CI: 38.7-52.2 %), 26.2 % (95 %CI: 20.4-32.4 %) and 18.8 % (95 %CI: 13.7-24.5 %), respectively. CFFS at 12, 24 and 36 months was: 71.4 % (95 %CI: 64.7-77.0 %), 50.4 % (95 %CI: 43.4-57.1 %) and 39.2 % (95 %CI: 32.4-45.8 %), respectively.Median ADT-FS was 41.98 months (95 %CI: 32.76-52.90), with 5-year ADT-FS reported at 37.5 % (95 %CI:29.8-45.1 %).
Conclusion: This is the largest cohort of PSMA PET staged patients undergoing SABR for omPC, effective in delaying treatment escalation and ADT exposure beyond 3 years.
Last updated 30 April 2024