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.
Sun V, Coombs S, Armitage N, Dowling M, Jaaniste T.
Abstract: This study aimed to establish the frequency and congruence between preferred and actual locations of expected pediatric deaths and to identify associated factors. A retrospective review of death review forms and medical records was conducted in two pediatric palliative care services in Sydney, Australia, involving 486 patients who died between January 2017 and May 2024). Hospital was the most common LOD (49.8%), then home (28.4%) and hospice (21.0%). At the last documented LOD conversation, 36.2% of families preferred home, 28.6% hospice and 26.4% hospital. Preferred LOD outcomes were achieved for 87.7% of families, although 21% who preferred a home death did not achieve this. Preferred and actual LODs of home were significantly associated with having a community palliative care referral and palliative care home visit. The findings highlight the importance of enabling families to plan for their child's LOD, and ensuring preferences are documented and communicated across health services.
Sundararajan K, Aziz S, Anderson N, Damarell RA, Raith E, Phelan C, et al.
Background: Patients and families from culturally and linguistically diverse (CALD) backgrounds face distinct challenges during end-of-life care (EOLC) in intensive care unit (ICU) settings, where communication, cultural expectations and decision-making may conflict with clinical norms. These complexities have important implications for intensive and palliative care teams.
Objectives: To map literature on clinician, patient and family perspectives on end-of-life communication with CALD populations in ICUs, and identify barriers and facilitators to culturally responsive care.
Design: This scoping review followed Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The protocol was registered with the Open Science Framework and published in BMJ Open. Screening, review and data extraction were conducted by multiple reviewers using Covidence and the Joanna Briggs Institute tool, with findings synthesised through inductive thematic analysis.
Primary and secondary outcome measures: The primary outcome was to identify barriers and facilitators to communication between clinicians, patients and families from CALD backgrounds during EOLC. Secondary outcomes were to map the scope of evidence, describe study characteristics and participant demographics, and summarise themes on cultural sensitivity, clinician awareness, family involvement, decision-making and integration of support services.
Results: Thirty of 766 screened studies were included. Three themes emerged: communication challenges; cultural sensitivity and humility and decision-making and support. Barriers included limited access to palliative care, language discordance, underuse of interpreters, clinician discomfort and conflicting care expectations. Facilitators included structured meetings, inclusive practices and interdisciplinary collaboration.
Conclusions: Structural, communicative and cultural barriers undermine equitable EOLC for CALD patients. Embedding palliative care principles, cultural responsiveness and shared decision-making into ICU practice requires coordinated input from a multidisciplinary team involving physicians, nurses, social workers, spiritual care, psychologists and interpreters. System-level reforms in training, service delivery and research are needed to ensure person-centred care.
Carey M, Mason K, Fox L, Moeke-Maxwell T, Gott M.
Background: Māori people in Aotearoa New Zealand and Australia experience significant healthcare inequity as they age and towards the end of their lives. Compassionate community approaches to ageing and end-of-life care are increasing in popularity throughout the world. However, this approach has arisen from Eurocentric knowledge systems and not from First Nations people and their communities.
Objectives: This research aimed to gain insight into what the Compassionate Communities approach means for First Nations people and identify implications for Māori in Aotearoa New Zealand and Australia. A systematic literature review explored the intersection of Compassionate Communities and First Nations peoples' perspectives and needs. Addressing the overarching question of: What does the Compassionate Communities approach mean for older First Nations people?
Design: A Kaupapa Māori approach was used to answer the research question and to explore the literature retrieved.
Methods: The main literature search was conducted during 2020-2022, with subsequent searches in 2023 and a final search in 2025. The review was conducted in Covidence systematic review software following the PRISMA process. Screening was completed by two reviewers and assessed against the inclusion and exclusion criteria. Kaupapa Māori theoretical questions were applied to each full-text article, with a rating of positive, neutral or negative allocated to establish conceptual alignment. NVivo thematic analysis software was utilised to code and explore themes.
Results: Fifty papers were imported into Covidence, with 22 studies included in the final review.
Conclusion: The review found minimal discussion about how Compassionate Communities approaches are implemented in a way that includes First Nations knowledges of ageing and end of life. There is a greater need to understand the contribution First Nations peoples' wellness philosophies make to the Compassionate Communities approach. Evaluations of Compassionate Community initiatives need to be more inclusive of First Nation peoples and their knowledges. In Aotearoa New Zealand and Australia, more research is needed to understand pathways to well-being for older Māori people based upon existing community strengths to ensure flourishing futures. Addressing these knowledge deficits will support efforts to address the inequities experienced by First Nations people as they age and at the end of life.
Chaganti R, Ghasemzadeh M, Wong M, Hanson J.
Objective: Review outcomes for patients undergoing biliary drainage and stenting via percutaneous transhepatic cholangiography, drainage, and stenting (PTCDS) for malignant hilar biliary obstruction secondary to hepatopancreaticobiliary (HPB) tumors versus other tumor types, to identify factors which predict poor outcomes and assist discussions with patients and clinicians.
Methods: Retrospective search electronic medical records for adult patients who underwent PTCDS for malignant hilar obstruction. The primary endpoint was in-hospital bilirubin reduction, with secondary endpoints of progression to further systemic therapy, length of hospital stay, and overall survival from procedure date.
Results: Within the cohort of 50 patients, PTCDS led to a statistically significant reduction in bilirubin (p < 0.0001). The median overall survival was 81.9 days, with a median hospital stay of 11.5 days. Nineteen patients had further systemic therapy. There was no significant difference in bilirubin improvement between different cancer types, and bilirubin improvement was positively correlated with survival and with having further systemic therapy (p = 0.016). There was no significant difference in overall survival between patients with HPB cancers versus other cancers (p = 0.49). Background cirrhosis of the liver (p = 0.03) and the presence of more than one liver lesion (p = 0.02) independently negatively impacted survival. There was no impact of any covariate on the length of hospital stay.
Conclusion: PTCDS for malignant biliary obstruction has a beneficial role in the palliative management of cancer patients, but should only be pursued with very significant caution in those with background liver cirrhosis and in those with a large burden of hepatic disease.
Guo J, McErlean G, Ding J, Jiang S, Dai Y, Johnson CE.
Background: Identifying palliative care needs in older adults is challenging due to variations in the indicator focus, applicability, and sensitivity of existing instruments.
Aim: To systematically review the appropriate instruments for identifying potential palliative care needs in older adults and to assess their clinical performance and effectiveness.
Design: We conducted an umbrella review of systematic reviews that evaluated validated instruments for identifying palliative care needs in older adults across any healthcare setting (PROSPERO registration number: CRD42024616393).
Data sources: PubMed, Web of Science, CINAHL, Cochrane Library, CNKI, WangFang, and VIP databases were used to systematically search for published studies from their inception to October 2024.
Results: Eleven systematic reviews were included in this study and a total of 29 instruments were identified in the literature. Of these, eight provided data on clinical performance. The Surprise Question (SQ), Supportive and Palliative Care Indicators Tool (SPICT), Necesidades Paliativas (Palliative Needs) (NECPAL), and the Palliative Care Rapid Emergency Screening (P-CaRES) were the most frequently identified instruments in older adults. Findings regarding the prognostic capacity of these instruments were inconsistent across the reviews. While three reviews reported the effectiveness of these instruments, evidence on their impact remains limited.
Conclusion: The SPICT and NECPAL instruments have been implemented across diverse healthcare settings, including inpatient, outpatient, and general practice environments, demonstrating good sensitivity in their applications, while the P-CaRES is recommended for identifying palliative care needs in emergency departments. Future research should employ rigorous study designs to validate their effectiveness in enhancing patient-centered outcomes.
Last updated 30 April 2024