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.
Das A, Kondasinghe JS.
Background: Managing pain in patients with incurable intestinal failure requires a multidisciplinary approach that addresses complex pharmacological and systemic challenges while navigating prognostic uncertainties.
Case presentation: This case report of gastrointestinal hypoganglionosis demonstrates the use of subcutaneous ketamine when conventional opioids fail due to intestinal malabsorption and dysmotility. Effective care required interdisciplinary collaboration, yet persistent discordance between the patient’s curative expectations and her life-limiting prognosis hindered timely advance care planning and community support transitions.
Conclusions: Prognostic uncertainty, compounded by the condition’s rarity, highlights the need for early palliative care integration in non-malignant conditions, to ensure that care goals align with patient and family priorities. The case report advocates for adaptable care models that bridge inpatient and community services, even amid prognostic ambiguity, to prevent fragmented care during critical transitions.
Freeman-Spratt G, Tan B, Kasiri H.
Background: Palliative sedation therapy (PST) is used to treat refractory symptoms at the end of life. Phenobarbital is infrequently used as a third-line agent following unsuccessful symptom control with first-line and second-line agents. However, there is wide clinical and guideline variance in the use of phenobarbital, reflecting a gap in the literature.
Objective: The aim of this study is to summarise the current evidence and guidelines surrounding practices of phenobarbital use in PST and discuss areas for future investigations, specifically regarding route of administration, time to death, dosing and concurrent use of first-line and second-line PST.
Methods: Studies and guidelines on the use of phenobarbital in PST were retrieved from PubMed and Google and the reference list of identified papers through to August 2024.
Key findings: Limited case studies and retrospective audits have been conducted into the use of phenobarbital in PST. These studies and existing guidelines reflect a degree of variance specifically regarding recommendations about route of administration, dosing and use of first-line and second-line PST. Efficacy is not well reported. However, phenobarbital use appears to be safe and does not appear to impact time to survival.
Conclusion: Phenobarbital appears to have a safe and potentially efficacious role as a third-line agent in PST. Great variance exists with regards to optimal dosing and the concurrent use of first- and second-line PST agents. High-quality research and multicentre reviews are required to enhance the understanding of optimal phenobarbital use and encourage evidence-based practice in palliative medicine.
Jain VK, Sanchez P, Christian B, Ajwani S, Malik Z, Pais R, et al.
Aim: Poor oral health is a common but often overlooked concern in palliative care, negatively impacting patients' quality of life. There is limited understanding of how palliative care providers (PCPs) approach oral health promotion in this context. This review synthesises evidence on the knowledge, attitudes and practices of PCPs regarding oral health care and strategies to support them in this area.
Design: Integrative review.
Data sources: A systematic literature search was undertaken until January 2025 across multiple databases (MEDLINE, CINAHL, Cochrane, ProQuest, EMBASE and Scopus) and grey literature. Inclusion criteria focused on nurses, medical specialists and allied health professionals involved in palliative or end-of-life care, with no publication year restriction.
Methods: This review followed Whittemore and Knafl's (2005) framework for integrative reviews. Study quality was assessed using appropriate tools for qualitative and quantitative studies, clinical guidelines and screening tools. A hybrid thematic synthesis approach was used for analysis.
Results: Twenty-five studies were included, mostly of moderate to high quality. Sample sizes ranged from 8 to 1339, with most participants being nurses and nursing assistants, followed by medical professionals. Findings revealed inconsistent knowledge, varied practices and limited prioritisation of oral health care. Barriers included system constraints, limited training and patient-related challenges. Supportive strategies such as guidelines, screening tools and educational interventions were identified.
Conclusions: A significant gap exists in PCP knowledge and practices regarding oral healthcare due to various barriers, with few supportive strategies documented in this field.
Lin RZ, Evans S, Lau DH.
Abstract: Modern advances in cardiovascular care emphasize early intervention and guideline-directed therapies, which have significantly improved survival and longevity. Over the last decades, landmark trials have defined the role for implantable cardioverter-defibrillator (ICD) in at-risk populations to prevent sudden cardiac death, which remains a leading cause of mortality from cardiovascular disease worldwide. However, competing and non-cardiac causes of death begin to increase with senescence. With aging, the goals of care may change, and in those with an ICD, this requires a proactive, multi-disciplinary and patient-centered approach as part of holistic care. A critical aspect of care is the option to deactivate ICD therapies to prevent unwanted, futile and distressing defibrillation attempts. Although this approach is endorsed by major professional societies, the process for deactivation of an ICD in those requiring end-of-life care may prove to be challenging in the real-world scenario, with many devices remaining active even in those with a do-not-resuscitate order in place. This highlights the need for urgent education and reform to improve our care in those with an ICD and requiring end-of-life care. It is in this context that the thoughtful review by Mugnai et al. in the current issue of the Journal is particularly welcomed, as they explore the many challenges and propose practical solutions towards integrated patient-centered care in this patient population.
Stokes C, Gurgenci T, Herbert A, Huggett G, Poxton M, Good P.
Abstract: Over a quarter of Australians reside in rural and remote areas, where access to clinical trials is limited. This disparity affects the generalisability of trial results and may contribute to poorer health outcomes for rural and remote patients. Teletrials - where regional, rural, or remote research sites are connected to primary research sites via telehealth - can overcome geographic barriers and improve access to clinical trials. In April 2024, Queensland launched a palliative care teletrial cluster recruiting to a clinical trial investigating medicinal cannabis for advanced cancer symptoms. This innovative model differs from other teletrial models in that it utilises existing health jurisdictions to create a statewide research cluster. This approach has the potential to expand clinical trial access throughout Australia. However, procedural delays in setting up satellite sites and high setup costs underscore the need to reform trial management processes and prompt discussion about optimal decentralised trial models to achieve universal access to clinical trials.
Last updated 30 April 2024