Home Hospitalization in Palliative Care for Advanced Cancer and Dementia: A Systematic Review

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY

Journal of pain and symptom management Pub Date : 2024-11-24 DOI:10.1016/j.jpainsymman.2024.11.013

Beatriz Farinha-Costa MD, MSc , Paulo Reis-Pina MD, MSc, PhD

{"title":"Home Hospitalization in Palliative Care for Advanced Cancer and Dementia: A Systematic Review","authors":"Beatriz Farinha-Costa MD, MSc , Paulo Reis-Pina MD, MSc, PhD","doi":"10.1016/j.jpainsymman.2024.11.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Context</h3><div>Home hospitalization (HHOSP) is an alternative care model aimed at alleviating pressure on healthcare systems and catering to the increasing patient population. It aligns with the preference for home-based palliative care (PALC) and end-of-life care.</div></div><div><h3>Objectives</h3><div>This study systematically reviewed the literature to evaluate HHOSP's role in PALC, focusing on hospital readmissions, length of stay, patient and caregiver safety and satisfaction, place of death, and overall survival.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Scopus, and Web of Science databases from 2013 to 2023. Participants: patients of any age or gender diagnosed with advanced, metastatic, or incurable cancer or advanced dementia. Intervention: HHOSP. Comparator: usual care. Outcomes: hospital readmissions, length of stay, patient and caregiver safety and satisfaction, place of death, and overall survival. The risk of bias was assessed using Cochrane tools.</div></div><div><h3>Results</h3><div>Six studies with 843 participants from Denmark, France, Spain, and Israel were included. The overall risk of bias was moderate to high. HHOSP reduced hospital readmissions, with 42.2%–91% of patients avoiding further hospitalizations. Caregivers reported feeling safe and satisfied with HHOSP, experiencing reduced burden. Most patients died at home (52.2%–75%). Median overall survival ranged from 28 days–11.2 months.</div></div><div><h3>Conclusion</h3><div>The findings highlight HHOSP's potential as an alternative for delivering PALC, reducing hospital readmissions, and improving patient and caregiver satisfaction. Despite heterogeneity in study designs and outcomes, HHOSP aligns with patient and caregiver preferences, enhancing the quality of end-of-life care. Further standardized research is needed to optimize HHOSP implementation.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"69 3","pages":"Pages 289-303"},"PeriodicalIF":3.2000,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pain and symptom management","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0885392424011308","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Context

Home hospitalization (HHOSP) is an alternative care model aimed at alleviating pressure on healthcare systems and catering to the increasing patient population. It aligns with the preference for home-based palliative care (PALC) and end-of-life care.

Objectives

This study systematically reviewed the literature to evaluate HHOSP's role in PALC, focusing on hospital readmissions, length of stay, patient and caregiver safety and satisfaction, place of death, and overall survival.

Methods

A systematic search was conducted in PubMed, Scopus, and Web of Science databases from 2013 to 2023. Participants: patients of any age or gender diagnosed with advanced, metastatic, or incurable cancer or advanced dementia. Intervention: HHOSP. Comparator: usual care. Outcomes: hospital readmissions, length of stay, patient and caregiver safety and satisfaction, place of death, and overall survival. The risk of bias was assessed using Cochrane tools.

Results

Six studies with 843 participants from Denmark, France, Spain, and Israel were included. The overall risk of bias was moderate to high. HHOSP reduced hospital readmissions, with 42.2%–91% of patients avoiding further hospitalizations. Caregivers reported feeling safe and satisfied with HHOSP, experiencing reduced burden. Most patients died at home (52.2%–75%). Median overall survival ranged from 28 days–11.2 months.

Conclusion

The findings highlight HHOSP's potential as an alternative for delivering PALC, reducing hospital readmissions, and improving patient and caregiver satisfaction. Despite heterogeneity in study designs and outcomes, HHOSP aligns with patient and caregiver preferences, enhancing the quality of end-of-life care. Further standardized research is needed to optimize HHOSP implementation.

查看原文本刊更多论文

晚期癌症和痴呆症姑息治疗中的居家住院治疗：系统回顾

导言：居家住院（HHOSP）是一种替代性护理模式，旨在减轻医疗系统的压力，并满足日益增多的患者需求。它符合以家庭为基础的姑息治疗（PALC）和临终关怀的偏好：本研究系统回顾了相关文献，以评估 HHOSP 在 PALC 中的作用，重点关注再入院率、住院时间、患者和护理人员的安全性和满意度、死亡地点和总体存活率：在 PubMed、Scopus 和 Web of Science 数据库中对 2013 年至 2023 年的数据进行了系统性检索。参与者：任何年龄或性别的晚期、转移性或无法治愈的癌症或晚期痴呆症患者：结果：再入院率、住院时间、患者和护理人员的安全性和满意度、死亡地点和总生存率。使用 Cochrane 工具评估偏倚风险：结果：纳入了来自丹麦、法国、西班牙和以色列的六项研究，共有 843 名参与者。总体偏倚风险为中度至高度。HHOSP 降低了再入院率，42.2% 到 91% 的患者避免了再次住院。护理人员表示对 HHOSP 感到安全和满意，减轻了他们的负担。大多数患者死于家中（52.2% 至 75%）。中位总生存期从28天到11.2个月不等：研究结果强调了 HHOSP 作为提供 PALC、减少再入院率以及提高患者和护理人员满意度的替代方案的潜力。尽管研究设计和结果存在差异，但HHOSP符合患者和护理者的偏好，提高了临终关怀的质量。需要进一步开展标准化研究，以优化 HHOSP 的实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of pain and symptom management 医学-临床神经学

CiteScore

8.90

自引率

6.40%

发文量

821

审稿时长

26 days

期刊介绍： The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.