The experience of individuals living with alcohol use disorder within palliative care and end of life services: A scoping review

Abstract

Background

Individuals with alcohol use disorder (AUD) often face stigma and fragmented care, contributing to the underutilization of palliative care (PC), despite overlapping clinical needs. Research on the specific experiences of AUD patients in PC and end of life (EOL) settings remains limited.

Methods

A scoping review following PRISMA guidelines was conducted across five databases. From 865 initial results, eight studies met inclusion criteria after full-text screening. Five of them were case reports. Eligible studies focused on the experiences of individuals living with AUD receiving PC or EOL services. Data extraction and narrative synthesis were then conducted.

Results

Patients with AUD in PC often experienced significant symptom burden, including poorly managed pain, depression, and alcohol withdrawal symptoms. AUD was frequently underrecognized by healthcare professionals, and details of alcohol use were inconsistently reported. Transitions to PC were often delayed, with limited patient involvement in EOL decision-making. Stigma, clinician discomfort, and lack of integrated addiction and PC approaches were recurring barriers to optimal care.

Conclusion

Given the limited research on the management of AUD within PC settings, this review highlights the need for further investigation. While the findings suggest potential priorities for future research and clinical practice, including improved AUD screening, enhanced training for PC providers, and earlier, patient-centered EOL planning. These findings should be interpreted with caution, as they are based on a small number of studies, most of which are case reports. Addressing these gaps may enhance the quality of care and outcomes for individuals with AUD at the EOL.