Barriers to and facilitators of implementation of the integration of oncology and palliative care in daily practice: a systematic review

Uneno, Yu; Horie, Yoshiki; Kataoka, Yuki; Mori, Masanori; Hirakawa, Mami; Suzuki, Takaaki; Nakajima, Takako Eguchi; Shimizu, Chikako; Tsuneto, Satoru; Morita, Tatsuya; Muto, Manabu

doi:10.21203/rs.3.rs-421082/v1

Cited by 1 publication

(1 citation statement)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,3 Significant evidence from randomised clinical trials has validated the proven benefits of early palliative care for people with advanced cancer including better symptom management, 4 increased satisfaction with care, and reduced psychological suffering. [5][6][7] This has led to a strong global consensus supporting the integration of early palliative care in routine cancer practice. 2,8 Implementation science is the study of methods and approaches that facilitate the uptake of research into clinical practice.…”

Section: Introductionmentioning

confidence: 99%

An evidence-base for the implementation of hospital-based palliative care programs in routine cancer practice: A systematic review

et al. 2023

View full text Add to dashboard Cite

Background: Despite global support, there remain gaps in the integration of early palliative care into cancer care. The methods of implementation whereby evidence of benefits of palliative care is translated into practice deserve attention. Aim: To identify implementation frameworks utilised in integrated palliative care in hospital-based oncology services and to describe the associated enablers and barriers to service integration. Design: Systematic review with a narrative synthesis including qualitative, mixed methods, pre-post and quasi experimental designs following the guidance by the Centre for Reviews and Dissemination (PROSPERO registration CRD42021252092). Data sources: Six databases searched in 2021: EMBASE, EMCARE, APA PsycINFO, CINAHL, Cochrane Library and Ovid MEDLINE searched in 2023. Included were qualitative or quantitative studies, in English language, involving adults >18 years, and implementing hospital-based palliative care into cancer care. Critical appraisal tools were used to assess the quality and rigour. Results: Seven of the 16 studies explicitly cited the use of frameworks including those based on RE-AIM, Medical Research Council evaluation of complex interventions and WHO constructs of health service evaluation. Enablers included an existing supportive culture, clear introduction to the programme across services, adequate funding, human resources and identification of advocates. Barriers included a lack of communication with the patients, caregivers, physicians and palliative care team about programme goals, stigma around the term ‘palliative’, a lack of robust training, or awareness of guidelines and undefined staff roles. Conclusions: Implementation science frameworks provide a method to underpin programme development and evaluation as palliative care is integrated within the oncology setting.

show abstract