Referral Criteria to Specialist Palliative Care for People with Advanced Chronic Kidney Disease: A Systematic Review

Collins, A; Hui, D; Davison, SN; Ducharlet, K; Murtagh, F; Chang, YK; Philip, J

Author(s): Collins, A; Hui, D; Davison, SN; Ducharlet, K; Murtagh, F; Chang, YK; Philip, J;
Details: Publication Year 2023-07-26,Volume 66,Issue #5,Page 541-550
Journal Title: Journal of Pain and Symptom Management
Publication Type: Review
Abstract: CONTEXT: People with advanced chronic kidney disease (CKD) have significant morbidity, yet for many, access to palliative care occurs late, if at all. OBJECTIVES: This study sought to examine criteria for referral to specialist palliative care for adults with advanced CKD with a view to improving use of these essential services. METHOD: Systematic review of studies detailing referral criteria to palliative care in advanced CKD conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline and registered (PROSPERO: CRD42021230751). DATA SOURCES: Electronic databases (Ovid, MEDLINE, Ovid Embase, and PubMed) were used to identify potential studies, which were subjected to double review, data extraction, thematic coding, and descriptive analyses. RESULTS: Searches yielded 650 unique titles ultimately resulting in 56 studies addressing referral criteria to specialist palliative care in advanced CKD. Of 10 categories of referral criteria, the most commonly discussed were: Critical times of treatment decision making (n=23, 41%); physical or emotional symptoms (n=22, 39%); limited prognosis (n=18, 32%); patient age and comorbidities (n=18, 32%); category of CKD/ biochemical criteria (n=13, 23%); functional decline (n=13, 23); psychosocial needs (n=9, 16%); future care planning (n=9, 16%); anticipated decline in illness course (n=8, 14%); and hospital use (n=8, 14%). CONCLUSIONS: Clinicians consider referral to specialist palliative care for a wide range of reasons, with many related to care needs. As palliative care continues to integrate with nephrology, our findings represent a key step towards developing consensus criteria to standardize referral for patients with chronic kidney diseases.
Publisher: Elsevier
Keywords: Eskd; End-Stage Kidney Disease; End-Stage Renal Disease; Palliative Care, Kidney failure, Chronic (Chronic Kidney Failure; Renal Disease, End-Stage; Renal Failure, Chronic; Renal Failure, End-Stage), Systematic review, Referral and Consultation
Department(s): Palliative Care
PubMed ID: 37507095
Publisher's Version: https://doi.org/10.1016/j.jpainsymman.2023.07.013
Open Access at Publisher's Site: https://doi.org/10.1016/j.jpainsymman.2023.07.013
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-10-17 06:55:50

Last Modified: 2023-10-17 06:58:32