A literature review of randomized controlled trials of the organization of care at the end of life.
We searched nine electronic databases for randomized controlled trials (RCTs) about care at the end of life and found 23 RCTs. We assessed their quality using the criteria of the Cochrane Collaboration. The RCTs researched three themes: (a) the effect of providing palliative care through dedicated community teams on quality of life, on the management of symptoms, on satisfaction with care, on the duration of the palliative period, and on place of death; (b) the effects of specific palliative care interventions-advanced planning of care for the end of life, patient-held records, providing quality-of-life data to patients and physicians, grief education for relatives, palliative care education for nurses, and palliative care for patients with dementia; and (c) the costs of palliative compared to conventional care. We identify difficulties in conducting research on palliative care and solutions and discuss future possible research themes.
Thomas
Roger E
RE
Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, T2N 1M7, Canada. rthomas@ucalgary.ca
Wilson
Donna
D
Sheps
Sam
S
D003153:Community Health Services / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013727:Terminal Care / Q000379:methods*