Journal
CURRENT OPINION IN CRITICAL CARE
Volume 19, Issue 5, Pages 504-510Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCC.0b013e328364d50f
Keywords
critical care; outcomes; palliative care; patient-centered outcomes research
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Funding
- Foundation for Anesthesia Education and Research
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Purpose of reviewProfessional organizations, consensus groups, and stakeholders are calling for better palliative care in acute care settings, particularly in ICUs. Our ability to deliver that care is dependent on the outcomes associated with palliative care in the ICU. This review provides a conceptual framework for these outcomes, discusses current and future challenges for work in this field, and advocates for better use of patient-centered outcomes in future studies.Recent findingsPrevious studies of palliative care interventions in the ICU have used heterogeneous outcomes, conceptualized as: systems-related, content-related, clinician-related, or patient/family-related. Few outcomes were used in multiple studies and many studies had insufficient power and questionable generalizability and impact. Although nearly all previous studies incorporated family-related outcomes, not one incorporated patient-centered outcomes, such as health-related quality of life, patient symptom score, or consensus between patient goals and care provided.SummaryDelivery of palliative care in the ICU will be hampered until studies incorporate outcomes that are: responsive to and reflective of variations in care, and multi-faceted (with patient-centered components) to reflect the multi-dimensional nature of palliative care and the varied needs of different stakeholders.
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