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Palliative care provision in long-term care facilities differs across Europe : results of a cross-sectional study in six European countries (PACE)

(2019) PALLIATIVE MEDICINE. 33(9). p.1176-1188
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Abstract
Background: While the need for palliative care in long-term care facilities is growing, it is unknown whether palliative care in this setting is sufficiently developed. Aim: To describe and compare in six European countries palliative care provision in long-term care facilities and to assess associations between patient, facility and advance care planning factors and receipt and timing of palliative care. Design: Cross-sectional after-death survey regarding care provided to long-term care residents in Belgium, England, Finland, Italy, the Netherlands and Poland. Generalized estimating equations were used for analyses. Setting/participants: Nurses or care assistants who are most involved in care for the resident. Results: We included 1298 residents in 300 facilities, of whom a majority received palliative care in most countries (England: 72.6%-Belgium: 77.9%), except in Poland (14.0%) and Italy (32.1%). Palliative care typically started within 2 weeks before death and was often provided by the treating physician (England: 75%-the Netherlands: 98.8%). A palliative care specialist was frequently involved in Belgium and Poland (57.1% and 86.7%). Residents with cancer, dementia or a contact person in their record more often received palliative care, and it started earlier for residents with whom the nurse had spoken about treatments or the preferred course of care at the end of life. Conclusion: The late initiation of palliative care (especially when advance care planning is lacking) and palliative care for residents without cancer, dementia or closely involved relatives deserve attention in all countries. Diversity in palliative care organization might be related to different levels of its development.
Keywords
Nursing homes, palliative care, residential facilities, long-term care, aged 80 and over, aged, cross-sectional studies, retrospective studies, OF-LIFE CARE, ADVANCE CARE, NURSING-HOME, OLDER-PEOPLE, DEMENTIA, PERSPECTIVES, HEALTH, CANCER, RECOMMENDATIONS, ASSOCIATION

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MLA
ten Koppel, Maud, et al. “Palliative Care Provision in Long-Term Care Facilities Differs across Europe : Results of a Cross-Sectional Study in Six European Countries (PACE).” PALLIATIVE MEDICINE, vol. 33, no. 9, 2019, pp. 1176–88.
APA
ten Koppel, M., Onwuteaka-Philipsen, B. D., Van den Block, L., Deliens, L., Gambassi, G., Heymans, M. W., … Van Den Noortgate, N. (2019). Palliative care provision in long-term care facilities differs across Europe : results of a cross-sectional study in six European countries (PACE). PALLIATIVE MEDICINE, 33(9), 1176–1188.
Chicago author-date
Koppel, Maud ten, Bregje D Onwuteaka-Philipsen, Lieve Van den Block, Luc Deliens, Giovanni Gambassi, Martijn W Heymans, Marika Kylänen, et al. 2019. “Palliative Care Provision in Long-Term Care Facilities Differs across Europe : Results of a Cross-Sectional Study in Six European Countries (PACE).” PALLIATIVE MEDICINE 33 (9): 1176–88.
Chicago author-date (all authors)
ten Koppel, Maud, Bregje D Onwuteaka-Philipsen, Lieve Van den Block, Luc Deliens, Giovanni Gambassi, Martijn W Heymans, Marika Kylänen, Mariska G Oosterveld-Vlug, H Roeline W Pasman, Sheila Payne, Tinne Smets, Katarzyna Szczerbińska, Jos WR Twisk, Jenny T van der Steen, on behalf of PACE, and Nele Van Den Noortgate. 2019. “Palliative Care Provision in Long-Term Care Facilities Differs across Europe : Results of a Cross-Sectional Study in Six European Countries (PACE).” PALLIATIVE MEDICINE 33 (9): 1176–1188.
Vancouver
1.
ten Koppel M, Onwuteaka-Philipsen BD, Van den Block L, Deliens L, Gambassi G, Heymans MW, et al. Palliative care provision in long-term care facilities differs across Europe : results of a cross-sectional study in six European countries (PACE). PALLIATIVE MEDICINE. 2019;33(9):1176–88.
IEEE
[1]
M. ten Koppel et al., “Palliative care provision in long-term care facilities differs across Europe : results of a cross-sectional study in six European countries (PACE),” PALLIATIVE MEDICINE, vol. 33, no. 9, pp. 1176–1188, 2019.
@article{8622827,
  abstract     = {Background: While the need for palliative care in long-term care facilities is growing, it is unknown whether palliative care in this setting is sufficiently developed.
Aim: To describe and compare in six European countries palliative care provision in long-term care facilities and to assess associations between patient, facility and advance care planning factors and receipt and timing of palliative care.
Design: Cross-sectional after-death survey regarding care provided to long-term care residents in Belgium, England, Finland, Italy, the Netherlands and Poland. Generalized estimating equations were used for analyses.
Setting/participants: Nurses or care assistants who are most involved in care for the resident.
Results: We included 1298 residents in 300 facilities, of whom a majority received palliative care in most countries (England: 72.6%-Belgium: 77.9%), except in Poland (14.0%) and Italy (32.1%). Palliative care typically started within 2 weeks before death and was often provided by the treating physician (England: 75%-the Netherlands: 98.8%). A palliative care specialist was frequently involved in Belgium and Poland (57.1% and 86.7%). Residents with cancer, dementia or a contact person in their record more often received palliative care, and it started earlier for residents with whom the nurse had spoken about treatments or the preferred course of care at the end of life.
Conclusion: The late initiation of palliative care (especially when advance care planning is lacking) and palliative care for residents without cancer, dementia or closely involved relatives deserve attention in all countries. Diversity in palliative care organization might be related to different levels of its development.},
  author       = {ten Koppel, Maud and Onwuteaka-Philipsen, Bregje D and Van den Block, Lieve and Deliens, Luc and Gambassi, Giovanni and Heymans, Martijn W and Kylänen, Marika and Oosterveld-Vlug, Mariska G and Pasman, H Roeline W and Payne, Sheila and Smets, Tinne and Szczerbińska, Katarzyna and Twisk, Jos WR and van der Steen, Jenny T and PACE, on behalf of and Van Den Noortgate, Nele},
  issn         = {0269-2163},
  journal      = {PALLIATIVE MEDICINE},
  keywords     = {Nursing homes,palliative care,residential facilities,long-term care,aged 80 and over,aged,cross-sectional studies,retrospective studies,OF-LIFE CARE,ADVANCE CARE,NURSING-HOME,OLDER-PEOPLE,DEMENTIA,PERSPECTIVES,HEALTH,CANCER,RECOMMENDATIONS,ASSOCIATION},
  language     = {eng},
  number       = {9},
  pages        = {1176--1188},
  title        = {Palliative care provision in long-term care facilities differs across Europe : results of a cross-sectional study in six European countries (PACE)},
  url          = {http://dx.doi.org/10.1177/0269216319861229},
  volume       = {33},
  year         = {2019},
}

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