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Community access to palliative care medicines - Patient and professional experience: Systematic review and narrative synthesis

Community access to palliative care medicines - Patient and professional experience: Systematic review and narrative synthesis
Community access to palliative care medicines - Patient and professional experience: Systematic review and narrative synthesis
Background: providing palliative care patients living at home with timely access to medicines is critical to enable effective symptom management, minimise burden and reduce unplanned use of healthcare services. Little is known about how diverse community-based palliative care models influence medicines access.

Objective: to produce a critical overview of research on experiences and outcomes of medicine access in community-based palliative care models of service delivery through a systematic review and narrative synthesis.

Methods:: MEDLINE, CINAHL, Embase, PsycINFO, Cochrane Library databases and grey literature were systematically searched for all types of studies. Study quality was assessed using the Mixed Method Appraisal Tool; a narrative synthesis was used to integrate and summarise findings.

Results: 331 articles were screened; 10 studies were included in the final sample. Studies included a focus on community pharmacy (n=4), hospice emergency medication kits (HEMKs) in the home (n=3), specialist community nurse prescribers (n=1), General Practice (n=1) and one study included multiple service delivery components. Community pharmacy was characterised by access delays due to lack of availability of medicine stock and communication difficulties between the pharmacy and other healthcare professionals. HEMKs were perceived to reduce medicines’ access time out-of-hours, and speed symptom control. However, the majority of studies comprised small, local samples, largely limited to self-reports of health professionals. There was a lack of data on outcomes, and no comparisons between service delivery models.

Conclusions: further research is required to understand which models facilitate rapid and efficient access to medicines for community-based palliative care patients.
home care, service evaluation, symptoms and symptom management
2045-435X
Ogi, Mizue
8d83d578-85c8-40db-865a-14cc14429d9d
Campling, Natasha
0e0410b0-a9cd-486d-a51f-20d80df04791
Birtwistle, Jacqueline
584beb99-2f59-4762-a936-e00c9945e0aa
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Bennett, Michael I
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Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Latter, Susan
83f100a4-95ec-4f2e-99a5-186095de2f3b
Ogi, Mizue
8d83d578-85c8-40db-865a-14cc14429d9d
Campling, Natasha
0e0410b0-a9cd-486d-a51f-20d80df04791
Birtwistle, Jacqueline
584beb99-2f59-4762-a936-e00c9945e0aa
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Bennett, Michael I
b5976b37-b115-4044-9baa-df409c391b17
Santer, Miriam
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Latter, Susan
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Ogi, Mizue, Campling, Natasha, Birtwistle, Jacqueline, Richardson, Alison, Bennett, Michael I, Santer, Miriam and Latter, Susan (2021) Community access to palliative care medicines - Patient and professional experience: Systematic review and narrative synthesis. BMJ Supportive & Palliative Care. (doi:10.1136/bmjspcare-2020-002761).

Record type: Article

Abstract

Background: providing palliative care patients living at home with timely access to medicines is critical to enable effective symptom management, minimise burden and reduce unplanned use of healthcare services. Little is known about how diverse community-based palliative care models influence medicines access.

Objective: to produce a critical overview of research on experiences and outcomes of medicine access in community-based palliative care models of service delivery through a systematic review and narrative synthesis.

Methods:: MEDLINE, CINAHL, Embase, PsycINFO, Cochrane Library databases and grey literature were systematically searched for all types of studies. Study quality was assessed using the Mixed Method Appraisal Tool; a narrative synthesis was used to integrate and summarise findings.

Results: 331 articles were screened; 10 studies were included in the final sample. Studies included a focus on community pharmacy (n=4), hospice emergency medication kits (HEMKs) in the home (n=3), specialist community nurse prescribers (n=1), General Practice (n=1) and one study included multiple service delivery components. Community pharmacy was characterised by access delays due to lack of availability of medicine stock and communication difficulties between the pharmacy and other healthcare professionals. HEMKs were perceived to reduce medicines’ access time out-of-hours, and speed symptom control. However, the majority of studies comprised small, local samples, largely limited to self-reports of health professionals. There was a lack of data on outcomes, and no comparisons between service delivery models.

Conclusions: further research is required to understand which models facilitate rapid and efficient access to medicines for community-based palliative care patients.

Text
What are patients’ and health professionals’ experiences of access to palliative care medicines in different models of community care provision Systematic review and narrative synthesis-merged - Accepted Manuscript
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More information

Accepted/In Press date: 15 February 2021
e-pub ahead of print date: 28 March 2021
Keywords: home care, service evaluation, symptoms and symptom management

Identifiers

Local EPrints ID: 447193
URI: http://eprints.soton.ac.uk/id/eprint/447193
ISSN: 2045-435X
PURE UUID: 3a0b2f6c-6527-4253-a785-f321e1a9504a
ORCID for Natasha Campling: ORCID iD orcid.org/0000-0002-4158-7894
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260
ORCID for Susan Latter: ORCID iD orcid.org/0000-0003-0973-0512

Catalogue record

Date deposited: 04 Mar 2021 17:42
Last modified: 09 Jan 2022 03:49

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Contributors

Author: Mizue Ogi
Author: Jacqueline Birtwistle
Author: Michael I Bennett
Author: Miriam Santer ORCID iD
Author: Susan Latter ORCID iD

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