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Ventura AD, Burney S, Brooker J, et al. Home-based palliative care: A systematic literature review of the self-reported unmet needs of patients and carers Palliative Medicine. 2014;28(5):391-402.
What are the self-reported unmet needs of home-based palliative care patients and their caregivers?
More people are now surviving into old age, which brings additional burden of disease, additional burden on their caregivers, and the need for specialized health services, including palliative care, towards the end of life.
Home-based palliative care is becoming the dominant approach for providing palliative services to those at the end of life, offering benefits to patients and their family caregivers such as the prospect of dying at home in a comfortable setting.
Little is known about whether patients and their caregivers feel that they have unmet needs when receiving home-based palliative care services.
A number of electronic databases were searched covering 1975 to 2012, and studies were included if they were original research, reported self-perceived unmet needs, and focused on patients and their caregivers who are currently receiving palliative-care support.
Searches identified 5,213 studies, and after reviewing the results, the authors included 15 studies.
The authors stated that there were no specific sources of funding that supported this review.
The relief of physical suffering is generally managed well with home-based palliative-care services.
Patients and their caregivers felt that they have a range of unmet needs including communication, spiritual, psychosocial, practical, informational and respite care, as well as those associated with social isolation and loss of autonomy.
The need for open communication was the most frequently identified unmet need among patients and their caregivers.
While physical suffering is managed well with home-based palliative-care services, other types of non-physical suffering need more attention.
Patients and their caregivers may need to request more open communication from healthcare professionals, and more support for other types of suffering that are currently not addressed in home-based palliative care.
This summary is based on a review that was determined to be of medium methodological quality based on an assessment using the AMSTAR tool.