The Evidence-based Practice Center (EPC) Program at the Agency for Healthcare Research and Quality (AHRQ) has completed an evidence review on Integrating Palliative Care in Ambulatory Care of Noncancer Serious Chronic Illness. The final report is available at the Effective Healthcare Web site.
Key findings include:
- A variety of resources exist, particularly for patient and caregiver education and clinician education and training, but few have been evaluated for effectiveness or implementation.
- Shared decision-making tools may increase patient satisfaction and advance directive documentation.
- The models evaluated for integrating palliative care may have little to no effect on reducing overall symptom burden and were not more effective than usual care for improving health-related quality of life or depressive symptom scores but were more effective for increasing advance directive documentation.
- Patients and caregivers prefer advance care planning discussions grounded in patient and caregiver experiences and individualized for timing.