Referral Criteria to Specialist Palliative Care for People with Advanced Chronic Kidney Disease: A Systematic Review

Collins, Anna; Hui, David; Davison, Sara N.; Ducharlet, Kathryn; Murtagh, Fliss; Chang, Yuchieh Kathryn; Philip, Jennifer

Abstract

Context: People with advanced chronic kidney disease (CKD) have significant morbidity, yet for many, access to palliative care occurs late, if at all. Objectives: This study sought to examine criteria for referral to specialist palliative care for adults with advanced CKD with a view to improving use of these essential services. Methods: Systematic review of studies detailing referral criteria to palliative care in advanced CKD conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline and registered (PROSPERO: CRD42021230751). Data sources: Electronic databases (Ovid, MEDLINE, Ovid Embase, and PubMed) were used to identify potential studies, which were subjected to double review, data extraction, thematic coding, and descriptive analyses. Results: Searches yielded 650 unique titles ultimately resulting in 56 studies addressing referral criteria to specialist palliative care in advanced CKD. Of 10 categories of referral criteria, most commonly discussed were: Critical times of treatment decision making (n = 23, 41%); physical or emotional symptoms (n = 22, 39%); limited prognosis (n = 18, 32%); patient age and comorbidities (n = 18, 32%); category of CKD/ biochemical criteria (n = 13, 23%); functional decline (n = 13, 23); psychosocial needs (n = 9, 16%); future care planning (n = 9, 16%); anticipated decline in illness course (n = 8, 14%); and hospital use (n = 8, 14%). Conclusion: Clinicians consider referral to specialist palliative care for a wide range of reasons, with many related to care needs. As palliative care continues to integrate with nephrology, our findings represent a key step towards developing consensus criteria to standardize referral for patients with chronic kidney diseases.

Citation

Collins, A., Hui, D., Davison, S. N., Ducharlet, K., Murtagh, F., Chang, Y. K., & Philip, J. (2023). Referral Criteria to Specialist Palliative Care for People with Advanced Chronic Kidney Disease: A Systematic Review. Journal of pain and symptom management, 66(5), 541-550.e1. https://doi.org/10.1016/j.jpainsymman.2023.07.013

• Journal Article Type: Article
• Acceptance Date: Jul 21, 2023
• Online Publication Date: Jul 26, 2023
• Publication Date: Nov 1, 2023
• Deposit Date: Aug 14, 2023
• Publicly Available Date: Oct 13, 2023
• Journal: Journal of Pain and Symptom Management
• Print ISSN: 0885-3924
• Electronic ISSN: 1873-6513
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 66
• Issue: 5
• Pages: 541-550.e1
• DOI: https://doi.org/10.1016/j.jpainsymman.2023.07.013
• Keywords: Palliative care, kidney failure, chronic (chronic kidney failure; ESKD; End-stage kidney disease; End-stage renal disease; Renal disease, end-stage; Renal failure, chronic; Renal failure, end-stage), systematic review, referral, consultation
• Public URL: https://hull-repository.worktribe.com/output/4360514
• Additional Information: This article is maintained by: Elsevier; Article Title: Referral Criteria to Specialist Palliative Care for People with Advanced Chronic Kidney Disease: A Systematic Review; Journal Title: Journal of Pain and Symptom Management; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.jpainsymman.2023.07.013; Content Type: article; Copyright: © 2023 The Authors. Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.