| Title: | Realist review of palliative and end of life care programmes in primary care and community settings |
| Project Description: | This project is for a realist review of palliative and end of life care (PEoLC) programmes in primary care and community settings. While the review addresses healthcare services in England, we are also reaching out to broader literature where theoretical considerations are judged to be transferable.
In line with realist ideas, the review elicits and refines the theories of change underpinning the programmes of interest; the mechanisms (M) through which they produce their outcomes (O) or the ones that block the intended pathways; and the contexts (C) which trigger or counteract those mechanisms. These are then linked into explanatory CMO-configurations. After having gone through eight stages of narrowing down the review focus (including stakeholder consultations and initial mapping of the field by granular coding of 253 highly relevant abstracts), we have prioritised issues of “time and timing”. In particular, we are developing CMO (Context-Mechanism-Outcome) configurations around identifying patients who may be at the end of their life; temporally defined services (e.g. 24/7, rapid response services); advance care planning and patients’ last wishes. Preliminary findings are both challenging and complementing core assumptions in current palliative and end of life care policy and practice. |
| Project organisation | |
| Start date: | 1st March 2018 |
| End date: | 30th June 2020 |
| Contact person: | Dr Mila Petrova |
| Contact Details: | Primary Care Unit Institute of Public Health University Forvie Site, Robinson Way Cambridge Cambs CB2 0SR UK Telephone: 63887 Fax: 01223 762515 E-mail: mp686@medschl.cam.ac.uk |
| Collaborative: | Dr Stephen Barclay (PI) – Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge Dr Ian Wellwood Ms Isla Kuhn – Medical Library, University of Cambridge Dr Geoff Wong – Nuffield Department of Primary Care Health Sciences, University of Oxford |
| Further Information, References and Publications | |
| End of Life Care and Bereavement Workstream of the NIHR SPCR Evidence Synthesis Working Group: https://www.spcr.nihr.ac.uk/eswg/End_of_life_care_and_bereavement PROSPERO protocol: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=97218 |
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