Hospital at home: home-based end of life care.

Abstract:

BACKGROUND:The policy in a number of countries is to provide people with a terminal illness the choice of dying at home. This policy is supported by surveys indicating that the general public and patients with a terminal illness would prefer to receive end of life care at home. OBJECTIVES:To determine if providing home-based end of life care reduces the likelihood of dying in hospital and what effect this has on patients' symptoms, quality of life, health service costs and care givers compared with inpatient hospital or hospice care. SEARCH STRATEGY:We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library) to October 2009, Ovid MEDLINE(R) 1950 to March 2011, EMBASE 1980 to October 2009, CINAHL 1982 to October 2009 and EconLit to October 2009. We checked the reference lists of articles identified for potentially relevant articles. SELECTION CRITERIA:Randomised controlled trials, interrupted time series or controlled before and after studies evaluating the effectiveness of home-based end of life care with inpatient hospital or hospice care for people aged 18 years and older. DATA COLLECTION AND ANALYSIS:Two authors independently extracted data and assessed study quality. We combined the published data for dichotomous outcomes using fixed-effect Mantel-Haenszel meta-analysis. When combining outcome data was not possible we presented the data in narrative summary tables. MAIN RESULTS:We included four trials in this review. Those receiving home-based end of life care were statistically significantly more likely to die at home compared with those receiving usual care (RR 1.33, 95% CI 1.14 to 1.55, P = 0.0002; Chi (2) = 1.72, df = 2, P = 0.42, I(2) = 0% (three trials; N=652)). We detected no statistically significant differences for functional status (measured by the Barthel Index), psychological well-being or cognitive status, between patients receiving home-based end of life care compared with those receiving standard care (which included inpatient care). Admission to hospital while receiving home-based end of life care varied between trials and this was reflected by high levels of statistically significant heterogeneity in this analysis. There was some evidence of increased patient satisfaction with home-based end of life care, and little evidence of the impact this form of care has on care givers. AUTHORS' CONCLUSIONS:The evidence included in this review supports the use of end of life home-care programmes for increasing the number of patients who will die at home, although the numbers of patients being admitted to hospital while receiving end of life care should be monitored. Future research should also systematically assess the impact of end of life home care on care givers.

authors

Shepperd S,Wee B,Straus SE

doi

10.1002/14651858.CD009231

subject

Has Abstract

pub_date

2011-07-06 00:00:00

pages

CD009231

issue

7

issn

1469-493X

pub_type

杂志文章,meta分析,评审
  • Cognitive behaviour therapy for schizophrenia.

    abstract:BACKGROUND:Although medication is the mainstay of treatment for schizophrenia, always, some sort of informal or formal talking therapy is indicated. In cognitive behavioural therapy (CBT) links are made between the person's feelings and patterns of thinking which underpin their distress. OBJECTIVES:To review the effec...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000524

    authors: Jones C,Cormac I,Mota J,Campbell C

    更新日期:2000-01-01 00:00:00

  • Anti-cholinergic drugs for wheeze in children under the age of two years.

    abstract:BACKGROUND:Wheeze in infancy and early childhood is common and appears to be increasing though the magnitude of any increase is unclear. Most wheezing episodes in infancy are precipitated by respiratory viral infections. Treatment of very young children with wheeze remains controversial. Anti-cholinergics are often pre...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001279

    authors: Everard ML,Bara A,Kurian M

    更新日期:2000-01-01 00:00:00

  • Combined inhaled anticholinergic agents and beta-2-agonists for initial treatment of acute asthma in children.

    abstract:BACKGROUND:Anti-cholinergic agents and beta2-agonist drugs are both bronchodilators used to reverse acute bronchospasm in children with asthma. These drugs have different modes of action, so may have complementary or additive effects. OBJECTIVES:The objective of this review was to assess the effects of adding inhaled ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000060

    authors: Plotnick LH,Ducharme FM

    更新日期:2000-01-01 00:00:00

  • Laser treatment of drusen to prevent progression to advanced age-related macular degeneration.

    abstract:BACKGROUND:Drusen are amorphous yellowish deposits beneath the sensory retina. People with drusen, particularly large drusen, are at higher risk of developing age-related macular degeneration (AMD). The most common complication in AMD is choroidal neovascularisation (CNV), the growth of new blood vessels in the centre ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006537.pub3

    authors: Virgili G,Michelessi M,Parodi MB,Bacherini D,Evans JR

    更新日期:2015-10-23 00:00:00

  • Treatment for amphetamine withdrawal.

    abstract:BACKGROUND:Amphetamine withdrawal has been less studied although it is a common problem with a prevalent rate of 87% among amphetamine users. Its symptoms, in particular intense craving, may be a critical factor leading to relapse of amphetamine use. In clinical practice, treatment for cocaine withdrawal has been recom...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003021

    authors: Srisurapanont M,Jarusuraisin N,Kittirattanapaiboon P

    更新日期:2001-01-01 00:00:00

  • Iron therapy for preoperative anaemia.

    abstract:BACKGROUND:Preoperative anaemia is common and occurs in 5% to 76% of patients preoperatively. It is associated with an increased risk of perioperative allogeneic blood transfusion, longer hospital stay, and increased morbidity and mortality. Iron deficiency is one of the most common causes of anaemia. Oral and intraven...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD011588.pub3

    authors: Ng O,Keeler BD,Mishra A,Simpson JA,Neal K,Al-Hassi HO,Brookes MJ,Acheson AG

    更新日期:2019-12-07 00:00:00

  • Platinum-containing regimens for metastatic breast cancer.

    abstract:BACKGROUND:Studies have reported high tumour response rates for platinum-containing regimens in the treatment of women with metastatic breast cancer. Most of these studies were conducted prior to the 'intrinsic subtype' era, and did not specifically focus on metastatic triple-negative breast cancers (mTNBCs). OBJECTIV...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003374.pub4

    authors: Egger SJ,Willson ML,Morgan J,Walker HS,Carrick S,Ghersi D,Wilcken N

    更新日期:2017-06-23 00:00:00

  • Beta2-agonists for acute bronchitis.

    abstract:BACKGROUND:There are no clearly effective treatments for the cough of acute bronchitis, and beta2-agonists are often prescribed, perhaps because clinicians suspect many patients also have reversible airflow restriction contributing to the symptoms. OBJECTIVES:To determine whether beta2-agonists improve symptoms of acu...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001726.pub3

    authors: Smucny J,Becker L,Glazier R

    更新日期:2006-10-18 00:00:00

  • Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse.

    abstract:BACKGROUND:A wide variety of grafts have been introduced with the aim of improving the outcomes of traditional native tissue repair (colporrhaphy) for vaginal prolapse. OBJECTIVES:To determine the safety and effectiveness of transvaginal mesh or biological grafts compared to native tissue repair for vaginal prolapse. ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD012079

    authors: Maher C,Feiner B,Baessler K,Christmann-Schmid C,Haya N,Marjoribanks J

    更新日期:2016-02-09 00:00:00

  • Exercise-based rehabilitation for coronary heart disease.

    abstract:BACKGROUND:The burden of cardiovascular disease world-wide is one of great concern to patients and health care agencies alike. Cardiac rehabilitation aims to restore patients with heart disease to health through exercise only based rehabilitation or comprehensive cardiac rehabilitation. OBJECTIVES:To determine the eff...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001800

    authors: Jolliffe JA,Rees K,Taylor RS,Thompson D,Oldridge N,Ebrahim S

    更新日期:2001-01-01 00:00:00

  • Prophylactic syntometrine versus oxytocin for delivery of the placenta.

    abstract:BACKGROUND:The routine prophylactic administration of an oxytocic agent is an integral part of active management of the third stage of labour. These agents help prevent postpartum haemorrhage. OBJECTIVES:The objective of this review was to assess the effects of ergometrine-oxytocin (syntometrine) with oxytocin alone i...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000201

    authors: McDonald S,Prendiville WJ,Elbourne D

    更新日期:2000-01-01 00:00:00

  • Intraoperative mild hypothermia for postoperative neurological deficits in people with intracranial aneurysm.

    abstract:BACKGROUND:Rupture of an intracranial aneurysm causes aneurysmal subarachnoid haemorrhage, which is one of the most devastating clinical conditions. It can be classified into five Grades using the Hunt-Hess or World Federation of Neurological Surgeons (WFNS) scale. Grades 4 and 5 predict poor prognosis and are known as...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008445.pub3

    authors: Li LR,You C,Chaudhary B

    更新日期:2016-03-22 00:00:00

  • School policies for preventing smoking among young people.

    abstract:BACKGROUND:School tobacco policies (STPs) might prove to be a promising strategy to prevent smoking initiation among adolescents, as there is evidence that the school environment can influence young people to smoke. STPs are cheap, relatively easy to implement and have a wide reach, but it is not clear whether this app...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009990.pub2

    authors: Coppo A,Galanti MR,Giordano L,Buscemi D,Bremberg S,Faggiano F

    更新日期:2014-10-24 00:00:00

  • Pharmacotherapies for sleep disturbances in Alzheimer's disease.

    abstract:BACKGROUND:Sleep disturbances, including reduced nocturnal sleep time, sleep fragmentation, nocturnal wandering and daytime sleepiness are common clinical problems in dementia due to Alzheimer's disease (AD), and are associated with significant caregiver distress, increased healthcare costs and institutionalisation. Dr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009178.pub2

    authors: McCleery J,Cohen DA,Sharpley AL

    更新日期:2014-03-21 00:00:00

  • Pre-admission antibiotics for suspected cases of meningococcal disease.

    abstract:BACKGROUND:Meningococcal disease begins suddenly and death can follow within hours. Pre-admission antibiotic therapy aims to prevent delay in starting therapy that occurs if bacterial confirmation is sought before instituting therapy. OBJECTIVES:To study the effectiveness and safety of pre-admission antibiotics versus...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005437.pub2

    authors: Sudarsanam T,Rupali P,Tharyan P,Abraham OC,Thomas K

    更新日期:2008-01-23 00:00:00

  • Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis.

    abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) is a common adverse effect of anaesthesia and surgery. Up to 80% of patients may be affected. These outcomes are a major cause of patient dissatisfaction and may lead to prolonged hospital stay and higher costs of care along with more severe complications. Many antiem...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD012859.pub2

    authors: Weibel S,Rücker G,Eberhart LH,Pace NL,Hartl HM,Jordan OL,Mayer D,Riemer M,Schaefer MS,Raj D,Backhaus I,Helf A,Schlesinger T,Kienbaum P,Kranke P

    更新日期:2020-10-19 00:00:00

  • Antenatal interventions for fetomaternal alloimmune thrombocytopenia.

    abstract:BACKGROUND:Fetomaternal alloimmune thrombocytopenia results from the formation of antibodies by the mother which are directed against a fetal platelet alloantigen inherited from the father. The resulting fetal thrombocytopenia (reduced platelet numbers) may cause bleeding, particularly into the brain, before or shortly...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004226.pub3

    authors: Rayment R,Brunskill SJ,Soothill PW,Roberts DJ,Bussel JB,Murphy MF

    更新日期:2011-05-11 00:00:00

  • Pharmacological interventions for non-alcohol related fatty liver disease (NAFLD): an attempted network meta-analysis.

    abstract:BACKGROUND:Non-alcohol related fatty liver disease (commonly called non-alcoholic fatty liver disease (NAFLD)) is liver steatosis in the absence of significant alcohol consumption, use of hepatotoxic medication, or other disorders affecting the liver such as hepatitis C virus infection, Wilson's disease, and starvation...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011640.pub2

    authors: Lombardi R,Onali S,Thorburn D,Davidson BR,Gurusamy KS,Tsochatzis E

    更新日期:2017-03-30 00:00:00

  • Miniport versus standard ports for laparoscopic cholecystectomy.

    abstract:BACKGROUND:In conventional (standard) laparoscopic cholecystectomy, four abdominal ports (two of 10 mm diameter and two of 5 mm diameter) are used. Recently, use of smaller ports have been reported. OBJECTIVES:To assess the benefits and harms of miniport (defined as ports smaller than conventional ports) laparoscopic ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006804.pub2

    authors: Gurusamy KS,Samraj K,Ramamoorthy R,Farouk M,Fusai G,Davidson BR

    更新日期:2010-03-17 00:00:00

  • Reduction in saturated fat intake for cardiovascular disease.

    abstract:BACKGROUND:Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJE...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD011737.pub2

    authors: Hooper L,Martin N,Jimoh OF,Kirk C,Foster E,Abdelhamid AS

    更新日期:2020-05-19 00:00:00

  • Luteinising hormone releasing hormone (LHRH) agonists for the treatment of relapsed epithelial ovarian cancer.

    abstract:BACKGROUND:Ovarian cancer is seventh most common cancer in women worldwide. Approximately 1.3% of women will be diagnosed with ovarian cancer at some point during their life time. The majority of tumours arise from surface of the ovary (epithelial). Two thirds of these women will present with advanced disease, requirin...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD011322.pub2

    authors: Wuntakal R,Seshadri S,Montes A,Lane G

    更新日期:2016-06-29 00:00:00

  • Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents.

    abstract:BACKGROUND:Vomiting caused by acute gastroenteritis is very common in children and adolescents. Treatment of vomiting in children can be problematic and the use of antiemetics remains a controversial issue. There have been concerns expressed about apparently unacceptable levels of side effects such as sedation and extr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005506.pub4

    authors: Alhashimi D,Al-Hashimi H,Fedorowicz Z

    更新日期:2009-04-15 00:00:00

  • Antibiotics for treating scrub typhus.

    abstract:BACKGROUND:Scrub typhus is a cause of fever in regions of Asia and the Pacific. Recently, resistance to antibiotics has been reported. OBJECTIVES:To assess treatment regimens for scrub typhus through time to fever resolution and incidence of relapse. SEARCH STRATEGY:Cochrane Controlled Trials Register, MEDLINE, EMBAS...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002150

    authors: Panpanich R,Garner P

    更新日期:2000-01-01 00:00:00

  • Magnesium supplementation in pregnancy.

    abstract:BACKGROUND:Many women, especially those from disadvantaged backgrounds, have intakes of magnesium below recommended levels. Magnesium supplementation during pregnancy may be able to reduce fetal growth retardation and pre-eclampsia, and increase birthweight. OBJECTIVES:The objective of this review was to assess the ef...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000937

    authors: Makrides M,Crowther CA

    更新日期:2000-01-01 00:00:00

  • Nutrition support in hospitalised adults at nutritional risk.

    abstract:BACKGROUND:The prevalence of disease-related malnutrition in Western European hospitals is estimated to be about 30%. There is no consensus whether poor nutritional status causes poorer clinical outcome or if it is merely associated with it. The intention with all forms of nutrition support is to increase uptake of ess...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011598.pub2

    authors: Feinberg J,Nielsen EE,Korang SK,Halberg Engell K,Nielsen MS,Zhang K,Didriksen M,Lund L,Lindahl N,Hallum S,Liang N,Xiong W,Yang X,Brunsgaard P,Garioud A,Safi S,Lindschou J,Kondrup J,Gluud C,Jakobsen JC

    更新日期:2017-05-19 00:00:00

  • Continuous positive airways pressure for obstructive sleep apnoea in adults.

    abstract:BACKGROUND:Obstructive sleep apnoea is the periodic reduction (hypopnoea) or cessation (apnoea) of breathing due to narrowing or occlusion of the upper airway during sleep. The main symptom is daytime sleepiness and it has been suggested it is linked to premature death, hypertension, ischaemic heart disease, stroke and...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001106.pub3

    authors: Giles TL,Lasserson TJ,Smith BH,White J,Wright J,Cates CJ

    更新日期:2006-07-19 00:00:00

  • Vaginal dilator therapy for women receiving pelvic radiotherapy.

    abstract:BACKGROUND:Vaginal dilation therapy is advocated after pelvic radiotherapy to prevent stenosis (abnormal narrowing of the vagina), but can be uncomfortable and psychologically distressing. OBJECTIVES:To assess the benefits and harms of different types of vaginal dilation methods offered to women treated by pelvic radi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007291.pub3

    authors: Miles T,Johnson N

    更新日期:2014-09-08 00:00:00

  • Traditional Chinese Medicine herbs for stopping bleeding from haemorrhoids.

    abstract:BACKGROUND:Haemorrhoids is a common perianal disease, which often causes haematochezia. Besides a surgical operation or minimally invasive treatment, a variety of traditional Chinese medicinal herbs (TCMHs) have been used to treat bleeding haemorrhoids. OBJECTIVES:To assess the effectiveness of traditional Chinese med...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006791.pub2

    authors: Gan T,Liu YD,Wang Y,Yang J

    更新日期:2010-10-06 00:00:00

  • Antithrombotic drugs for carotid artery dissection.

    abstract:BACKGROUND:Extracranial internal carotid artery dissection can lead to occlusion of the artery and hence cause an ischaemic stroke. It is the underlying stroke mechanism in approximately 2.5% of all strokes. It is the second leading cause of stroke in patients younger than 45 years of age. Anticoagulants or antiplatele...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000255

    authors: Lyrer P,Engelter S

    更新日期:2003-01-01 00:00:00

  • Home or foster home care versus institutional long-term care for functionally dependent older people.

    abstract:BACKGROUND:Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce costs an...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009844.pub2

    authors: Young C,Hall AM,Gonçalves-Bradley DC,Quinn TJ,Hooft L,van Munster BC,Stott DJ

    更新日期:2017-04-03 00:00:00