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Abstract
Background: palliative care interventions are focused on improving the quality of life of patients and families facing a life-threatening illness and relieving suffering by identification, assessment and treatment of pain, physical, psychosocial and spiritual problems [1]. Managing symptoms, quality of life, quality of death, family distress and grief can be difficult for healthcare professionals. Following the same rationale, proper assessments of the effects of palliative care interventions has been a challenge for researchers. Since 2010, the COMET Initiative has promoted discussion of the importance of establishing a core set outcomes for each health condition, mainly to provide support for clinical trials that are being planned. The choice of outcomes when planning Cochrane Reviews (CRs) should also be guided by such type of initiative.
Objectives: to compare the outcomes considered by CRs to those recommended by the COMET Initiative.
Methods: we performed a sensitive search of the Cochrane Database of Systematic Reviews (CDSR), considering all completed Cochrane Reviews about palliative care (Table 1). We selected the eligible reviews (two authors), collected the primary and secondary outcomes and compared them to those available at the COMET Initiative webpage (www.comet-initiative.org).
Results: of the 93 CRs retrieved by the search, we included 42 that fullfiled our eligibility criteria. Table 2 presents the outcomes considered in the CR and available at the Comet website.
Conclusions: some patient-oriented outcomes, including advance care planning, reference to hospice care, preferred place of death and well-being were considered by both CSR and the COMET Initiative. However, published CRs have not considered caregiver- and family-oriented outcomes (bereavement support and carer satisfaction) and quality of death.
Patient or healthcare consumer involvement: Cochrane is very concerned about engaging patients in the planning and development of their reviews. Since its inception, efforts have been made to approximate the CR findings to its end users, including strategies for translation and dissemination. The use of patient-oriented outcomes, like those presented by the COMET Initiative, should be considered by all Cochrane authors.
Objectives: to compare the outcomes considered by CRs to those recommended by the COMET Initiative.
Methods: we performed a sensitive search of the Cochrane Database of Systematic Reviews (CDSR), considering all completed Cochrane Reviews about palliative care (Table 1). We selected the eligible reviews (two authors), collected the primary and secondary outcomes and compared them to those available at the COMET Initiative webpage (www.comet-initiative.org).
Results: of the 93 CRs retrieved by the search, we included 42 that fullfiled our eligibility criteria. Table 2 presents the outcomes considered in the CR and available at the Comet website.
Conclusions: some patient-oriented outcomes, including advance care planning, reference to hospice care, preferred place of death and well-being were considered by both CSR and the COMET Initiative. However, published CRs have not considered caregiver- and family-oriented outcomes (bereavement support and carer satisfaction) and quality of death.
Patient or healthcare consumer involvement: Cochrane is very concerned about engaging patients in the planning and development of their reviews. Since its inception, efforts have been made to approximate the CR findings to its end users, including strategies for translation and dissemination. The use of patient-oriented outcomes, like those presented by the COMET Initiative, should be considered by all Cochrane authors.
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