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Research ArticleSystematic Review

Implementation and Effectiveness of Integrating Palliative Care Into Ambulatory Care of Noncancer Serious Chronic Illness: Mixed Methods Review and Meta-Analysis

Linda C. Chyr, Lyndsay DeGroot, Julie M. Waldfogel, Susan M. Hannum, Danetta H. Sloan, Valerie T. Cotter, Allen Zhang, JaAlah-Ai Heughan, Renee F. Wilson, Karen A. Robinson and Sydney M. Dy
The Annals of Family Medicine January 2022, 20 (1) 77-83; DOI: https://doi.org/10.1370/afm.2754
Linda C. Chyr
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
MPH
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  • For correspondence: lchyr@jhmi.edu
Lyndsay DeGroot
2Johns Hopkins University, School of Nursing, Baltimore, Maryland
BSN, RN
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Julie M. Waldfogel
3Department of Pharmacy, Johns Hopkins Hospital, Baltimore, Maryland
PharmD, BCGP
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Susan M. Hannum
4Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
PhD, MA
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Danetta H. Sloan
4Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
PhD, MSW
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Valerie T. Cotter
2Johns Hopkins University, School of Nursing, Baltimore, Maryland
DrNP, MSN
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Allen Zhang
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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JaAlah-Ai Heughan
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
MS
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Renee F. Wilson
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
MS
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Karen A. Robinson
5Johns Hopkins University, School of Medicine, Baltimore, Maryland
PhD
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Sydney M. Dy
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
MD, MS
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Article Figures & Data

Figures

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    Figure 1.

    PRISMA flow diagram.

  • Figure 2.
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    Figure 2.

    Meta-analysis of the effects of models for integrating palliative care on improving health-related quality of life in patients with noncancer serious chronic illness compared with usual care.

  • Figure 3.
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    Figure 3.

    Meta-analysis of the effects of models for integrating palliative care on improving depressive symptom scores in patients with noncancer serious chronic illness compared with usual care.

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    Figure 4.

    Meta-analysis of the effects of models for integrating palliative care on increasing advance directive documentation in patients with noncancer serious chronic illness compared with usual care.

Additional Files

  • Figures
  • Supplemental materials in PDF file below

    Supplemental Appendix 1. Methods 

    Study Selection (Tables 1a-1e) 

    Table 1a. PICOTS: Inclusion and exclusion criteria for quantitative studies relevant to integrating palliative care into ambulatory care for serious life-threatening chronic illness or conditions 

    Table 1b. Additional inclusion and exclusion criteria for qualitative, mixed-methods, and process evaluation studies 

    Table 1c: Literature Search Strategies on PubMed 

    Table 1d. Minimal clinically important differences and clinical cutoff scores for outcome assessment tools included in review 

    Table 1e. Definitions of the grades of overall strength of evidence 

    Supplemental Appendix 2. Results 

    Quantitative Studies (Tables 2a-2b) 

    Supplemental Table 2a. Characteristics of effectiveness studies assessing models for integrating palliative care

    Table 2b. Summary of effectiveness findings for models for integrating palliative care and multimodal interventions by outcome 

    Table 2c. Characteristics of qualitative studies for models and multimodal interventions 

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The Annals of Family Medicine: 20 (1)
The Annals of Family Medicine: 20 (1)
Vol. 20, Issue 1
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Implementation and Effectiveness of Integrating Palliative Care Into Ambulatory Care of Noncancer Serious Chronic Illness: Mixed Methods Review and Meta-Analysis
Linda C. Chyr, Lyndsay DeGroot, Julie M. Waldfogel, Susan M. Hannum, Danetta H. Sloan, Valerie T. Cotter, Allen Zhang, JaAlah-Ai Heughan, Renee F. Wilson, Karen A. Robinson, Sydney M. Dy
The Annals of Family Medicine Jan 2022, 20 (1) 77-83; DOI: 10.1370/afm.2754

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Implementation and Effectiveness of Integrating Palliative Care Into Ambulatory Care of Noncancer Serious Chronic Illness: Mixed Methods Review and Meta-Analysis
Linda C. Chyr, Lyndsay DeGroot, Julie M. Waldfogel, Susan M. Hannum, Danetta H. Sloan, Valerie T. Cotter, Allen Zhang, JaAlah-Ai Heughan, Renee F. Wilson, Karen A. Robinson, Sydney M. Dy
The Annals of Family Medicine Jan 2022, 20 (1) 77-83; DOI: 10.1370/afm.2754
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Subjects

  • Domains of illness & health:
    • Chronic illness
  • Methods:
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  • Other research types:
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  • Other topics:
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Keywords

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  • ambulatory care
  • mixed methods review
  • meta-analysis

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