SynthesisBMJ open2021
Common elements of service delivery models that optimise quality of life and health service use among older people with advanced progressive conditions: a tertiary systematic review.
Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 4 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Models, components and outcomes of palliative and end-of-life care provided to adults living at home: A systematic umbrella review of reviews.Palliative medicine · 2025Pooled it
- Barriers and Facilitators for Implementation of Palliative Care for Patients with Heart failure - a Rapid Synthesis of Reviews.Current heart failure reports · 2025Pooled it
- Pooled it
- How is community based 'out-of-hours' care provided to patients with advanced illness near the end of life: A systematic review of care provision.Palliative medicine · 2023Pooled it
- Mapping Long-Term Care Needs in Person-Centred Interventions for Older People with Multimorbidity: A WHO Framework-Guided Secondary Analysis.Healthcare (Basel, Switzerland) · 2026Article
- Non-pharmacological symptom self-management in non-malignant chronic disease: A scoping review.African journal of primary health care & family medicine · 2025Article
- Pain management in a patient with intestinal failure in the palliative care setting: case report.BMC palliative care · 2025Article
- Integrating community services provision for older people living with severe frailty: implications from an England-wide survey.Age and ageing · 2025Article
- Psychological interventions for emotional well-being in adults with advanced progressive life-limiting illness.The Cochrane database of systematic reviews · 2024Article
- Integration of primary care and palliative care services to improve equality and equity at the end-of-life: Findings from realist stakeholder workshops.Palliative medicine · 2024Article
- The impact of long-term care interventions on healthcare utilisation among older persons: a scoping review of reviews.BMC geriatrics · 2024Article
- Practices, issues and possibilities at the interface between geriatrics and palliative care (InGaP): A case study exemplifying knotworking.Health open research · 2024Article
- Addressing inequity in palliative care provision for older people living with multimorbidity. Perspectives of community-dwelling older people on their palliative care needs: A scoping review.Palliative medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHealth and social care services worldwide need to support ageing populations to live well with advanced progressive conditions while adapting to functional decline and finitude. We aimed to identify and map common elements of effective geriatric and palliative care services and consider their scalability and generalisability to high, middle and low-income countries.
methodsTertiary systematic review (Cochrane Database of Systematic Reviews, CINAHL, Embase, January 2000-October 2019) of studies in geriatric or palliative care that demonstrated improved quality of life and/or health service use outcomes among older people with advanced progressive conditions. Using frameworks for health system analysis, service elements were identified. We used a staged, iterative process to develop a 'common components' logic model and consulted experts in geriatric or palliative care from high, middle and low-income countries on its scalability.
results78 studies (59 geriatric and 19 palliative) spanning all WHO regions were included. Data were available from 17 739 participants. Nearly half the studies recruited patients with heart failure (n=36) and one-third recruited patients with mixed diagnoses (n=26). Common service elements (≥80% of studies) included collaborative working, ongoing assessment, active patient participation, patient/family education and patient self-management. Effective services incorporated patient engagement, patient goal-driven care and the centrality of patient needs. Stakeholders (n=20) emphasised that wider implementation of such services would require access to skilled, multidisciplinary teams with sufficient resource to meet patients' needs. Identified barriers to scalability included the political and societal will to invest in and prioritise palliative and geriatric care for older people, alongside geographical and socioeconomic factors.
conclusionOur logic model combines elements of effective services to achieve optimal quality of life and health service use among older people with advanced progressive conditions. The model transcends current best practice in geriatric and palliative care and applies across the care continuum, from prevention of functional decline to end-of-life care. PROSPERO REGISTRATION NUMBER: CRD42020150252.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.