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Abstract(s)
Introdução: Os doentes com necessidades paliativas recorrem frequentemente ao Serviço de Urgência (SU), o que acarreta sofrimento para os próprios e seus cuidadores. Os Cuidados Paliativos (CP) têm sido associados, em alguns estudos, a uma menor utilização do SU por parte dos doentes terminais. Assim, foi realizada uma revisão sistemática da literatura, com o objetivo de determinar o impacto dos CP na utilização do SU. Metodologia: Foi feita uma pesquisa em seis bases de dados – PUBMED, CINAHL, SCOPUS, MedicLatina, Web of Science e PsyArticles. Foram pesquisados estudos sobre o impacto dos CP nas idas ao SU, em doentes com idade superior a 18 anos, que incluíssem patologia oncológica e/ou não oncológica e qualquer das tipologias de CP. Foram incluídos ensaios clínicos, estudos de coorte, estudos caso-controlo e estudos transversais. Um segundo revisor independente participou na seleção dos estudos. Após selecionados os artigos, foram extraídos os dados e os resultados apresentados como análise quantitativa e meta-análise. Resultados: Foram incluídos 67 artigos, sobre patologia oncológica e não oncológica e abrangendo as várias tipologias de CP – CP domiciliários, hospices, Unidades de Cuidados Paliativos (UCP) e consulta. A maioria dos estudos demonstrou um impacto positivo dos CP na utilização do SU. Através da meta-análise, obteve-se um odds ratio de 0,439, o que nos permite afirmar que os CP, de acordo com este estudo, permitem reduzir as idas ao SU em 2,3 vezes. Conclusões: A presente revisão sistemática da literatura demonstra evidência de que os CP estão associados a uma menor utilização do SU por parte dos doentes com necessidades paliativas.
Introduction: Patients with palliative needs frequently visit the emergency department (ED), which is associated with increased suffering for both them and their carers. Some studies have showed that Palliative Care (PC) is associated with reduced ED visits. Therefore, a systematic review of the literature was undertaken, aiming to determine the impact of PC in ED visits by terminal patients. Methods: A search was made in six databases - PUBMED, CINAHL, SCOPUS, MedicLatina, Web of Science and PsyArticles. We have considered studies about the impact of PC in ED visits, including adult patients with both malignant and non-malignant diseases. All PC models were considered. Clinical trials, cohort studies, case-control studies and observational studies were all included. A second reviewer independently selected the articles. After article selection, data were extracted and results were presented both qualitatively and through a meta-analysis. Results: 67 articles were included in this review, including cancer and non-cancer patients and different PC models – community PC, hospices, PC units and outpatient clinic. Most studies have shown a positive impact of PC in ED visits. Through the meta-analysis made, we obtained an odds ratio of 0,439, which means that PC can reduce ED visits by 2,3 times, according to this study. Conclusions: This systematic review of the literature gives evidence that PC is associated with less ED visits by terminal patients.
Introduction: Patients with palliative needs frequently visit the emergency department (ED), which is associated with increased suffering for both them and their carers. Some studies have showed that Palliative Care (PC) is associated with reduced ED visits. Therefore, a systematic review of the literature was undertaken, aiming to determine the impact of PC in ED visits by terminal patients. Methods: A search was made in six databases - PUBMED, CINAHL, SCOPUS, MedicLatina, Web of Science and PsyArticles. We have considered studies about the impact of PC in ED visits, including adult patients with both malignant and non-malignant diseases. All PC models were considered. Clinical trials, cohort studies, case-control studies and observational studies were all included. A second reviewer independently selected the articles. After article selection, data were extracted and results were presented both qualitatively and through a meta-analysis. Results: 67 articles were included in this review, including cancer and non-cancer patients and different PC models – community PC, hospices, PC units and outpatient clinic. Most studies have shown a positive impact of PC in ED visits. Through the meta-analysis made, we obtained an odds ratio of 0,439, which means that PC can reduce ED visits by 2,3 times, according to this study. Conclusions: This systematic review of the literature gives evidence that PC is associated with less ED visits by terminal patients.
Description
Keywords
Cuidados paliativos Hospice Serviço de urgência Palliative care Emergency department Emergency room