Media Watch is intended as an advocacy and research tool. The weekly report, published by Barry R. Ashpole, a Canadian communications consultant and educator, monitors the literature and the lay press on issues specific to the quality of end-of-life care. It is international in scope and distribution. Each month, this section of the IAHPC will publish an abstract or summary of an article or report of special interest noted in a recent issue of Media Watch (see below).
End-of-life care pathways
Do palliative care health professionals settle for low level evidence?
Palliative Medicine | In Press – Accessed 19 November 2013 – The findings of the recent independent review of the U.K. Liverpool Care Pathway (LCP), following substantial concerns raised by members of the public and health professionals found that the implementation of the LCP is often associated with poor care. The Neuberger Report highlighted the complexity of various ethical, safety, clinical practice and negligence issues associated with pathway usage and how, despite technological advances, diagnosing dying continues to be challenging. The U.K. Government"s decision to phase out the LCP as policy following these findings, has generated considerable debate both within and beyond the U.K. However, another key issue raised by the Neuberger"s report is the issue of the palliative care community"s perceived willingness to readily adopt new clinical practices in the absence of evidence.
It is this translational issue that this editorial explores http://eprints.qut.edu.au/64198/
Review of Liverpool Care Pathway for dying patients [in England), Department of Health, July 2013. [Noted in Media Watch, 22 July 2013, #315 (p.6)]
Of related interest
Cochrane Database of Systematic Reviews | Online – 18 November 2013 – "End-of-life care pathways for improving outcomes in caring for the dying."
With sustained concerns about the safety of the pathway implementation and the lack of available evidence on important patient and relative outcomes, recommendations for the use of end-of-life pathways in caring for the dying cannot be made. No new studies met criteria for inclusion in the review update. With recently documented concerns related to the potential adverse effects associated with Liverpool Care Pathway (the most commonly used end-of-life care pathway), the authors do not recommend decision making based on indirect or low-quality evidence. All health services using end-of-life care pathways are encouraged to have their use of the pathway, to date, independently audited.
Any subsequent use should be based on carefully documented evaluations.
The current and back issues of the weekly report can be accessed here.