Lessons from the Literature

Volume 23, Number 10: October 2022

Editor’s note: Barry Ashpole announced a few months ago that he was scaling back his longtime project, MediaWatch, to focus on articles involving palliative care in lower-income or marginalized populations. Now, he has now decided to retire completely. His last contributions will close out 2022, ending a venture in advocacy that has lasted for decades.

On My Radar

By Barry Ashpole

Area Ripe for Research

Palliative and End-of-Life Care in Intensive Care Units in Low- and Middle-Income Countries: A systematically constructed scoping review. J Critical Care 2022; 71: 154115. DOI: 10.1016/j.jcrc.2022.154115 Link to article

In this scoping review, nine databases were systematically searched for literature published in English on palliative care in intensive care units in low- and middle- income settings (01/01/1990 to 31/05/2021). Thirty papers reported 19 empirical studies, two clinical case reports and six discussion papers. Papers originated from Asia and Africa, primarily using observational designs and qualitative approaches, with no trials or other robust evaluative or comparative studies. No studies directly sought data from patients or families. Five areas of research focus were identified: withholding and withdrawing treatment; professional knowledge and skills; patient and family views; culture and context; and costs of care. Research focused on the specific needs of intensive care in low- and middle-income countries is required to ensure optimal patient outcomes.

What Robust Research Can Accomplish

Contribution of Eastern Mediterranean Region Countries to Palliative Care Journals from 1991 to 2020 and Its Relationship to the Development of Palliative Care. BMC Palliat Care 2022; 21(123). DOI: 10.1186/s12904-022-01016-0 Link to article

This study, led by IAHPC member Samy Alsirafy, aimed to describe the contribution of Eastern Mediterranean Region (EMR) countries to palliative care (PC) research and to study the relationship between this contribution and the levels of PC development. The number of articles published during the 30-year period was 31,108 of which 402 (1.3%) were EMR-affiliated (the number steadily rose over time). The 2018–2020 average articles per million population per year (AAMY) was significantly higher in countries with greater PC development than in those without. Also, it was significantly higher in countries that progressed to a higher level of PC development between 2006 and 2017. There was a significant positive correlation between the average opioid consumption for the years 2017–2019 and the AAMY for the same period. A metric based on the contribution to specialized PC journals may be a useful indicator of PC development.

Also of interest:

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