Palliative Care Interventions for Patients With Kidney Disease: A Scoping Review by the Kidney Disease Aging Research Collaborative
Eleanor Rivera, Ilana Mittleman, Juliana Magro, Totini Chatterjee, Nidhi Ghildayal, Areeba Jawed, Jack Kimball, Jessica E. Ma, Fahad Saeed, Carly Weaver, Jordana Yahr, Mara McAdams‐DeMarco, Rasheeda K. Hall, Jennifer S. SchererABSTRACT
Background
Chronic Kidney Disease (CKD) impacts ~40% of US adults aged ≥ 60 years. Palliative care, which can improve symptoms of serious illness, is underutilized in CKD despite it's association with a high symptom burden. We conducted a scoping review of palliative care interventions in CKD, with particular attention to older adults.
Methods
We searched PubMed, CINAHL, EMBASE, Cochrane Central, PsycInfo,
Results
Of 2046 studies screened, 25 (1%) met inclusion criteria. Ten studies (40%) were randomized controlled designs. The most common quality domains addressed were physical aspects of care (21, 84%) and structure and processes of care (16, 64%). Twenty‐four (96%) studies measured symptoms, 12 (48%) measured quality of life, and 11 (44%) measured both. Twenty‐one different instruments were used to measure symptoms or quality of life. Six (24%) studies were limited to older adults.
Conclusions
In our sample of studies evaluating CKD palliative care interventions, limited quality domains were addressed, a variety of measurement tools were used, and less than a quarter of studies were conducted only in older adults. Future research should address the holistic nature of palliative care, apply standardized instruments, and increase inclusion of older adults.