Enhancing End-of-Life Care With Home-Based Palliative Interventions: A Systematic Review.

CONTEXT

Home-Based Palliative Care (HPC) interventions have emerged as a promising approach to deliver patient-centered care in familiar surroundings, aligning with patients' preferences and improving quality of life (QOL).

OBJECTIVES

This review aimed to systematically assess the impact of HPC interventions on symptom management, QOL, healthcare resource utilization and place of death among patients with severe, progressive illnesses requiring end-of-life care.

METHODS

A comprehensive search was conducted across PubMed, Cochrane, and Scopus databases to identify relevant studies published between January 1, 2013, and December 31, 2023. Eligible studies included randomized controlled trials and clinical studies evaluating the effectiveness of HPC interventions compared to usual care. Risk of bias assessment was performed using Cochrane tools.

RESULTS

Nine publications meeting inclusion criteria were identified. Findings indicate that HPC interventions, delivered by specialized teams or integrated care approaches, significantly improve QOL and increase the likelihood of patients dying at home. Moreover, HPC is associated with reduced healthcare utilization, including fewer hospital admissions, emergency department visits, and shorter hospital stays. No significant differences were observed in symptom management.

CONCLUSION

HPC interventions demonstrate significant benefits in addressing the complex needs of patients with advanced illnesses. These findings underscore the importance of integrating HPC into healthcare systems to optimize outcomes and promote quality end-of-life care. Future research should focus on expanding access to HPC services, enhancing interdisciplinary collaboration, and incorporating patient preferences to further improve care delivery in this vulnerable population.