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BMC Psychiatry
Published in: BMC Psychiatry 1/2019

Open Access 01-12-2019 | Care | Research article

A systematic review of palliative care tools and interventions for people with severe mental illness

Authors: Karin den Boer, Anke J. E. de Veer, Linda J. Schoonmade, Kim J. Verhaegh, Berno van Meijel, Anneke L. Francke

Published in: BMC Psychiatry | Issue 1/2019

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Abstract

Background

Increasing attention to palliative care for the general population has led to the development of various evidence-based or consensus-based tools and interventions. However, specific tools and interventions are needed for people with severe mental illness (SMI) who have a life-threatening illness. The aim of this systematic review is to summarize the scientific evidence on tools and interventions in palliative care for this group.

Methods

Systematic searches were done in the PubMed, Cochrane Library, CINAHL, PsycINFO and Embase databases, supplemented by reference tracking, searches on the internet with free text terms, and consultations with experts to identify relevant literature. Empirical studies with qualitative, quantitative or mixed-methods designs concerning tools and interventions for use in palliative care for people with SMI were included. Methodological quality was assessed using a critical appraisal instrument for heterogeneous study designs. Stepwise study selection and the assessment of methodological quality were done independently by two review authors.

Results

Four studies were included, reporting on a total of two tools and one multi-component intervention. One study concerned a tool to identify the palliative phase in patients with SMI. This tool appeared to be usable only in people with SMI with a cancer diagnosis. Furthermore, two related studies focused on a tool to involve people with SMI in discussions about medical decisions at the end of life. This tool was assessed as feasible and usable in the target group. One other study concerned the Dutch national Care Standard for palliative care, including a multi-component intervention. The Palliative Care Standard also appeared to be feasible and usable in a mental healthcare setting, but required further tailoring to suit this specific setting. None of the included studies investigated the effects of the tools and interventions on quality of life or quality of care.

Conclusions

Studies of palliative care tools and interventions for people with SMI are scarce. The existent tools and intervention need further development and should be tailored to the care needs and settings of these people. Further research is needed on the feasibility, usability and effects of tools and interventions for palliative care for people with SMI.
Appendix
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Literature
1.
Brennan F. Palliative care as an international human right. J Pain Symptom Manag. 2007;33(5):494–9.CrossRef
2.
Radbruch L, Payne S, de Lima L, Lohmann D. The Lisbon challenge: acknowledging palliative care as a human right. J Palliat Med. 2013;16(3):301–4.PubMedCrossRef
3.
Gwyther L, Brennan F, Harding R. Advancing palliative care as a human right. J Pain Symptom Manag. 2009;38(5):767–74.CrossRef
4.
5.
Fleischhacker WW, Cetkovich-Bakmas M, De Hert M, Hennekens CH, Lambert M, Leucht S, Maj M, McIntyre RS, Naber D, Newcomer JW, et al. Comorbid somatic illnesses in patients with severe mental disorders: clinical, policy, and research challenges. J Clin Psychiatry. 2008;69(4):514–9.PubMedCrossRef
6.
7.
Parabiaghi A, Bonetto C, Ruggeri M, Lasalvia A, Leese M. Severe and persistent mental illness: a useful definition for prioritizing community-based mental health service interventions. Soc Psychiatry Psychiatr Epidemiol. 2006;41(6):457–63.PubMedCrossRef
8.
Ruggeri M, Leese M, Thornicroft G, Bisoffi G, Tansella M. Definition and prevalence of severe and persistent mental illness. Br J Psychiatry. 2000;177:149–55.PubMedCrossRef
9.
Woods A, Willison K, Kington C, Gavin A. Palliative care for people with severe persistent mental illness: a review of the literature. Can J Psychiatr. 2008;53(11):725–36.CrossRef
10.
Pulay AJ, Stinson FS, Dawson DA, Goldstein RB, Chou SP, Huang B, Saha TD, Smith SM, Pickering RP, Ruan WJ, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV schizotypal personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions. Prim Care Companion J Clin Psychiatry. 2009;11(2):53–67.PubMedPubMedCentralCrossRef
11.
Leucht S, Burkard T, Henderson J, Maj M, Sartorius N. Physical illness and schizophrenia: a review of the literature. Acta Psychiatr Scand. 2007;116(5):317–33.PubMedCrossRef
12.
Laursen TM, Nordentoft M, Mortensen PB. Excess early mortality in schizophrenia. Annu Rev Clin Psychol. 2014;10:425–48.PubMedCrossRef
13.
Kisely S. Excess mortality from chronic physical disease in psychiatric patients-the forgotten problem. Can J Psychiatr. 2010;55(12):749–51.CrossRef
14.
De Hert M, Correll CU, Bobes J, Cetkovich-Bakmas M, Cohen D, Asai I, Detraux J, Gautam S, Möller HJ, Ndetei DM, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10(1):52–77.CrossRef
15.
Irwin KE, Henderson DC, Knight HP, Pirl WF. Cancer care for individuals with schizophrenia. Cancer. 2014;120(3):323–34.PubMedCrossRef
16.
Koekkoek B, van Meijel B, Hutschemaekers G. “difficult patients” in mental health care: a review. Psychiatr Serv. 2006;57(6):795–802.PubMedCrossRef
17.
Talbott JA, Linn L. Reactions of schizophrenics to life-threatening disease. Psychiatr Q. 1978;50(3):218–27.PubMedCrossRef
18.
Engels G, Francke AL, van Meijel B, Douma JG, de Kam H, Wesselink W, Houtjes W, Scherder EJ. Clinical pain in schizophrenia: a systematic review. J Pain. 2014;15(5):457–67.PubMedCrossRef
19.
Cai X, Cram P, Li Y. Origination of medical advance directives among nursing home residents with and without serious mental illness. Psychiatr Serv. 2011;62(1):61–6.PubMedPubMedCentralCrossRef
20.
Sweers K, Dierckx de Casterle B, Detraux J, De Hert M. End-of-life (care) perspectives and expectations of patients with schizophrenia. Arch Psychiatr Nurs. 2013;27(5):246–52.PubMedCrossRef
21.
Candilis PJ, Foti ME, Holzer JC. End-of-life care and mental illness: a model for community psychiatry and beyond. Community Ment Health J. 2004;40(1):3–16.PubMedCrossRef
22.
Terpstra TL, Terpstra TL. Hospice and palliative care for terminally ill individuals with serious and persistent mental illness: widening the horizons. J Psychosoc Nurs Ment Health Serv. 2012;50(9):28–34.PubMedCrossRef
23.
McNamara B, Same A, Rosenwax L, Kelly B. Palliative care for people with schizophrenia: a qualitative study of an under-serviced group in need. BMC Palliat Care. 2018;17(1):53.PubMedPubMedCentralCrossRef
24.
Lloyd-Williams M, Abba K, Crowther J. Supportive and palliative care for patients with chronic mental illness including dementia. Curr Opin Support Palliat Care. 2014;8(3):303–7.PubMedCrossRef
25.
Ganzini L, Gross AF. Cancer care for patients with schizophrenia. In: Holland JC, Breitbart WS, Butow PN, Jacobsen PB, Loscalzo MJ, McCorkle R, Holland JC, Breitbart WS, Butow PN, Jacobsen PB, et al., editors. Psycho-oncology. 3rd ed. New York: Oxford University Press; 2015. p. 345–55.
26.
Steves F, Williams T. Enhancing end-of-life care for terminally ill psychiatric patients. Nursing. 2016;46(8):54–8.PubMedCrossRef
27.
Sweers K, De Hert M, Detraux J. Een menswaardige palliatieve zorgverlening voor patiënten met een (ernstige) psychiatrische stoornis: utopie of noodzaak? Een systematische literatuurstudie. Psychiatrie en Verpleging. 2011;87(3):14.
28.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, Group P-P. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1.PubMedPubMedCentralCrossRef
29.
Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, Group P-P. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;49:g7647.CrossRef
30.
Peters MD. Managing and coding references for systematic reviews and scoping reviews in EndNote. Med Ref Serv Q. 2017;36(1):19–31.PubMedCrossRef
31.
Hawker S, Payne S, Kerr C, Hardey M, Powell J. Appraising the evidence: reviewing disparate data systematically. Qual Health Res. 2002;12(9):1284–99.PubMedCrossRef
32.
Voss H, Vogel A, Wagemans AMA, Francke AL, Metsemakers JFM, Courtens AM, de Veer AJE. Advance care planning in palliative care for people with intellectual disabilities: a systematic review. J Pain Symptom Manag. 2017;54(6):938–60.CrossRef
33.
Crowe M, Sheppard L. A review of critical appraisal tools show they lack rigor: alternative tool structure is proposed. J Clin Epidemiol. 2011;64(1):79–89.PubMedCrossRef
34.
Klop HT, de Veer AJE, van Dongen SI, Francke AL, Rietjens JAC, Onwuteaka-Philipsen BD. Palliative care for homeless people: a systematic review of the concerns, care needs and preferences, and the barriers and facilitators for providing palliative care. BMC Palliat Care. 2018;17(1):67.PubMedPubMedCentralCrossRef
35.
Pluye P, Gagnon MP, Griffiths F, Johnson-Lafleur J. A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed studies reviews. Int J Nurs Stud. 2009;46(4):529–46.PubMedCrossRef
36.
Irwin S. Integrating mental health services into hospice settings: the palliative care psychiatric program, San Diego hospice and the Institute for Palliative Medicine, San Diego. Psychiatr Serv. 2009;60(10):1395–7.CrossRef
37.
Addington-Hall J. Positive Partnerships - Palliative Care for Adults with Severe Mental Health Problems. London: National Council for Hospice and Specialist Palliative Care; 2000. p. 34.
38.
Akamatsu ET, Kadokura RH, Ohshima A, Doi N. Consultation service by a team made up of psychiatrists, a clinical psychologist and psychosomatic physicians. Jpn J Psychosom Med. 1996;36:7.
39.
Avery JD, Baez MA. Dignity therapy for major depressive disorder: a case report. J Palliat Med. 2012;15(5):509.PubMedCrossRef
40.
Bakker TJ. Palliative care in chronic psycho-geriatrics: a case-study. Patient Educ Couns. 2000;41(1):107–13.PubMedCrossRef
41.
Berk M, Berk L, Udina M, Moylan S, Stafford L, Hallam K, Goldstone S, McGorry PD. Palliative models of care for later stages of mental disorder: maximizing recovery, maintaining hope, and building morale. Aust N Z J Psychiatry. 2012;46(2):92–9.PubMedCrossRef
42.
Berlim MT, Mattevi BS, Duarte AP, Thome FS, Barros EJ, Fleck MP. Quality of life and depressive symptoms in patients with major depression and end-stage renal disease: a matched-pair study. J Psychosom Res. 2006;61(5):731–4.PubMedCrossRef
43.
Candilis PJ, Foti ME. Case presentation: end-of-life care and mental illness: the case of Ms. W. J Pain Symptom Manag. 1999;18(6):447–8.CrossRef
44.
Davie E. A social work perspective on palliative care for people with mental health problems. Eur J Palliat Care. 2006;13(1):26.
45.
Harman SM. Psychiatric and palliative Care in the Intensive Care Unit. Crit Care Clin. 2017;33(3):735–43.PubMedCrossRef
46.
Hilderley LJIRR. Language barrier and psychiatric disorder as challenges to effective pain management. Cancer Pract. 1999;7(5):221–5.CrossRef
47.
Lent B, Brown-Bradley K. Case report: treating a mentally ill patient with serious medical problems. Can Fam Physician. 1999;45:1743–4.PubMedPubMedCentral
48.
Moorey S, Cort E, Kapari M, Monroe B, Hansford P, Mannix K, Henderson M, Fisher L, Hotopf M. A cluster randomized controlled trial of cognitive behaviour therapy for common mental disorders in patients with advanced cancer. Psychol Med. 2009;39(5):713–23.PubMedCrossRef
49.
O'Neill P. Quality of life in schizophrenia: preliminary validity investigation of Bernheim’s ACSA. US: ProQuest Information & Learning; 2011.
50.
Papageorgiou A, King M, Janmohamed A, Davidson O, Dawson J. Advance directives for patients compulsorily admitted to hospital with serious mental illness. Randomised controlled trial. Br J Psychiatry. 2002;181:513–9.PubMedCrossRef
51.
Picot SA, Glaetzer KM, Myhill KJ. Coordinating end of life care for individuals with a mental illness--A nurse practitioner collaboration. Collegian (Royal College of Nursing, Australia). 2015;22(1):143–9.CrossRef
52.
Rhondali W, Ledoux M, Sahraoui F, Marotta J, Sanchez V, Filbet M. Management of psychiatric inpatients with advanced cancer: a pilot study. Bull Cancer. 2013;100(9):819–27.PubMedCrossRef
53.
Stecker E. The terminally ill patient on an acute psychiatric unit. J Psychosoc Nurs Ment Health Serv. 1993;31(5):13–35.PubMed
54.
Tate FB, Longo DA. Death and dying: implications for inpatient, psychiatric care. Palliat Support Care. 2005;3(3):239–43.PubMedCrossRef
55.
Terpstra TL, Williamson S, Terpstra T. Palliative care for terminally ill individuals with schizophrenia. J Psychosoc Nurs Ment Health Serv. 2014;52(8):32–8.PubMedCrossRef
56.
Burton MC, Warren M, Cha SS, Stevens M, Blommer M, Kung S, Lapid MI. Identifying patients in the acute psychiatric hospital who may benefit from a palliative care approach. Am J Hosp Palliat Care. 2016;33(3):228–32.PubMedCrossRef
57.
Foti ME, Bartels SJ, Merriman MP, Fletcher KE, Van Citters AD. Medical advance care planning for persons with serious mental illness. Psychiatr Serv. 2005;56(5):576–84.PubMedCrossRef
58.
Foti ME, Bartels SJ, Van Citters AD, Merriman MP, Fletcher KE. End-of-life treatment preferences of persons with serious mental illness. Psychiatr Serv. 2005;56(5):585–91.PubMedCrossRef
59.
60.
Metadata
Title
A systematic review of palliative care tools and interventions for people with severe mental illness
Authors
Karin den Boer
Anke J. E. de Veer
Linda J. Schoonmade
Kim J. Verhaegh
Berno van Meijel
Anneke L. Francke
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
BMC Psychiatry / Issue 1/2019
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-019-2078-7

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