Abstract
Background: End-of-life (EOL) communication plays a critical role in ensuring that patients receive care concordant with their wishes and experience high quality of life. As the baby boomer population ages, scalable models of end-of-life communication will be needed to ensure that patients receive appropriate care. Information and communication technologies (ICTs) may help address the needs of this generation; however, few resources exist to guide the use of ICTs in EOL care.Objective: The primary objective was to identify the ICTs being used in EOL communication. The secondary objective was to compare the effectiveness of different ICTs in EOL communication.Methods: The study was a systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched seven databases for experimental and observational studies on EOL communication between doctors and patients using ICTs, published in 1997–2013.Results: The review identified 38 relevant articles. Eleven types of technology were identified: video, website, telephone, videoconferencing, e-mail, telemonitoring, Internet search, compact disc, fax, PalmPilot, and short message service (SMS) text messaging. ICTs were most commonly used to provide information or education, serve as decision aids, promote advance care planning (ACP), and relieve physical symptom distress.Conclusions: The use of ICTs in EOL care is a small but growing field of research. Additional research is needed to adapt older, analog technologies for use in the digital age. Many of the interventions discussed in this review do not take full advantage of the affordances of mobile, connected health ICTs. The growing evidence base for e-health applications in related fields should guide future interventions in EOL care.
Highlights
Communication between doctors, patients and families plays a decisive role in ensuring that patients receive end-of-life (EOL) care concordant with their wishes
The noncancer population was subdivided by age, with 29% of the studies[33,55,56,63,64,66,68,72,78,79,81] focused on populations aged 60 years and older (n = 11); 8% of the studies[70,82,83] focused on populations aged 40 and older (n = 3); and 24% of the studies focused on populations defined by other features, including race,[71,86] primary language,[71] and referral[57,67,74,75,76,77,88] to palliative care or pain clinic (n = 9)
Twenty-five[33,34,55,56,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,76,78,79,82,83,86] of the studies were conducted in the United States; three[77,84,85] in Canada; five in Europe; two[87,88] in Australia; one[81] in Japan; one[54] in Korea; and one[74] in India
Summary
Communication between doctors, patients and families plays a decisive role in ensuring that patients receive end-of-life (EOL) care concordant with their wishes. End-of-life (EOL) communication plays a critical role in ensuring that patients receive care concordant with their wishes and experience high quality of life. As the baby boomer population ages, scalable models of end-of-life communication will be needed to ensure that patients receive appropriate care. Information and communication technologies (ICTs) may help address the needs of this generation; few resources exist to guide the use of ICTs in EOL care. We systematically searched seven databases for experimental and observational studies on EOL communication between doctors and patients using ICTs, published in 1997–2013. The growing evidence base for e-health applications in related fields should guide future interventions in EOL care
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