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Review
Rehabilitation medicine in palliative care of chronic neurological conditions
  1. Krishnan P S Nair1,
  2. Barbara Chandler2,
  3. Mark Lee3,
  4. David Oliver4,
  5. Kate Sansam5,
  6. Lenyalo King6,
  7. Suzanne Paisley7,
  8. Anthea Sutton7 and
  9. Anna Cantrell7
  1. 1 Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  2. 2 Raigmore Hospital, NHS Highland, Inverness, Highland, UK
  3. 3 St Benedict's Hospice, Sunderland, UK
  4. 4 Tizard Centre, University of Kent, Canterbury, Kent, UK
  5. 5 Rehabilitation Medicine, Harrogate and District NHS Foundation Trust, Harrogate, North Yorkshire, UK
  6. 6 Rehabilitation Medicine, King's College Hospital NHS Foundation Trust, London, UK
  7. 7 ScHARR, The University of Sheffield, Sheffield, UK
  1. Correspondence to Dr Krishnan P S Nair, Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK; siva.nair{at}nhs.net

Abstract

Background People living with long-term neurological conditions (LTNC) often require palliative care. Rehabilitation medicine specialists often coordinate the long-term care of these patients.

Objective The aim of the present review was to undertake systematic literature searches to identify the evidence on palliative care for people with LTNC to guide rehabilitation medicine specialists caring for these patients in the UK.

Methods We searched for evidence for (1) discussion of end of life, (2) planning for end-of-life care, (3) brief specialist palliative care interventions, (4) support for family and carers, (5) training of rehabilitation medicine specialists in palliative care, and (6) commissioning of services. The databases searched were MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database and Health Technology Assessment Database. Evidence was assimilated using a simplified version of the Grading of Recommendations Assessment, Development and Evaluation method.

Results We identified 2961 records through database searching for neurological conditions and 1261 additional records through database searches for specific symptoms. We removed duplicate records and conference presentations. We screened 3234 titles and identified 330 potentially relevant abstracts. After reading the abstracts we selected 34 studies for inclusion in the evidence synthesis.

Conclusions From the evidence reviewed we would like to recommend that we move forward by establishing a closer working relationship with specialists in palliative care and rehabilitation medicine and explore the implications for cross-specialty training.

  • chronic conditions
  • neurological conditions
  • rehabilitation
  • supportive care

https://doi.org/10.1136/bmjspcare-2020-002415

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    Footnotes

    • Contributors KPSN, BC, KS and LK contributed to the design and evaluation of evidence. ML and DO contributed to evaluation of evidence. SP, AS and AC contributed to literature search. All authors contributed to drafting and reviewing of the paper.

    • Funding This study was supported by a grant from British Society of Rehabilitation Medicine.

    • Disclaimer The views expressed are those of the authors and not necessarily those of the British Society of Rehabilitation Medicine.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.