Cochrane · systematic review · CD011513

Palliative care interventions in advanced dementia

Walsh, SC, Murphy, E, Devane, D, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library

Dementia and Cognitive Improvement2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
8
No studies
6
Included studies
NR
No studies 6 · 42.9%Ungraded 0 · 0%Very low 6 · 42.9%Low 2 · 14.3%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Organisation and delivery compared to usual care in advanced dementia

Population: advanced dementia
7 questions
OutcomeEffectEvidenceStatus / GRADE
Comfort in dying
Organisation and delivery vs usual care
no estimate extracted5 studies · 335 participantsVery low
Downgraded: risk of bias, inconsistency
Symptom management
Organisation and delivery vs usual care
no estimate extracted2 studies · 226 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Pain ‐ not measured
Organisation and delivery vs usual care
no estimate extractedNRNo studies
Palliative care plan in place
Organisation and delivery vs usual care
RR 5.84 [1.37, 25.02]1 study · 99 participantsVery low
Downgraded: risk of bias, imprecision
Quality of life
Organisation and delivery vs usual care
no estimate extracted1 study · 15 participantsVery low
Downgraded: risk of bias, imprecision
Advance care planning discussion occurred
Organisation and delivery vs usual care
RR 1.08 [1, 1.18]1 study · 193 participantsVery low
Downgraded: risk of bias, imprecision
Concordance with goals of care ‐ not measured
Organisation and delivery vs usual care
no estimate extractedNRNo studies

Advance care planning compared to usual care in advanced dementia

Population: advanced dementia
7 questions
OutcomeEffectEvidenceStatus / GRADE
Comfort in dying ‐ not measured
Advance care planning vs usual care
no estimate extractedNRNo studies
Symptom management
Advance care planning vs usual care
no estimate extracted1 study · 67 participantsVery low
Downgraded: risk of bias, imprecision
Pain ‐ not measured
Advance care planning vs usual care
no estimate extractedNRNo studies
Palliative care plan in place ‐ not measured
Advance care planning vs usual care
no estimate extractedNRNo studies
Quality of Life ‐ not measured
Advance care planning vs usual care
no estimate extractedNRNo studies
Advance care planning discussion occurred
Advance care planning vs usual care
RR 1.04 [0.87, 1.24]1 study · 67 participantsLow
Downgraded: risk of bias, imprecision
Concordance with goals of care
Advance care planning vs usual care
RR 1.39 [1.08, 1.79]1 study · 63 participantsLow
Downgraded: risk of bias, imprecision