Title

Evaluating the Liverpool Care Pathway for care of the terminally ill in rural Australia

Document Type

Article

Publisher

Springer Verlag

School

School of Nursing and Midwifery / Nursing, Midwifery and Health Services Research

RAS ID

20111

Funders

SHRAC, State Health Research Advisory Council

Grant Number

RSD 03680/02

Comments

Originally published as: Wilkinson, A.M., Johnson, C.E., Walker, H., Colgan, V., Arnet, H., Rai, T. (2015). Evaluating the Liverpool Care Pathway for care of the terminally ill in rural Australia in Supportive Care in Cancer, 23(11), 3173-3181. Available here.

Abstract

Purpose: This study evaluates a pilot implementation of the Liverpool Care Pathway (LCP), a clinical tool used to guide the care of dying patients in the last days of life, on the end-of-life care for dying patients in three regions in rural Australia. Methods: The LCP was implemented at 13 participating sites: nine hospitals (general wards), one community-based palliative care service, and three in-hospital palliative care units. To evaluate the implementation of the LCP, 415 eligible patient records were examined: 223 pre-implementation and 192 post-implementation (116 on the LCP and 76 receiving usual care). The primary analysis compared all patients pre-implementation of the LCP versus all patients post-implementation. Results: Increases were found post-implementation for communication with other health professionals and with patients or family (pre-69 %, post-87 %; p ≤ 0.000), use of palliative medications (pre-87 %, post-98 %; p ≤ 0.000) and frequency of symptom assessments (pre-66 %, post-82 %; p ≤ 0.000). Fewer blood and radiological investigations were conducted and venous access devices used in the post-implementation groups than in the pre-implementation period. Conclusions: This study suggests that when rigorously implemented, the LCP improves important components of end-of-life care for dying patients and their families.

DOI

10.1007/s00520-015-2697-6