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  • CovPall_JPSM_Overall_AAM_5.2.21

    Rights statement: This is the author’s version of a work that was accepted for publication in Journal of Pain and Symptom Management. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Pain and Symptom Management, ?, ?, 2021 DOI: 10.1016/j.jpainsymman.2021.01.038

    Accepted author manuscript, 268 KB, PDF document

    Embargo ends: 5/02/22

    Available under license: CC BY-NC-ND: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

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The challenges of caring for people dying from COVID-19: a multinational, observational study (CovPall)

Research output: Contribution to journalJournal articlepeer-review

E-pub ahead of print
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<mark>Journal publication date</mark>5/02/2021
<mark>Journal</mark>Journal of Pain and Symptom Management
Publication StatusE-pub ahead of print
Early online date5/02/21
<mark>Original language</mark>English

Abstract

Context
Systematic data on the care of people dying with COVID-19 are scarce.

Objectives
To understand the response of and challenges faced by palliative care services during the COVID-19 pandemic, and identify associated factors.

Methods
We surveyed palliative care and hospice services, contacted via relevant organisations. Multivariable logistic regression identified associations with challenges. Content analysis explored free text responses.

Results
458 services responded; 277 UK, 85 rest of Europe, 95 rest of the world; 81% cared for patients with suspected or confirmed COVID-19, 77% had staff with suspected or confirmed COVID-19; 48% reported shortages of Personal Protective Equipment (PPE), 40% staff shortages, 24% medicines shortages, 14% shortages of other equipment. Services provided direct care and education in symptom management and communication; 91% changed how they worked. Care often shifted to increased community and hospital care, with fewer admissions to inpatient palliative care units. Factors associated with increased odds of PPE shortages were: charity rather than public management (OR 3.07, 95% CI 1.81-5.20), inpatient palliative care unit rather than other settings (OR 2.34, 95% CI 1.46-3.75). Being outside the UK was associated with lower odds of staff shortages (OR 0.44, 95% CI 0.26-0.76). Staff described increased workload, concerns for their colleagues who were ill, whilst expending time struggling to get essential equipment and medicines, perceiving they were not a front-line service.

Conclusion
Palliative care services were often overwhelmed, yet felt ignored in the COVID-19 response. Palliative care needs better integration with health care systems when planning and responding to future epidemics/pandemics.

Bibliographic note

This is the author’s version of a work that was accepted for publication in Journal of Pain and Symptom Management. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Pain and Symptom Management, ?, ?, 2021 DOI: 10.1016/j.jpainsymman.2021.01.038