Defining “early palliative care” for adults diagnosed with a life-limiting illness: a scoping review

Abstract Background Palliative care is for people suffering from life-limiting illnesses that focuses on providing relief from symptoms and stress of illness. Previous studies have demonstrated that specialist palliative care consultation delivered earlier in the disease process can enhance patients...

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Main Authors: Colleen E Kircher, Timothy P. Hanna, Joan Tranmer, Craig E. Goldie, Amanda Ross-White, Elizabeth Moulton, Jack Flegal, Catherine L. Goldie
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Palliative Care
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Online Access:https://doi.org/10.1186/s12904-025-01712-7
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author Colleen E Kircher
Timothy P. Hanna
Joan Tranmer
Craig E. Goldie
Amanda Ross-White
Elizabeth Moulton
Jack Flegal
Catherine L. Goldie
author_facet Colleen E Kircher
Timothy P. Hanna
Joan Tranmer
Craig E. Goldie
Amanda Ross-White
Elizabeth Moulton
Jack Flegal
Catherine L. Goldie
author_sort Colleen E Kircher
collection DOAJ
description Abstract Background Palliative care is for people suffering from life-limiting illnesses that focuses on providing relief from symptoms and stress of illness. Previous studies have demonstrated that specialist palliative care consultation delivered earlier in the disease process can enhance patients’ quality of life, reduce their symptom burden, reduce use of hospital-based acute care services and extend their survival. However, various definitions exist for the term early palliative care (EPC). Objective To investigate how EPC has been defined in the literature for adults with life- limiting illnesses. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping Reviews guidelines and follows the Joanna Briggs Institution methodology for scoping reviews. The literature search was conducted using MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), PsycINFO (Ovid), Web of Science Core Collection, Ovid Cochrane Library, and ProQuest (Health and Medicine and Sociology Collections). All articles retrieved were screened by three independent reviewers. Results 153 articles met the inclusion criteria between 2008 and 2024. Five categories of definitions for EPC were created to organize definitions: (1) time-based (e.g. time from advanced cancer diagnosis to EPC initiation); (2) prognosis-based (e.g. prognosis or the ‘surprise question’); (3) location-based (e.g. access point within the healthcare system such as outpatient setting); (4) treatment-based (e.g. physician’s judgement or prior to specific therapies); and (5) symptom-based (e.g. using symptom intensity questionnaires). Many studies included patients with cancer (n = 103), with the most common definition category being time-based (n = 53). Amongst studies focusing on multiple or non-cancer diagnoses (n = 50), the most common definition category was symptom-based (n = 16). Conclusion Our findings provide a useful reference point for those seeking to understand the scope and breadth of existing EPC definitions in cancer and non-cancer illnesses and contemplate their application within clinical practice.
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spelling doaj-art-3de7e3b1aed34ad9b6f20113fa94d1d92025-08-20T02:08:11ZengBMCBMC Palliative Care1472-684X2025-04-0124111310.1186/s12904-025-01712-7Defining “early palliative care” for adults diagnosed with a life-limiting illness: a scoping reviewColleen E Kircher0Timothy P. Hanna1Joan Tranmer2Craig E. Goldie3Amanda Ross-White4Elizabeth Moulton5Jack Flegal6Catherine L. Goldie7School of Nursing, Faculty of Health Sciences, Queen’s UniversityDivision of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s UniversitySchool of Nursing, Faculty of Health Sciences, Queen’s UniversityDivision of Palliative Medicine, Department of Medicine, School of Medicine, Faculty of Health Sciences, Queen’s UniversityQueen’s Collaboration for Health Care Quality, A JBI Centre of ExcellenceSchool of Nursing, St. Lawrence CollegeSchool of Nursing, St. Lawrence CollegeSchool of Nursing, Faculty of Health Sciences, Queen’s UniversityAbstract Background Palliative care is for people suffering from life-limiting illnesses that focuses on providing relief from symptoms and stress of illness. Previous studies have demonstrated that specialist palliative care consultation delivered earlier in the disease process can enhance patients’ quality of life, reduce their symptom burden, reduce use of hospital-based acute care services and extend their survival. However, various definitions exist for the term early palliative care (EPC). Objective To investigate how EPC has been defined in the literature for adults with life- limiting illnesses. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping Reviews guidelines and follows the Joanna Briggs Institution methodology for scoping reviews. The literature search was conducted using MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), PsycINFO (Ovid), Web of Science Core Collection, Ovid Cochrane Library, and ProQuest (Health and Medicine and Sociology Collections). All articles retrieved were screened by three independent reviewers. Results 153 articles met the inclusion criteria between 2008 and 2024. Five categories of definitions for EPC were created to organize definitions: (1) time-based (e.g. time from advanced cancer diagnosis to EPC initiation); (2) prognosis-based (e.g. prognosis or the ‘surprise question’); (3) location-based (e.g. access point within the healthcare system such as outpatient setting); (4) treatment-based (e.g. physician’s judgement or prior to specific therapies); and (5) symptom-based (e.g. using symptom intensity questionnaires). Many studies included patients with cancer (n = 103), with the most common definition category being time-based (n = 53). Amongst studies focusing on multiple or non-cancer diagnoses (n = 50), the most common definition category was symptom-based (n = 16). Conclusion Our findings provide a useful reference point for those seeking to understand the scope and breadth of existing EPC definitions in cancer and non-cancer illnesses and contemplate their application within clinical practice.https://doi.org/10.1186/s12904-025-01712-7Early palliative careLife-limiting illnessCancerChronic illness, scoping review.
spellingShingle Colleen E Kircher
Timothy P. Hanna
Joan Tranmer
Craig E. Goldie
Amanda Ross-White
Elizabeth Moulton
Jack Flegal
Catherine L. Goldie
Defining “early palliative care” for adults diagnosed with a life-limiting illness: a scoping review
BMC Palliative Care
Early palliative care
Life-limiting illness
Cancer
Chronic illness, scoping review.
title Defining “early palliative care” for adults diagnosed with a life-limiting illness: a scoping review
title_full Defining “early palliative care” for adults diagnosed with a life-limiting illness: a scoping review
title_fullStr Defining “early palliative care” for adults diagnosed with a life-limiting illness: a scoping review
title_full_unstemmed Defining “early palliative care” for adults diagnosed with a life-limiting illness: a scoping review
title_short Defining “early palliative care” for adults diagnosed with a life-limiting illness: a scoping review
title_sort defining early palliative care for adults diagnosed with a life limiting illness a scoping review
topic Early palliative care
Life-limiting illness
Cancer
Chronic illness, scoping review.
url https://doi.org/10.1186/s12904-025-01712-7
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