TY  - JOUR
PY  - 2024//
TI  - Strategies to improve end-of-life decision-making and palliative care following hip fracture in frail older adults: a scoping review
JO  - Age and ageing
A1  - Tremblay, Alexandra
A1  - Pelet, Stéphane
A1  - Belzile, Étienne
A1  - Boulet, Justine
A1  - Morency, Chantal
A1  - Dion, Norbert
A1  - Gagnon, Marc-Aurèle
A1  - Gauthier, Lynn
A1  - Khalfi, Amal
A1  - Bérubé, Mélanie
SP  - afae134
EP  - afae134
VL  - 53
IS  - 7
N2  - BACKGROUND: Although surgery is the gold standard following a hip fracture, the potential for rehabilitation and survival rates are low in frail older patients. Some patients may derive more benefit from palliative care. The objectives of this review were to identify the available strategies to improve end-of-life decision-making and palliative care for frail patients with hip fractures and to synthetise their level of support. <br><br>METHODS: We conducted a scoping review of the scientific and grey literature, searching seven databases and websites of associations. We included all study designs, expert opinion articles and clinical practice guidelines (CPGs). Data were synthetised according to the Approach to Patient with Limited Life Expectancy and Hip Fracture framework. The number of research items and their level of evidence were tabulated for each of the recommended strategies. <br><br>RESULTS: Of the 10 591 items identified, 34 were eligible. The majority of included articles were original research studies (n = 15). Half of the articles and CPGs focused on intervention categories (55%) such as goals of care discussion and comfort care, followed by factors to consider in the end-of-life decision-making process (25%) and prognosis assessments (20%), mainly through the estimation of life expectancy. The level of evidence for these strategies remains low, given the limited number of prospective studies supporting them. <br><br>CONCLUSIONS: This scoping review highlighted that end-of-life care in frail older patients with a hip fracture remains understudied. The strategies identified could be prioritised for future research to improve the well-being of the target population while promoting sustainable resource management.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-0729
UR  - http://dx.doi.org/10.1093/ageing/afae134
ID  - ref1
ER  -