{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:54:31Z","timestamp":1782489271278,"version":"3.54.5"},"reference-count":34,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"unspecified","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"DHR, Government of India","award":["I\/3824058\/2025"],"award-info":[{"award-number":["I\/3824058\/2025"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,28]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chronic and life-limiting illnesses require coordinated care beyond hospital settings, with increasing emphasis on continuity of care in community and out-of-hospital environments. Respite care plays an important role in supporting both patients and caregivers; however, its delivery is often variable and lacks structured clinical guidance. While several frameworks exist to support chronic and palliative care, these have been primarily studied in broader care settings and have not been systematically examined within out-of-hospital respite care. This scoping review aims to map clinical guidance frameworks used in respite care, describe their components and implementation and identify reported patient-level, caregiver-level and system-level outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This scoping review will be conducted in accordance with Joanna Briggs Institute methodology and reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search will be undertaken across the electronic databases PubMed, Scopus, Embase, CINAHL, Web of Science, PsycINFO and Global Health, along with grey literature sources (ProQuest). Studies of any design including quantitative, qualitative, mixed-methods, implementation studies and service evaluations, published in English from database inception to 31 December 2025 will be included. Two reviewers will independently screen studies, extract data using a structured data-charting form and resolve discrepancies through discussion. Extracted data will be synthesised using descriptive mapping and thematic analysis. Findings will be integrated to identify gaps and implications for low and middle-income country settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required for this review, as it will use publicly available data. Findings will be disseminated through peer-reviewed publication, conference presentations and integration into the ongoing mixed-methods doctoral project.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study registration<\/jats:title>\n                    <jats:p>Open Science Framework, osf.io\/avyzp.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-117775","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:35:34Z","timestamp":1778502934000},"page":"e117775","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation and outcomes of structured clinical guidance frameworks for people with chronic illnesses in out-of-hospital respite care settings: protocol for a scoping review"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4469-0846","authenticated-orcid":false,"given":"Anuja","family":"Damani","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9975-2568","authenticated-orcid":false,"given":"Arunangshu","family":"Ghoshal","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gayatri","family":"S","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1410-0996","authenticated-orcid":false,"given":"Joseph","family":"Clark","sequence":"additional","affiliation":[{"name":"Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherian Varghese","family":"V","sequence":"additional","affiliation":[{"name":"Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, KA, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Rao","sequence":"additional","affiliation":[{"name":"Manipal Hospice and Respite Centre, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyusha","family":"Majumdar","sequence":"additional","affiliation":[{"name":"Indian Institute of Health Management Research, Jaipur, RJ, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Salins","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"2026062608314855000_16.5.e117775.1","unstructured":"World Health Organization . Geneva: WHO; Palliative care, 2023. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/palliative-care [Accessed 13 Dec 2025]."},{"key":"2026062608314855000_16.5.e117775.2","unstructured":"Institute of Medicine (US) . Dying in America: Improving Quality and Honoring Individual Preferences near the End of Life. Washington (DC): National Academies Press, 2015."},{"key":"2026062608314855000_16.5.e117775.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1404684"},{"key":"2026062608314855000_16.5.e117775.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60240-2"},{"key":"2026062608314855000_16.5.e117775.5","unstructured":"Organisation for Economic Co-Operation and Development (OECD) . Realising the Potential of Primary Health Care. Paris: OECD, 2020."},{"key":"2026062608314855000_16.5.e117775.6","unstructured":"National Institute on Aging . Bethesda (MD): NIA; What is respite care?, 2023. Available: https:\/\/www.nia.nih.gov\/health\/caregiving\/what-respite-care [Accessed 29 Mar 2026]."},{"key":"2026062608314855000_16.5.e117775.7","doi-asserted-by":"crossref","unstructured":"Candy B , Jones L , Drake R , et al . Interventions for supporting informal caregivers of patients in the terminal phase of a disease. Cochrane Database Syst Rev 2011;CD007617. doi:10.1002\/14651858.CD007617.pub2","DOI":"10.1002\/14651858.CD007617.pub2"},{"key":"2026062608314855000_16.5.e117775.8","doi-asserted-by":"crossref","unstructured":"Centeno C , Payne S , Garralda E . International Progress in the Development of Palliative Medicine. 5th edn. Oxford: Oxford University Press, 2021:3\u201312.","DOI":"10.1093\/med\/9780198821328.003.0001"},{"key":"2026062608314855000_16.5.e117775.9","unstructured":"World Health Organization . Framework on integrated, people-centred health services: report by the secretariat. sixty-ninth world health assembly; A69\/39. Geneva, 2016. Available: https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/wha69\/a69_39-en.pdf [accessed 31 Mar 2026]"},{"key":"2026062608314855000_16.5.e117775.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7425.1219"},{"key":"2026062608314855000_16.5.e117775.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000678"},{"key":"2026062608314855000_16.5.e117775.12","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2003.51186.x"},{"key":"2026062608314855000_16.5.e117775.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01234.x"},{"key":"2026062608314855000_16.5.e117775.14","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12416"},{"key":"2026062608314855000_16.5.e117775.15","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hct200"},{"key":"2026062608314855000_16.5.e117775.16","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0b013e3181f684e5"},{"key":"2026062608314855000_16.5.e117775.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(02)00415-4"},{"key":"2026062608314855000_16.5.e117775.18","unstructured":"World Health Organization . Integrated Care for Older People: Guidelines on Community-Level Interventions to Manage Declines in Intrinsic Capacity. Geneva, 2017."},{"key":"2026062608314855000_16.5.e117775.19","unstructured":"World Health Organization . Integrating palliative care into primary health care and humanitarian settings, Available: https:\/\/www.knowledge-action-portal.com\/en\/content\/integrating-palliative-care-primary-health-care-and-humanitarian-settings [Accessed 13 Dec 2025]."},{"key":"2026062608314855000_16.5.e117775.20","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.19.2469"},{"key":"2026062608314855000_16.5.e117775.21","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1177\/0269216316647610","article-title":"How does uncertainty shape patient experience in advanced illness? A secondary analysis of qualitative data","volume":"31","author":"Etkind","year":"2017","journal-title":"Palliat Med"},{"key":"2026062608314855000_16.5.e117775.22","doi-asserted-by":"publisher","DOI":"10.5175\/JSWE.2008.773247702"},{"key":"2026062608314855000_16.5.e117775.23","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70396-0"},{"key":"2026062608314855000_16.5.e117775.24","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(18)30386-3"},{"key":"2026062608314855000_16.5.e117775.25","doi-asserted-by":"crossref","DOI":"10.4102\/ajod.v12i0.1115","article-title":"Respite care models and practices for persons with intellectual disability: A scoping review","volume":"12","author":"Abrahams","year":"2023","journal-title":"Afr J Disabil"},{"key":"2026062608314855000_16.5.e117775.26","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.17.00175"},{"key":"2026062608314855000_16.5.e117775.27","doi-asserted-by":"publisher","DOI":"10.1177\/0269216315589898"},{"key":"2026062608314855000_16.5.e117775.28","article-title":"Implementation research: what it is and how to do it","volume":"347","author":"Peters","year":"2013","journal-title":"BMJ"},{"key":"2026062608314855000_16.5.e117775.29","doi-asserted-by":"crossref","DOI":"10.1186\/s12904-022-00922-7","article-title":"A scoping review of the evidence for community-based dementia palliative care services and their related service activities","volume":"21","author":"O\u2019Connor","year":"2022","journal-title":"BMC Palliat Care"},{"key":"2026062608314855000_16.5.e117775.30","doi-asserted-by":"crossref","DOI":"10.1080\/16549716.2024.2422170","article-title":"A framework for chronic care quality: results of a scoping review and Delphi survey","volume":"17","author":"Ku","year":"2024","journal-title":"Glob Health Action"},{"key":"2026062608314855000_16.5.e117775.31","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-20-00167"},{"key":"2026062608314855000_16.5.e117775.32","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"2026062608314855000_16.5.e117775.33","doi-asserted-by":"publisher","DOI":"10.1080\/1941126X.2018.1444339"},{"key":"2026062608314855000_16.5.e117775.34","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2288-8-45","article-title":"Methods for the thematic synthesis of qualitative research in systematic reviews","volume":"8","author":"Thomas","year":"2008","journal-title":"BMC Med Res Methodol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-117775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:42:16Z","timestamp":1782488536000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-117775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,11]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bmjopen-2026-117775"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-117775","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}