{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T22:04:40Z","timestamp":1767045880260,"version":"build-2065373602"},"reference-count":41,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDB\/4255\/2020"],"award-info":[{"award-number":["UIDB\/4255\/2020"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,11,20]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Our systematic review aimed to summarise non-pharmacological interventions applicable in primary care that improve the quality of life of older patients with palliative care needs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Systematic review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>The primary outcome was patients\u2019 quality of life. Secondary outcomes were symptoms relief and patients\u2019 well-being measures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>We searched MEDLINE, EMBASE, PsycINFO, Cochrane and CINAHL up to October 2022 for randomised controlled trials (RCTs). We also handsearched abstract books of relevant congresses and scientific meetings in the last 5\u2009years. Screening, data extraction and quality evaluation (Cochrane risk-of-bias (RoB) V.2.0 tool and Grading of Recommendations, Assessment, Development and Evaluations (GRADE)) were done independently by two reviewers, with disagreements solved by a third reviewer. Findings were narratively synthesised.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 4 RCTs, including 268 patients. One study used a broad criteria of palliative care needs (\u2018progressive, life-threatening disease\u2019), two studies focused on advanced cancer and one study on heart failure. The non-pharmacological interventions evaluated were advance care planning conducted by general practitioners (GPs); social worker-aided palliative care; online primary palliative care training for GPs and spiritual history taking by nurses and GPs. No intervention showed a statistically significant impact on quality of life and the evidence was low according to GRADE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The results highlight a dearth of evidence on what non-pharmacological interventions can be effectively done in primary care to improve the quality of life of older persons with palliative care needs. The results should be interpreted with caution, as the search more comprehensively covers interventions delivered by GPs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42020154216.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-073950","type":"journal-article","created":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T13:22:13Z","timestamp":1702128133000},"page":"e073950","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Non-pharmacological interventions in primary care to improve the quality of life of older patients with palliative care needs: a systematic review of randomised controlled trials"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9214-6995","authenticated-orcid":false,"given":"Carlos","family":"Sei\u00e7a Cardoso","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, Coimbra, Portugal"},{"name":"CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal"}]},{"given":"Joana","family":"Rita Matos","sequence":"additional","affiliation":[{"name":"USF Vitasaurium, Coimbra, Portugal"}]},{"given":"Filipe","family":"Prazeres","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal"},{"name":"Faculty of Health Sciences, Universidade da Beira Interior Faculdade de Ciencias da Saude, Covilha, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8149-1806","authenticated-orcid":false,"given":"Barbara","family":"Gomes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, Coimbra, Portugal"},{"name":"Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK"}]}],"member":"239","published-online":{"date-parts":[[2023,12,9]]},"reference":[{"key":"2025101812542271000_13.12.e073950.1","unstructured":"The World Health Organization . Palliative care for people with life-limiting illnesses: a summary of WHO evidence. Geneva: World Health Organization, 2018."},{"key":"2025101812542271000_13.12.e073950.2","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1177\/1049909118809947","article-title":"Primary palliative care education programs: review and characterization","volume":"36","author":"Carroll","year":"2019","journal-title":"Am J Hosp Palliat Care"},{"key":"2025101812542271000_13.12.e073950.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2015.01.001"},{"key":"2025101812542271000_13.12.e073950.4","first-page":"100814","article-title":"Primary palliative care: skills for all Clinicians","volume":"50","author":"Sreedhar","year":"2020","journal-title":"Curr Probl Pediatr Adolesc Health Care"},{"key":"2025101812542271000_13.12.e073950.5","doi-asserted-by":"publisher","DOI":"10.1017\/S1463423619000598"},{"key":"2025101812542271000_13.12.e073950.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-017-0860-2","article-title":"How many people will need palliative care in 2040? 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