{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T02:15:34Z","timestamp":1793672134145,"version":"4.5.1"},"reference-count":66,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Evidence around pressure injuries in palliative care settings is limited and fragmented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To synthesize systematic review evidence regarding prevalence, risk factors, prevention and treatment of pressure injuries in non-acute care settings, and evaluate implications for specialist palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A rapid overview of reviews following the Cochrane guidance for overviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources:<\/jats:title>\n                    <jats:p>We searched four databases (MEDLINE, Cochrane Database of Systematic Reviews, JBI EBM Reviews, and CINAHL) from inception to October 2024. We included systematic reviews on adult patients in inpatient Palliative Care Units or settings likely involving end-of-life care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seventeen systematic reviews incorporating 149 unique studies (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20095,856,293) were included. Thirteen of the reviews were high quality. Only one low-quality review specifically addressed palliative care, focusing on prevalence and risk factors. Interventions were categorized into nutritional, physical (e.g. repositioning, tilt strategies), topical\/dressing-based, electrical stimulation and organizational approaches. Frequent repositioning and certain nutritional interventions may reduce incidence or surface area of pressure ulcers; however, certainty remains very low. Frequent repositioning, specific tilt strategies and specific nutritional interventions may help reduce the incidence of pressure injuries and decrease injury surface area; however certainty is very low. Other interventions have limited and inconclusive evidence and were rated low to very low certainty according to GRADE criteria due to poor trial design and population and setting variations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The evidence base remains weak and largely indirect, offering insufficient guidance for clinical practice in palliative care. High-quality, targeted research is needed to inform effective pressure injury prevention and management in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163251393817","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T05:21:12Z","timestamp":1764220872000},"page":"21-30","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence, risk factors and management of pressure injuries and their implications for palliative care: A rapid overview of reviews"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6420-887X","authenticated-orcid":false,"given":"Omar","family":"Dewidar","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, ON, Canada"},{"name":"Bruy\u00e8re Health Research Institute, University of Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hind","family":"Sabri","sequence":"additional","affiliation":[{"name":"Bruy\u00e8re Health Research Institute, University of Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0130-0182","authenticated-orcid":false,"given":"Elizabeth","family":"Ghogomu","sequence":"additional","affiliation":[{"name":"Bruy\u00e8re Health Research Institute, University of Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta","family":"Jaitly","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Claude","family":"Legacy","sequence":"additional","affiliation":[{"name":"Bruy\u00e8re Continuing Care, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8907-1283","authenticated-orcid":false,"given":"Shirley H.","family":"Bush","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, ON, Canada"},{"name":"Bruy\u00e8re Health Research Institute, Ottawa, ON, Canada"},{"name":"Ottawa Hospital Research Institute, ON, Canada"},{"name":"Department of Palliative Care, Bruy\u00e8re Health, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Rice","sequence":"additional","affiliation":[{"name":"Bruy\u00e8re Health Research Institute, University of Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Welch","sequence":"additional","affiliation":[{"name":"Bruy\u00e8re Health Research Institute, University of Ottawa, ON, Canada"},{"name":"School of Epidemiology and Public Health, University of Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-2261-9.50023-9"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2019.01.001"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14836"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.15386\/mpr-2531"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000470371.77571.5d"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000368360"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2020.103546"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/nur.21835"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12535"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0000000000000292"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216319846023"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-021-01044-8"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2020.103760"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12405"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.7748\/nop.2021.e1299"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-31738-0_116-1"},{"issue":"4","key":"e_1_3_3_18_2","article-title":"Old age, malnutrition, and pressure sores: an ill-fated alliance","volume":"59","author":"Mathus-Vliegen EMH","year":"2004","unstructured":"Mathus-Vliegen EMH. Old age, malnutrition, and pressure sores: an ill-fated alliance. J Gerontol Ser 2004; 59(4): M355\u2013M360.","journal-title":"J Gerontol Ser"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-018-0997-7"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12546-023-09320-z"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.06.004"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.12968\/bjcn.2012.17.Sup6.S18"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14109"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1590\/1980-220x-reeusp-2023-0039en"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2016.0697"},{"key":"e_1_3_3_26_2","volume-title":"Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta-analysis","author":"Shi C","year":"2021","unstructured":"Shi C, Dumville JC, Cullum N, et al Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta-analysis. Cochrane Library, 2021."},{"key":"e_1_3_3_27_2","unstructured":"Palliative Wound Care. EAPC. https:\/\/eapcnet.eu\/task-forces\/palliative-wound-care\/ (2024 accessed 25 December 2024)."},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2023.07.002"},{"key":"e_1_3_3_29_2","unstructured":"Palliative care. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/palliative-care (2020 accessed 3 December 2024)."},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1404684"},{"key":"e_1_3_3_31_2","unstructured":"JBI Global Wiki. 9.1.1 - why an umbrella review? - JBI Manual for Evidence Synthesis https:\/\/jbi-global-wiki.refined.site\/space\/MANUAL\/355829709\/9.1.1+-+Why+an+umbrella+review%3F (2024 accessed 3 December 2024)."},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-070849"},{"issue":"2","key":"e_1_3_3_33_2","article-title":"Nutritional interventions for preventing and treating pressure ulcers","volume":"2","author":"Langer G","year":"2024","unstructured":"Langer G, Wan CS, Fink A, et al Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev 2024; 2(2): CD003216.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_34_2","unstructured":"Committee on Approaching Death: Addressing Key End of Life Issues Institute of Medicine. Dying in America: Improving Quality and honoring individual preferences near the end of Life. National Academies Press 2015. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK285681\/ (accessed 25 December 2024)."},{"key":"e_1_3_3_35_2","article-title":"AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea BJ","year":"2017","unstructured":"Shea BJ, Reeves BC, Wells G, et al AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 2017; 358: j4008.","journal-title":"BMJ"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1390"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1557"},{"issue":"6","key":"e_1_3_3_38_2","article-title":"Repositioning for pressure injury prevention in adults","volume":"6","author":"Gillespie BM","year":"2020","unstructured":"Gillespie BM, Walker RM, Latimer SL, et al Repositioning for pressure injury prevention in adults. Cochrane Database Syst Rev 2020; 6(6): Cd009958.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0b013e3181be282f"},{"issue":"9","key":"e_1_3_3_40_2","article-title":"Support surfaces for pressure ulcer prevention","volume":"2015","author":"McInnes E","year":"2015","unstructured":"McInnes E, Jammali-Blasi A, Bell-Syer SE, et al Support surfaces for pressure ulcer prevention. Cochrane Database Syst Rev 2015; 2015(9): CD001735.","journal-title":"Cochrane Database Syst Rev"},{"issue":"8","key":"e_1_3_3_41_2","article-title":"Dressings and topical agents for preventing pressure ulcers","volume":"12","author":"Moore ZE","year":"2013","unstructured":"Moore ZE, Webster J. Dressings and topical agents for preventing pressure ulcers. Cochrane Database Syst Rev 2013; 12(8): Cd009362.","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"e_1_3_3_42_2","article-title":"Education of healthcare professionals for preventing pressure ulcers","volume":"5","author":"Porter-Armstrong AP","year":"2018","unstructured":"Porter-Armstrong AP, Moore ZE, Bradbury I, et al Education of healthcare professionals for preventing pressure ulcers. Cochrane Database Syst Rev 2018; 5(5): Cd011620.","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"e_1_3_3_43_2","article-title":"Alternating pressure (active) air surfaces for preventing pressure ulcers","volume":"5","author":"Shi C","year":"2021","unstructured":"Shi C, Dumville JC, Cullum N, et al Alternating pressure (active) air surfaces for preventing pressure ulcers. Cochrane Database Syst Rev 2021; 5(5): Cd013620.","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"e_1_3_3_44_2","article-title":"Reactive air surfaces for preventing pressure ulcers","volume":"5","author":"Shi C","year":"2021","unstructured":"Shi C, Dumville JC, Cullum N, et al Reactive air surfaces for preventing pressure ulcers. Cochrane Database Syst Rev 2021; 5(5): Cd013622.","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"e_1_3_3_45_2","article-title":"Foam surfaces for preventing pressure ulcers","volume":"5","author":"Shi C","year":"2021","unstructured":"Shi C, Dumville JC, Cullum N, et al Foam surfaces for preventing pressure ulcers. Cochrane Database Syst Rev 2021; 5(5): Cd013621.","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"e_1_3_3_46_2","article-title":"Dressings and topical agents for treating pressure ulcers","volume":"6","author":"Westby MJ","year":"2017","unstructured":"Westby MJ, Dumville JC, Soares MO, et al Dressings and topical agents for treating pressure ulcers. Cochrane Database Syst Rev 2017; 6(6): Cd011947.","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"e_1_3_3_47_2","article-title":"Electrical stimulation for treating pressure ulcers","volume":"1","author":"Arora M","year":"2020","unstructured":"Arora M, Harvey LA, Glinsky JV, et al Electrical stimulation for treating pressure ulcers. Cochrane Database Syst Rev 2020; 1(1): Cd012196.","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"e_1_3_3_48_2","article-title":"Topical phenytoin for treating pressure ulcers","volume":"2","author":"Hao XY","year":"2017","unstructured":"Hao XY, Li HL, Su H, et al Topical phenytoin for treating pressure ulcers. Cochrane Database Syst Rev 2017; 2(2): Cd008251.","journal-title":"Cochrane Database Syst Rev"},{"issue":"12","key":"e_1_3_3_49_2","article-title":"Organisation of health services for preventing and treating pressure ulcers","volume":"12","author":"Joyce P","year":"2018","unstructured":"Joyce P, Moore ZE, Christie J. Organisation of health services for preventing and treating pressure ulcers. Cochrane Database Syst Rev 2018; 12(12): Cd012132.","journal-title":"Cochrane Database Syst Rev"},{"issue":"10","key":"e_1_3_3_50_2","article-title":"Foam dressings for treating pressure ulcers","volume":"10","author":"Walker RM","year":"2017","unstructured":"Walker RM, Gillespie BM, Thalib L, et al Foam dressings for treating pressure ulcers. Cochrane Database Syst Rev 2017; 10(10): CD011332.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.14767"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2023.104605"},{"key":"e_1_3_3_53_2","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne JAC","year":"2019","unstructured":"Sterne JAC, Savovi\u0107 J, Page MJ, et al RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898.","journal-title":"BMJ"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.026"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.11.014"},{"key":"e_1_3_3_56_2","unstructured":"JBI. JBI critical appraisal tools https:\/\/jbi.global\/critical-appraisal-tools (accessed 5 April 2025)."},{"key":"e_1_3_3_57_2","first-page":"1","volume-title":"Textbook of Palliative Care","author":"Gourley P","year":"2020","unstructured":"Gourley P, Allen J. Swallowing difficulties in Palliative Care. In: MacLeod RD, Van den BL (eds) Textbook of Palliative Care. Springer International Publishing, 2020, pp.1\u201322."},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.02.005"},{"key":"e_1_3_3_59_2","unstructured":"RNAO.ca. Pressure injury management: risk assessment prevention and treatment. https:\/\/rnao.ca\/bpg\/guidelines\/pressure-injuries (2024 accessed 26 December 2024)."},{"key":"e_1_3_3_60_2","volume-title":"Prevention and management of pressure injuries","author":"Norton L","year":"2017","unstructured":"Norton L, Parslow RN, Johnston D, et al Prevention and management of pressure injuries. WoundsCanada; 2017."},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2019-001833"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-022-06908-8"},{"key":"e_1_3_3_63_2","unstructured":"World Health Organization. Global Atlas of Palliative Care (2nd edition) - PAHO\/WHO. Pan American Health Organization 2020. https:\/\/www.paho.org\/en\/node\/75063 (accessed 11 March 2025)."},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.24.00542"},{"key":"e_1_3_3_65_2","first-page":"101049","article-title":"Management using continence products: report of the 7th International Consultation on Incontinence","volume":"8","author":"Murphy C","year":"2023","unstructured":"Murphy C, Fader M, Bliss DZ, et al Management using continence products: report of the 7th International Consultation on Incontinence. Cont 2023; 8: 101049.","journal-title":"Cont"},{"issue":"1","key":"e_1_3_3_66_2","first-page":"52","article-title":"High-protein home parenteral nutrition in malnourished oncology patients: a systematic literature review","volume":"32","author":"Cotogni P","year":"2023","unstructured":"Cotogni P, Shaw C, Jimenez-Fonseca P, et al High-protein home parenteral nutrition in malnourished oncology patients: a systematic literature review. Support Care Cancer 2023; 32(1): 52.","journal-title":"Support Care Cancer"},{"key":"e_1_3_3_67_2","unstructured":"Palliative Wound Care. EAPC. https:\/\/eapcnet.eu\/task-forces\/palliative-wound-care\/ (2023 accessed 21 September 2025)."}],"container-title":["Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02692163251393817","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02692163251393817","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02692163251393817","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:38:02Z","timestamp":1777660682000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02692163251393817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":66,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/02692163251393817"],"URL":"https:\/\/doi.org\/10.1177\/02692163251393817","relation":{},"ISSN":["0269-2163","1477-030X"],"issn-type":[{"value":"0269-2163","type":"print"},{"value":"1477-030X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,26]]}}}