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Health services research on end-of-life care

Costantini, Massimo; Beccaro, Monica

Current Opinion in Supportive and Palliative Care: September 2009 - Volume 3 - Issue 3 - p 190–194
doi: 10.1097/SPC.0b013e32832e67c3
End-of-life management: Edited by Sam H. Ahmedzai and Gustavo De Simone

Purpose of review To summarize and discuss recent research aimed at evaluating palliative care services, and other complex interventions in end-of-life care.

Recent findings Innovative approaches for the evaluation of complex interventions are highly relevant in end-of-life care. The Medical Research Council Framework for the development and evaluation of complex interventions uses the classic approach to research for drug development, but with a wider range of study methods, including experimental. This approach has been used in some recent research and has proved useful for the evaluation of effectiveness of palliative care services. Moreover, during recent years some experimental studies have explored feasibility, effectiveness and costs of complex programs to improve the quality of end-of-life care. Finally, the effectiveness of population-based educational interventions has been shown by one study focused on the preferences and attitudes on end-of-life care.

Summary Health services research is crucial in end-of-life care because of the complex services and patients and families cared for. Health services research can provide information about the most effective (and cost-effective) strategies to improve the quality of end-of-life care. During recent years some interesting research and study protocols dealing with the evaluation of complex end-of-life programs have been designed and implemented.

Regional Palliative Care Network, National Cancer Research Institute, Genova, Italy

Correspondence to Massimo Costantini, MD, Regional Palliative Care Network, National Cancer Research Institute, Largo R. Benzi, 10 16132 Genova, Italy Tel: +39 010 5737 482; fax: +39 010 5737 355; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.