NLCAHR

The CHRSP Rapid Evidence Report on Chronic Disease and Palliative Care found that overall, there is limited robust evidence for a palliative approach to care and the effectiveness of integrating palliative care components at an early stage in disease progression. Available evidence has yet to identify an effective approach that applies to all settings and contexts. At a fundamental level, the parameters of the research necessary to guide this topic are still being determined. This is not to say that early palliative approaches are not an effective approach for people with chronic disease; rather, the scientific literature on this topic is still emerging.

Other key findings included:

• The literature featured a large number of approaches and models that differed widely in the terminology used, the diseases considered, the types of care included, and the outcomes discussed. These differences made it difficult for authors to draw clear comparisons and conclusions on how best to implement an early palliative approach to care at this time
• More research is necessary to provide evidence on the effectiveness of an early palliative approach to care, including evidence that validates tools for identifying patients early on, patient-reported outcome measures, and models of care.
• The best current evidence on early palliative care relates to studies of cancer patients for whom care is mainly delivered by palliative care specialists. Although this evidence is promising, researchers in the field consider the findings to be very preliminary and suggest that more research is necessary to confirm early findings
• With regards to non-cancerous chronic disease populations, there is very little research evidence of good quality to rely on thus far. There is also no evidence that palliative approaches to care and associated care delivery models that work for cancer populations would work for other chronic disease populations as a "one size fits all" model 
• As more evidence becomes available on appropriate approaches to early palliative care and their effectiveness on patient outcomes, there is potential for this upstream approach to care to have benefits for an aging population and for the high numbers of people living with advancing chronic diseases in Newfoundland and Labrador.

READ THE FULL REPORT HERE

The CHRSP Snapshot on Rural Psychiatry uncovered nine rural Canadian mental health and addictions programs and services of interest. Six were found using an online search, while three were discovered during key informant discussions.   Highlights from the programs and services in the scan include:

• Use of technology: nearly all of the programs identified used innovative digital information and communication technologies to reach rural and remote regions.
• Supporting primary care providers: many jurisdictions are using models in which psychiatrists support primary care providers in rural and remote settings by means of consultations and education.
• Improving coordination of care: a common goal of many programs is to improve coordination of care for rural and remote patients. o Travelling clinics: travelling clinics were commonly used to complement other community services. o Increasing focus on northern areas: strategies with a particular focus on the specific geographic, demographic and cultural challenges in northern regions are becoming more prominent.

Read the full report