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Change in Activity of Palliative Care Services during the Covid-19 Pandemic: A Multinational Survey (CovPall)

Research output: Contribution to journalArticlepeer-review

Katherine E. Sleeman, Rachel L. Cripps, Fliss E.M. Murtagh, Adejoke O. Oluyase, Mevhibe B. Hocaoglu, Matthew Maddocks, Catherine Walshe, Nancy Preston, Lesley Dunleavy, Andy Bradshaw, Sabrina Bajwah, Irene J. Higginson, Lorna K. Fraser

Original languageEnglish
Pages (from-to)465-471
Number of pages7
JournalJournal of palliative medicine
Issue number3
Early online date20 Dec 2021
Accepted/In press17 Nov 2021
E-pub ahead of print20 Dec 2021
Published1 Mar 2022

Bibliographical note

Funding Information: This work was supported by UKRI (United Kingdom Research and Innovation) and NIHR [COV0011; MR/ V012908/1]. Additional support was from the National Institute for Health Research (NIHR), Applied Research Collaboration, South London, hosted at King’s College Hospital NHS Foundation Trust, and Cicely Saunders International (Registered Charity No. 1087195). The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Funding Information: I.J.H. is an NIHR Emeritus Senior Investigator and is supported by the NIHR Applied Research Collaboration (ARC) South London (SL) at King's College Hospital National Health Service Foundation Trust. I.J.H. leads the Palliative and End-of-Life Care theme of the NIHR ARC SL and co-leads the national theme in this. M.M. is funded by an NIHR Career Development Fellowship (CDF-2017-10-009) and NIHR ARC SL. L.K.F. is funded by an NIHR Career Development Fellowship (CDF-2018-11-ST2-002). K.E.S. is funded by an NIHR Clinician Scientist Fellowship (CS-2015-15-005), and is the Laing Galazka Chair in Palliative Care at King's College London, funded by an endowment from Cicely Saunders International and the Kirby Laing Foundation. R.L.C. is funded by Cicely Saunders International and Marie Curie, grant [MCSON-20-102]. F.E.M.M. is an NIHR Senior Investigator. M.B.H. is supported by the NIHR ARC SL. Funding Information: I.J.H. is the grant holder and chief investigator; K.E.S., M.M., F.E.M.M., C.W., N.P., L.K.F., S.B., M.B.H., and A.O.O. are co-applicants for funding. I.J.H. and C.W., with critical input from all authors, wrote the protocol for the CovPall study. M.B.H., A.O.O., and R.L.C. coordinated data collection and liaised with centers, with input from I.J.H. R.L.C., K.E.S., and L.K.F. analyzed the data. All authors had access to all study data, discussed the interpretation of findings, and take responsibility for data integrity and analysis. K.E.S., R.L.C., and L.K.F. drafted the article. All authors (K.E.S., R.L.C., F.E.M.M., A.O.O., M.B.H., M.M., C.W., N.P., L.D., A.B., S.B., I.J.H., and L.K.F.) contributed to the analysis plan and provided critical revision of the article for important intellectual content. I.J.H. is the guarantor. Publisher Copyright: © Katherine E. Sleeman et al., 2022; Published by Mary Ann Liebert, Inc. 2022.


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Objectives: To identify factors associated with palliative care services being busier during Covid-19. Methods: Cross-sectional online survey of UK palliative care services (April to July 2020) (CovPall). Ethical approval was received from King's College London Research Ethics committee (LRS-19/20-18541). The primary outcome was change in busyness (five-point ordinal scale). Ordinal logistic regression investigated factors associated with the primary outcome. Results: Of 277 responses, 71 (26%) reported being a lot more busy, 62 (22%) slightly more, 53 (19%) about the same, 50 (18%) slightly less, and 28 (10%) much less busy. Increased business was associated with homecare services (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.15-3.25), nursing care at home (OR 3.24, 95% CI 1.70-6.19), publicly managed services (OR 2.20, 95% CI 1.11-4.34), Covid-19 cases (OR 1.01, 95% CI 1.00-1.01), and staff shortages (OR 2.71, 95% CI 1.64-4.48). Conclusion: Services providing community care, and publicly managed services, may have been better able to respond to escalating needs during Covid-19. This has potential implications for both service delivery and funding models.

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