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Decisions about palliative care are influenced by various factors—including communication between clinicians and patients, availability of services, and the specifics of treatment for different conditions. In the March PACED digest, we compile studies exploring these issues from different perspectives: why patients and their families choose palliative care, which tools encourage earlier discussions, and how place of residence affects access to support. The issue also features materials on the role of palliative approaches in cardiovascular disease and on reviewing cardiovascular medications in older patients with limited life expectancy.
If you wish to continue any of the topics listed below through a discussion or webinar, please do not hesitate to contact us at info@paced.org.uk.
Decisions about palliative care are influenced by various factors—including communication between clinicians and patients, availability of services, and the specifics of treatment for different conditions. In the March PACED digest, we compile studies exploring these issues from different perspectives: why patients and their families choose palliative care, which tools encourage earlier discussions, and how place of residence affects access to support. The issue also features materials on the role of palliative approaches in cardiovascular disease and on reviewing cardiovascular medications in older patients with limited life expectancy.
If you wish to continue any of the topics listed below through a discussion or webinar, please do not hesitate to contact us at info@paced.org.uk.
If you are a palliative care specialist representing one of the PACED countries and wish to join our community—please fill out this form, and we will contact you promptly.
Why Patients Choose Palliative Care: A Systematic Review
This review examines factors that influence patients and their families when deciding whether to utilise palliative or hospice care. By synthesising results from multiple studies, the authors identify 16 key factors, including patient and family awareness, previous experiences with healthcare services, communication with clinicians, health status, and personal preferences. The authors emphasise the importance of timely discussions about prognosis and open dialogue regarding available care options. Understanding these factors can help clinicians communicate more effectively.
Read the article:
https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-025-01793-4?
This review examines factors that influence patients and their families when deciding whether to utilise palliative or hospice care. By synthesising results from multiple studies, the authors identify 16 key factors, including patient and family awareness, previous experiences with healthcare services, communication with clinicians, health status, and personal preferences. The authors emphasise the importance of timely discussions about prognosis and open dialogue regarding available care options. Understanding these factors can help clinicians communicate more effectively.
Read the article:
https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-025-01793-4?
How to Initiate Conversations About Palliative Care Earlier
Discussing palliative care in the context of serious illness remains one of the most difficult topics in clinical practice. These conversations are often delayed by both clinicians and patients. In this large randomised study involving thousands of older patients with cancer, the authors examined whether two relatively simple tools could help improve this situation: short educational videos for patients explaining possible care options and communication skills training for clinicians. The findings suggest that such approaches can promote earlier and more meaningful discussions about future care planning.
Read the article:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833774?
Discussing palliative care in the context of serious illness remains one of the most difficult topics in clinical practice. These conversations are often delayed by both clinicians and patients. In this large randomised study involving thousands of older patients with cancer, the authors examined whether two relatively simple tools could help improve this situation: short educational videos for patients explaining possible care options and communication skills training for clinicians. The findings suggest that such approaches can promote earlier and more meaningful discussions about future care planning.
Read the article:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833774?
How the Place of Residence Influences Access to Palliative Care
Access to palliative and end-of-life care often depends on a person's location. In this systematic review of 51 studies from 24 countries, the authors examine how geographic factors—such as rural or urban settings, distance to healthcare facilities, and service availability—are associated with receiving palliative care and the place of death. People living in rural areas are more likely to die at home but less likely to receive specialised palliative care, whereas proximity to hospitals or hospices increases the chance of dying in those settings. The authors highlight that these differences may reflect not only patient preferences but also uneven resource distribution, and they emphasise the importance of considering these factors in planning palliative care services.
Read the article:
https://link.springer.com/article/10.1186/s12904-025-01869-1
Access to palliative and end-of-life care often depends on a person's location. In this systematic review of 51 studies from 24 countries, the authors examine how geographic factors—such as rural or urban settings, distance to healthcare facilities, and service availability—are associated with receiving palliative care and the place of death. People living in rural areas are more likely to die at home but less likely to receive specialised palliative care, whereas proximity to hospitals or hospices increases the chance of dying in those settings. The authors highlight that these differences may reflect not only patient preferences but also uneven resource distribution, and they emphasise the importance of considering these factors in planning palliative care services.
Read the article:
https://link.springer.com/article/10.1186/s12904-025-01869-1
Palliative Care and Advanced Cardiovascular Disease
Cardiovascular diseases remain among the leading causes of death and disability worldwide, yet palliative care is still significantly less utilised for these patients compared to oncology. In this scientific statement from the American Heart Association, the authors explore how palliative approaches can be incorporated throughout the course of serious cardiovascular disease—from symptom management and quality-of-life support to assisting families and facilitating shared decision-making about treatment. The statement also emphasises the importance of communicating with patients and their families, as well as addressing the complex clinical and ethical issues linked to implantable cardiac devices.
Read the article:
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001323
Cardiovascular diseases remain among the leading causes of death and disability worldwide, yet palliative care is still significantly less utilised for these patients compared to oncology. In this scientific statement from the American Heart Association, the authors explore how palliative approaches can be incorporated throughout the course of serious cardiovascular disease—from symptom management and quality-of-life support to assisting families and facilitating shared decision-making about treatment. The statement also emphasises the importance of communicating with patients and their families, as well as addressing the complex clinical and ethical issues linked to implantable cardiac devices.
Read the article:
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001323
Deprescribing: Reviewing Cardiovascular Therapy in Palliative Care
Patients receiving palliative care often continue taking medications initially prescribed for the long-term prevention of cardiovascular disease. However, as illness progresses, their benefits may diminish, while the medication burden and risk of side effects increase. This review explores approaches to reassessing cardiovascular therapy in older patients with limited life expectancy. The authors demonstrate how such a review can reduce medication burden and better align treatment with current care goals, while also addressing barriers that often impede these decisions in clinical practice.
Read the article:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12790966/?
Patients receiving palliative care often continue taking medications initially prescribed for the long-term prevention of cardiovascular disease. However, as illness progresses, their benefits may diminish, while the medication burden and risk of side effects increase. This review explores approaches to reassessing cardiovascular therapy in older patients with limited life expectancy. The authors demonstrate how such a review can reduce medication burden and better align treatment with current care goals, while also addressing barriers that often impede these decisions in clinical practice.
Read the article:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12790966/?
DIGEST