Palliative care needs in adults with chronic disease: a systematic review of measuring instruments

BACKGROUND: The need for palliative care continues to grow, however, early identification of patients with these needs remains challenging. Despite the emergence of new instruments, assessment tools applicable to chronic diseases remain scarce, targeting specific risks and populations. This study aims to review the current evidence on the properties of instruments used to identify and measure palliative care needs in adults with chronic diseases. METHODS: A systematic review was developed following the Joanna Briggs Institute methodology, adhering to the PRISMA-COSMIN guidelines for Outcome Measurement Instruments (OMIs), and registered on Prospero (CRD42024519532). Searches were conducted in Medline, CINAHL Complete, Cochrane, grey literature, and manual sources, between March and April 2024, applying the following eligibility criteria: studies that encompass palliative care measurement instruments in adult patients with chronic conditions, within acute or community care settings, with no restrictions on language or publication period. Two authors independently screened the studies, using Rayyan for data selection and the COSMIN tool to assess instrument quality. RESULTS: Of the 4769 studies screened, 11 met the inclusion criteria. The majority of the 11 instruments can be applied across various contexts, targeting different populations, including those with organ failure, dementia, and frailty. The tools were based on a wide range of both general and specific indicators, primarily dichotomous. The IPOS achieved the highest score in psychometric quality. CONCLUSIONS: This review supports healthcare professionals in their efforts to identify and measure palliative care needs in adults with chronic diseases. Further research should focus on the applicability of these instruments across various healthcare settings and populations to enhance their psychometric quality.