End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)

Coffey, Michael; Edwards, Deborah; Anstey, Sally; Gill, Paul; Mann, Mala; Meudell, Alan; Hannigan, Ben

doi:10.1136/bmjopen-2021-053223

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End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)

Michael Coffey

, Deborah Edwards

, Sally Anstey

, Paul Gill

, Mala Mann

, Alan Meudell

, Ben Hannigan

BMJ Open, Volume: 12, Issue: 2, Start page: e053223

Swansea University Author: Michael Coffey

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DOI (Published version): 10.1136/bmjopen-2021-053223

Abstract

Objectives People with severe mental illness (SMI) have significant comorbidities and reduced life expectancy. The objective of the review reported in this paper was to synthesise material from case studies relating to the organisation, provision and receipt of care for people with SMI who have an e...

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Published in:	BMJ Open
ISSN:	2044-6055 2044-6055
Published:	BMJ 2022
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The objective of the review reported in this paper was to synthesise material from case studies relating to the organisation, provision and receipt of care for people with SMI who have an end-of-life (EoL) diagnosis.Design Systematic review and thematic synthesis.Data sources MEDLINE, PsycINFO, EMBASE, HMIC, AMED, CINAHL, CENTRAL, ASSIA, DARE and Web of Science from inception to December 2019. Supplementary searching for additional material including grey literature along with 62 organisational websites.Results Of the 11 904 citations retrieved, 42 papers reporting 51 case studies were identified and are reported here. Twenty-five of the forty-two case study papers met seven, or more quality criteria, with eight meeting half or less. Attributes of case study subjects included that just over half were men, had a mean age of 55 years, psychotic illnesses dominated and the EoL condition was in most cases a cancer. Analysis generated themes as follows diagnostic delay and overshadowing, decision capacity and dilemmas, medical futility, individuals and their networks, care provision.Conclusions In the absence of high-quality intervention studies, this evidence synthesis indicates that cross disciplinary care is supported within the context of established therapeutic relationships. Attention to potential delay and diagnostic overshadowing is required in care provision. 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spelling	2022-11-21T12:17:33.2821653 v2 59446 2022-02-23 End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study) 12112bd2ce15561464c98607f3a8eb0b 0000-0002-0380-4704 Michael Coffey Michael Coffey true false 2022-02-23 PHAC Objectives People with severe mental illness (SMI) have significant comorbidities and reduced life expectancy. The objective of the review reported in this paper was to synthesise material from case studies relating to the organisation, provision and receipt of care for people with SMI who have an end-of-life (EoL) diagnosis.Design Systematic review and thematic synthesis.Data sources MEDLINE, PsycINFO, EMBASE, HMIC, AMED, CINAHL, CENTRAL, ASSIA, DARE and Web of Science from inception to December 2019. Supplementary searching for additional material including grey literature along with 62 organisational websites.Results Of the 11 904 citations retrieved, 42 papers reporting 51 case studies were identified and are reported here. Twenty-five of the forty-two case study papers met seven, or more quality criteria, with eight meeting half or less. Attributes of case study subjects included that just over half were men, had a mean age of 55 years, psychotic illnesses dominated and the EoL condition was in most cases a cancer. Analysis generated themes as follows diagnostic delay and overshadowing, decision capacity and dilemmas, medical futility, individuals and their networks, care provision.Conclusions In the absence of high-quality intervention studies, this evidence synthesis indicates that cross disciplinary care is supported within the context of established therapeutic relationships. Attention to potential delay and diagnostic overshadowing is required in care provision. The values and preferences of individuals with severe mental illness experiencing an end-of-life condition should be recognised. Journal Article BMJ Open 12 2 e053223 BMJ 2044-6055 2044-6055 22 2 2022 2022-02-22 10.1136/bmjopen-2021-053223 COLLEGE NANME Public Health COLLEGE CODE PHAC Swansea University SU Library paid the OA fee (TA Institutional Deal) This work was supported by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme, grant number HS&DR 17/100/15 2022-11-21T12:17:33.2821653 2022-02-23T16:15:48.1192089 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Michael Coffey 0000-0002-0380-4704 1 Deborah Edwards 0000-0003-1885-9297 2 Sally Anstey 0000-0003-2295-3761 3 Paul Gill 0000-0003-4056-3230 4 Mala Mann 0000-0002-2554-9265 5 Alan Meudell 0000-0001-8138-4744 6 Ben Hannigan 0000-0002-2512-6721 7 59446__22448__ec0cb8bc7c494e2b97e87a594f744f98.pdf BMJ Open Published.pdf 2022-02-23T16:21:15.2107337 Output 680914 application/pdf Version of Record true © Author(s) (or their employer(s)) 2022. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license true eng https://creativecommons.org/licenses/by/4.0/
title	End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)
spellingShingle	End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study) Michael Coffey
title_short	End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)
title_full	End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)
title_fullStr	End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)
title_full_unstemmed	End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)
title_sort	End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)
author_id_str_mv	12112bd2ce15561464c98607f3a8eb0b
author_id_fullname_str_mv	12112bd2ce15561464c98607f3a8eb0b_***_Michael Coffey
author	Michael Coffey
author2	Michael Coffey Deborah Edwards Sally Anstey Paul Gill Mala Mann Alan Meudell Ben Hannigan
format	Journal article
container_title	BMJ Open
container_volume	12
container_issue	2
container_start_page	e053223
publishDate	2022
institution	Swansea University
issn	2044-6055 2044-6055
doi_str_mv	10.1136/bmjopen-2021-053223
publisher	BMJ
college_str	Faculty of Medicine, Health and Life Sciences
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hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
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department_str	School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
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description	Objectives People with severe mental illness (SMI) have significant comorbidities and reduced life expectancy. The objective of the review reported in this paper was to synthesise material from case studies relating to the organisation, provision and receipt of care for people with SMI who have an end-of-life (EoL) diagnosis.Design Systematic review and thematic synthesis.Data sources MEDLINE, PsycINFO, EMBASE, HMIC, AMED, CINAHL, CENTRAL, ASSIA, DARE and Web of Science from inception to December 2019. Supplementary searching for additional material including grey literature along with 62 organisational websites.Results Of the 11 904 citations retrieved, 42 papers reporting 51 case studies were identified and are reported here. Twenty-five of the forty-two case study papers met seven, or more quality criteria, with eight meeting half or less. Attributes of case study subjects included that just over half were men, had a mean age of 55 years, psychotic illnesses dominated and the EoL condition was in most cases a cancer. Analysis generated themes as follows diagnostic delay and overshadowing, decision capacity and dilemmas, medical futility, individuals and their networks, care provision.Conclusions In the absence of high-quality intervention studies, this evidence synthesis indicates that cross disciplinary care is supported within the context of established therapeutic relationships. Attention to potential delay and diagnostic overshadowing is required in care provision. The values and preferences of individuals with severe mental illness experiencing an end-of-life condition should be recognised.
published_date	2022-02-22T04:16:45Z
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score	11.013686

End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)

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