Case Management Activities in Palliative Care for Cancer: A Scoping Review

Resumen

Introduction. Case Managers have long been deployed in palliative cancer care, but the heterogeneous nature of this role makes it difficult to gather evidence of its effectiveness and consequently foster standardized implementation by health policies. We explore the models, characteristics, and specific activities that Palliative Care Case Managers perform in oncology.

Methods. This scoping review was performed and reported according to the PRISMA-ScR checklist. Seven electronic databases (Cochrane Library, PubMed, Scopus, EMBASE, CINAHL, PsycINFO, and Web of Science) and Google Scholar, were searched for relevant papers until June 2024. Studies were included if they reported Case Management interventions for patients with cancer receiving palliative care. Charted data included study characteristics, Case management activities, Case management models, and intervention delivery.

Results. Twelve studies were included. A total of 38 activities emerged from the analysis and five themes were identified across them, including “Information, education and self-management”, “Support and counselling”, “Patient centredness”, “Network”, “Quality of care”. In all studies, the CMs role was performed by a nurse, with a specific experience or training in palliative care or oncology, with multidisciplinary teams acting as support or as possible consultants. Activities were provided by phone, by hospital visits, via homecare visits or a combination of all above models. Only seven studies reported outcome measures related to patient or health care system dimensions, while data regarding case load were reported in four studies. Research gaps include impact and feasibility methodology, informations about referral criteria for case management service, the satisfaction of patients and health care providers with the service, barriers and facilitators, and the investigation of the most suitable professional to perform the case management role.

Discussion and Conclusions. It is important to standardize the description of case management activities in the literature and establishing a shared definition of this role in diverse contexts, including its modes of multidisciplinary integration. A standardized reporting framework for studies on this topic is needed to guide future research. Further studies are needed to describe case management activities in palliative care for cancer. This is the first scoping review to systematically explore and summarize Case Management activities and models in Palliative Care for Cancer. These findings will support nursing organizational policies in the design of Case Management services in Cancer Palliative Care, address key issues in case management practice and proposing examples for personalized implementation of this service across clinical contexts. Nursing researchers can foster studies on this topic to improve the body of evidence at our disposal.