The impact of climate change on hospice and palliative medicine: A scoping and narrative review - 25/06/24

Doi : 10.1016/j.joclim.2024.100323 
David Harris a, , Bhargavi Chekuri b, Aldebra Schroll c, Nisha Shah d, Laadi Swende e, Collins Uzuegbu a, Pamela Young a
a Department of Palliative and Supportive Care, Taussig Cancer Institute, Cleveland Clinic, CA53, 9500 Euclid Ave, Cleveland, OH 44195, United States 
b University of Colorado School of Medicine, Aurora, Colorado, United States 
c Butte Home Health and Hospice, Chico, California, United States 
d Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States 
e National Health Insurance Authority, Federal Medical Centre, Makurdi, Nigeria 

Corresponding author.

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Highlights

Most articles are descriptive or offered recommendations for disaster preparedness.
Common barriers to patient care include physical access to patients, lack of power for medical equipment, and provider distress.
Identified future directions for research on the intersection of climate change and the field of hospice and palliative medicine.

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Abstract

Introduction

Climate change's severe impact on human health is becoming increasingly evident, particularly for vulnerable populations with serious illnesses. Climate-related extreme weather events are expected to increase demand for hospice and palliative care due to rising respiratory illnesses, heat-related issues, waterborne diseases, and aggravated chronic conditions. Our scoping review aimed to investigate the existing literature on climate change's impact on hospice and palliative medicine (HPM).

Methods

We conducted a comprehensive literature search across various databases (e.g., Medline, EMbase, Web of Science, and Cochrane) using predefined climate change and HPM terms, resulting in 382 records. Following predetermined inclusion and exclusion criteria, 44 articles were selected for full-text review, and 20 were included for final analysis. In light of the limited literature on climate change's impact on HPM, we also sought narratives from HPM practitioners from across the world on their experiences in a changing climate.

Results

Six major themes emerged: 1) The impact of climate change on HPM in low-income countries; 2) Descriptive pieces on climate change, climate disasters, and HPM; 3) Morbidity and mortality after climate disasters in the seriously ill population; 4) Discussion of euthanasia during climate disasters; 5) Recommendations and frameworks for disaster response in the field of HPM; 6) Carbon footprint of hospices. Additionally, narratives from HPM practitioners highlighted the disruptive effects of climate disasters on seriously ill patients and their caregivers as disasters caused care interruptions, reduced access to crucial health infrastructure, exacerbations of illness, accelerated disease progression, and increased morbidity and mortality.

Conclusion

Existing research on climate change's impact on HPM is primarily anecdotal and descriptive, with a focus on climate-related disasters. Narratives from HPM practitioners worldwide underscore the disproportionate impact of climate disasters on seriously ill patients. Further research is necessary to comprehensively understand climate's intricate effects on HPM and to assess adaptable, mitigative, and resilient solutions against its adverse impacts.

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Vol 18

Article 100323- juillet 2024 Retour au numéro
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