Members of the PaCE group currently lead on the following studies:
Understanding Inequalities in Palliative Care for Older People and Providing for Future Need (UP) Study (Funding: Health Service Executive)
The difficulties faced by seriously-ill older people are widely documented, as are the long-term policy challenges posed by population ageing and rising costs. A key recent policy document, the Sláintecare report, recognises these challenges and identifies universal palliative care (PC) as a key goal for Ireland’s health system.
UP is a mixed methods study that aims to generate evidence on (i) current and future PC needs in Ireland; (ii) the magnitude and drivers of financial hardship among the seriously-ill and their households; and (iii) what is required to effect change and deliver on equitable provision.
The International Access, Rights and Empowerment Plus (IARE II) Study (Funding: The Atlantic Philanthropies)
The IARE II study is a prospective cohort study analysing healthcare experience and utilisation among older adults in three cities: Dublin, Ireland; London, UK; and New York, US. Our collaborating centres are Cicely Saunders Institute, King’s College London and Icahn School of Medicine at Mount Sinai.
It follows on directly from the prior IARE I study conducted by the same investigators in the same locations, and applying where possible prior methodological approaches. The IARE I study focused on patients and families able to gain access to palliative care mainly within acute hospital settings. We need to learn more about barriers to access and outcomes experienced by patients with chronic disease, rather than only cancer.
By investigating the experiences and preferences of this yet unstudied group in IARE II we will gain sufficient knowledge to inform policy and practice, eradicate access barriers, and begin to provide the care patients require.
Community specialist palliative care (CSPC) provision in Ireland (Funding: The Research Collaborative in Quality and Patient Safety)
There is considerable variation in the way in which palliative care services are provided across Ireland. In particular, there is variation in the way that community palliative care (or ‘home care’) services are provided. This study aims to examine three community palliative care services in North and South Dublin and in Sligo in order to try and understand where the differences between services lie, and to find out whether there are any advantages or disadvantages to the different kinds of services.
Our research approach is three-fold. First, we speak to key informants in each of the organisations to gain an understanding of how their service is organised and run. Secondly, we ask patients with cancer who receive community palliative care whether they would be willing to complete a face-to-face interview that asks them about how they are feeling, what their care needs are, what healthcare services they are receiving and how well are the services meeting their needs. Finally, we conduct a survey of bereaved relatives of patients with cancer who received community palliative care services.
We are also contributing economic expertise to studies of serious illness with the following partners:
The Irish Longitudinal Study on Ageing, Ireland (TILDA)
The Intellectual Disability Supplement to TILDA, Ireland (IDS TILDA)
St Vincent’s University Hospital, Dublin, Ireland
Baylor Research Institute, Texas, USA
Harvard University, Massachusetts, USA
Icahn School of Medicine at Mount Sinai, New York, USA
King Hussein Cancer Center, Amman, Jordan
Oxford University Hospitals Foundation Trust, England
Virginia Commonwealth University, Virginia, USA