PPF44 Interventions that reduce or prevent emergency hospital admissions among adults with a terminal condition in the last year of life: a rapid scoping review

<h3>Background</h3> The End-of-Life Transformation Programme in Wales investigates the experiences of people using emergency services in their final year of life, aiming to address systemic challenges and improve palliative and end of life care. Evidence shows care quality varies by location, condition, and personal characteristics. Currently, 1 in 14 patients who attend the emergency department are in their last year of life1. Many of these visits result in hospital admissions which not only negatively impact patient experience of care but are also costly to the healthcare system. <h3>Aim</h3> This review aims to map the evidence on interventions that reduce or prevent emergency hospital admissions among adults with a terminal condition in the last year of life. <h3>Methods</h3> A scoping review was carried out following the Palliative Care Evidence Review Service (PaCERS)2 methods and utilising the JBI methodology for scoping reviews3. Four bibliographic databases were searched for relevant papers published between 2015-2025. Reference lists of systematic reviews were checked for appropriate studies. In addition, the AI research assistant ‘Elicit’ was used to get an overview of missing data. The screening process was performed by two independent researchers with the use of Rayyan. Data were extracted and presented in a tabular form. <h3>Results</h3> Of 558 articles identified, 47 studies met the inclusion criteria. They were from the USA (12), Australia (11), the UK (8) and Canada (7). Seven categories of interventions were identified, including community care, timely referral to palliative care services and emergency response team providing care at home. <h3>Discussion</h3> The review shows improved access to community palliative care services alongside better integration and co-ordination of care results in improved patient care. The findings will feed into the National Programme Board for Palliative and End of Life Care and policy recommendations for the next Welsh General Election and Programme for Government.