Background: Supportive and palliative care for people with cancer is being produced for National Guidance in the UK. In the current climate of evidence-based medicine this Guidance is underpinned by research evidence. Aim: To appraise the evidence available on supportive and palliative care with the aim of determining how the research base can function as a direct resource for service delivery.
Method: Relevant literature was identified through computerised databases and bibliography searches. The methodological quality of the studies was assessed according to the standard grading system of the Clinical Outcomes Group.
Results: 340 papers were reviewed on 12 topic areas. There were gaps in research evidence on the effectiveness of services, concentrated in topic areas such as complementary therapies, user involvement, spiritual support, support for carers, co-ordination of care, bereavement care, and social support. Other areas had ample evidence of effectiveness. However, the disparity of objectives of interventions that do not build on previous research or groups of interventions producing conflicting results still make it difficult to draw conclusions about the best models of care.
Conclusions: The conventional method of focusing on strong evidence appeared not to be appropriate. A more inclusive view of what constitutes evidence is needed to answer the complex questions in palliative care. This area of research requires the integration of literature from a variety of sources: RCTs, studies from qualitative or mixed-methods design, models deriving from local practice and expert opinion, combined with the rigorous framework of systematic review methodology.