[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-443634-105":59,"doc-detail-443634-en":134},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":127,"head_meta":129,"extra_data":131,"updated_unix":133},105,"en","the-inverse-palliative-care-law-in-advanced-lung-disease-a-mixed-methods-systematic-review-and-meta-analysis","The inverse palliative care law in advanced lung disease - a mixed-methods systematic review and meta-analysis","","People from socioeconomically deprived backgrounds face higher risk of advanced lung disease and heavier symptom burden, yet equitable access to and experience of palliative care remains uncertain. A mixed-methods systematic review synthesized evidence on socioeconomic inequalities in access, receipt, preference for, and experience of palliative care among advanced lung disease patients. Searches covered four databases up to March 28, 2025, combining meta-analysis and narrative synthesis using established quality and evidence-grading approaches.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-inverse-palliative-care-law-in-advanced-lung-disease-a-mixed-methods-systematic-review-and-meta-analysis/443634/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-inverse-palliative-care-law-in-advanced-lung-disease-a-mixed-methods-systematic-review-and-meta-analysis/443634.png","ImageObject",300,407,{"name":92,"@type":93},"\tJames","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study trying to determine about palliative care in advanced lung disease?","Question",{"text":112,"@type":113},"The review aimed to synthesize evidence on socioeconomic inequalities in access, receipt, preference for, and experience of palliative care among people with advanced lung disease.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the researchers conduct the review?",{"text":117,"@type":113},"They performed a mixed-methods systematic review, searching MEDLINE, Embase, PsychINFO, and CINAHL up to March 28, 2025, assessing study quality with the Mixed Methods Appraisal Tool and combining meta-analysis and narrative synthesis.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the meta-analysis show about palliative care access by socioeconomic position?",{"text":121,"@type":113},"In six studies, people with lung cancer in the lowest SEP group were 18% less likely to receive palliative care than those in the highest group.",{"name":123,"@type":110,"acceptedAnswer":124},"What qualitative barriers were identified for access to pain relief and oxygen?",{"text":125,"@type":113},"Financial hardship and insurance barriers were reported as limiting access to pain relief and oxygen.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},443634,1790794418,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149,"preview_page_count":4},2336474466412,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Articles  \nThe inverse palliative care law in advanced lung disease: a mixed-methods systematic review and meta-analysis  \nDonna Wakefield,a,∗ Tara Dehpour,a Clare Bambra,b Joanna Davies,c Fliss E. M. Murtagh,a and Jonathan Koffmana  \naWolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, UK  \nbPopulation Health Science Institute, Faculty of Medical Science, Newcastle University, Newcastle-Upon-Tyne, UK  \ncCicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Faculty of Nursing, Midwifery and Palliative Care, King’s College London, UK  \nSummary  \nBackground People from socioeconomically deprived backgrounds are at greater risk of developing lung disease and having a higher symptom burden. It remains unclear whether they have equitable access to and experience of palliative care. Therefore, we aimed to synthesise evidence on socioeconomic inequalities in access, receipt of, preference for, and experience of palliative care among people with advanced lung disease.  \nMethods Mixed-methods systematic review, searching four databases (MEDLINE, Embase, PsychINFO, CINAHL) from inception to March 28, 2025. We included studies that reported on socioeconomic position and palliative care in advanced lung disease (lung cancer, mesothelioma, chronic obstructive pulmonary disease, interstitial lung disease) . Study quality was assessed using the Mixed Methods Appraisal Tool. Both meta-analysis (using a random effects model with I2 to assess heterogeneity, sensitivity analysis and GRADE of evidence) and narrative synthesis were performed. PROSPERO CRD42024546502 .  \nFindings Of 10,572 records, 54 studies met inclusion criteria (4.2 million participants) . Meta-analysis of six studies showed people with lung cancer in the lowest SEP group were 18% less likely to receive palliative care than those in the highest (OR 0.82, 95% CI 0.75–0.90, I2 = 93.9%) . GRADE of evidence was assessed as moderate. Qualitative findings identified financial hardship and insurance barriers limited access to pain relief and oxygen. Few studies considered multiple demographic characteristics, but those that did reported worse access among ethnic minorities and rural populations.  \nInterpretation This review provides novel evidence of how the inverse care law operates in advanced lung disease. People from lower socioeconomic groups are significantly less likely to access palliative care, despite greater need. There is an urgent need for equity-focused research and policy interventions, co-produced with underserved communities that account for intersecting social disadvantages.  \nFunding National Institute for Health and Care Research.  \nCopyright © 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)).  \nKeywords: Inequalities; Lung cancer; Mesothelioma; COPD; ILD; Palliative care  \nIntroduction  \nPeople with life-limiting lung disease share a commonality ofa progressive illness associated with a high symptom burden.1–4 Non-malignant lung diseases (e.g. chronic obstructive pulmonary disease [COPD], interstitial lung disease [ILD]) are associated with burdensome symptoms and unmet needs similar to those with lung malignancy (lung cancer, pleural mesothelioma), which are challenging to address to improve quality of life.5–7 Lung cancer is the leading cause of  \ncancer-related death worldwide, accounting for 18% of all cancer deaths globally.8 COPD global incidence is estimated to be 480 million cases, projected to increase to 592 million cases by 2050.9 Morbidity and mortality from lung disease are not evenly distributed across society. People living in more socioeconomically deprived areas are more likely to experience lifelimiting lung disease compared to those in less deprived areas (e.g. 174% increase in the incidence of lung cancer10 and double the prevalence of CO","cbCaivlaJOum2CeP","https://ap.wps.com/l/cbCaivlaJOum2CeP","pdf",1651138,13,"English","# Summary\n## Background\n## Methods\n## Findings\n## Interpretation\n# Research in context\n## Evidence before this study\n## Added value of this study","[{\"question\":\"What was the study trying to determine about palliative care in advanced lung disease?\",\"answer\":\"The review aimed to synthesize evidence on socioeconomic inequalities in access, receipt, preference for, and experience of palliative care among people with advanced lung disease.\"},{\"question\":\"How did the researchers conduct the review?\",\"answer\":\"They performed a mixed-methods systematic review, searching MEDLINE, Embase, PsychINFO, and CINAHL up to March 28, 2025, assessing study quality with the Mixed Methods Appraisal Tool and combining meta-analysis and narrative synthesis.\"},{\"question\":\"What did the meta-analysis show about palliative care access by socioeconomic position?\",\"answer\":\"In six studies, people with lung cancer in the lowest SEP group were 18% less likely to receive palliative care than those in the highest group.\"},{\"question\":\"What qualitative barriers were identified for access to pain relief and oxygen?\",\"answer\":\"Financial hardship and insurance barriers were reported as limiting access to pain relief and oxygen.\"}]","The inverse palliative care law in advanced lung disease - a mixed-methods systematic review and meta-analysis | PDF",1790704716,33]