Assessment
Initial assessments of the effects and value of the pathway were largely positive. A 2003 study published in the International Journal of Palliative Nursing found that nurses saw the pathway as having a generally positive effect on patients and their families. A 2006 study published in the same journal found that, despite some "initial skepticism", the doctors and nurses who were interviewed saw the approach as having a valuable place in hospice care, though its use on 'dying' patients on general wards was not addressed. A multi-centre study was published in 2008 in the Journal of Palliative Medicine that found that nurses and relatives thought that the approach improved the management of patients' symptoms, but did not significantly improve communication. The authors concluded that they "consider LCP use beneficial for the care for dying patients and their family."
A 2009 study published in Journal of Pain and Symptom Management studied the impact of the pathway on the end-of-life care of over three hundred patients and found that it produced a large decrease in the use of medication that might shorten life and increased patients' involvement in their medication and care. A 2009 survey of 42 carers providing the pathway was published in the Journal of Palliative Medicine, it found that 84% were "highly satisfied" with the approach and that it enhanced patient dignity, symptom management and communication with families.
Jonathan Potter, the director of the Clinical Effectiveness and Evaluation Unit of the Royal College of Physicians stated in 2009 that their audits showed that "where the Liverpool Care Pathway for the dying patient (LCP) is used, people are receiving high quality clinical care in the last hours and days of life". The 2009 audit looked at end-of-life care in 155 hospitals, and examined the records of about 4,000 patients. A major criticism of this study was that each of the participating hospitals was only asked to submit datasets from 30 patients: arguably, the study was heavily biased by the ability to 'cherry-pick' the most favourable datasets, and the lack of availability of all data for independent scrutiny and objective assessment.
Version 12 of the LCP was launched on 8 December 2009, after over two years of consultation. Amongst other revisions, it includes new decision-making support on whether or not to start the LCP; highlighted guidance to review the appropriateness of continuing on the pathway at any time if concern is expressed by either the patient, a relative, or a team member; and new prompts to support decisions on artificial nutrition and hydration. An editorial in the BMJ judged the new release did "much to tackle recent criticisms".
Read more about this topic: Liverpool Care Pathway For The Dying Patient
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