C-TAC recently submitted comments advocating for more research on services to support bereaved persons. Comments were submitted on a review by the Agency for Healthcare Research and Quality (AHRQ) on the effectiveness of the evidence to support such services.
C-TAC is interested in this topic as our members care for those who need these important services. However, access to these services is limited as they are not paid for by payers, and the only requirement for them currently is in the Medicare Hospice Benefit.
While the AHRQ review was comprehensive and up-to-date, unfortunately, the quality of evidence they found was insufficient. This makes it impossible for policy makers to know which interventions to promote or pay for.
Here are the toplines on the evidence from the review’s Executive Summary:
• Only a small body of evidence has addressed screening approaches. There was insufficient evidence for evidence statements regarding patient experience, validity and diagnostic accuracy of the screening tool or approach, or adverse events associated with the screening process.
• A small body of evidence has addressed the identification of bereaved people at risk or with grief disorder; and reports positive diagnostic accuracy of the Inventory of Complicated Grief (ICG). However, none of the identified studies used a DSM or ICD grief disorder diagnosis as the reference standard.
• A substantial body of evidence addressed psychotherapy, pharmacotherapy, expert-facilitated support groups, peer support, self-help approaches, and other interventions (writing and music, comprehensive support, integrative medicine and CAM) but the strength of evidence (SoE) was limited for many interventions. No study evaluated spiritual counselling.
• We found moderate SoE for the beneficial effect of psychotherapy on severity of grief disorder, grief symptoms, and depression symptoms and expert-facilitated support groups on grief symptoms and depression symptoms.
• There is a small body of evidence reporting on patients diagnosed with grief disorders; with low SoE for the beneficial effect of psychotherapy on grief disorder and grief symptoms.
AHRQ is a federal agency that conducts and disseminates information on health care services. This review is an example of the kind of work they do. They also provide funding for research and C-TAC hopes they will consider future funding for bereavement services research to increase access to these needed services.
