MORECare - Methods for evaluating service delivery models for end of life care (EoLC): development of best practice guidance

* Funded by the UK Medical Research Council (MRC) and National Institutes of Health Research (NIHR)


Best practice to develop and evaluate models of service delivery and complex interventions in palliative and end of life care

 Latest News: MORECare e-learning is currently being developped

Despite being a core business of medicine, end of life care (EoLC) is neglected. It is hampered by research that is difficult to conduct with no common standards. We aimed to develop evidence-based guidance on the best methods for the design and conduct of research on EoLC to further knowledge in the field.


MORECare built on the Medical Research Council guidance on the development and evaluation of complex interventions. We conducted systematic literature reviews, transparent expert consultations (TEC) involving consensus methods of nominal group and online voting, and stakeholder workshops to identify challenges and best practice in EoLC research, including: participation recruitment, ethics, attrition, integration of mixed methods, complex outcomes and economic evaluation.

We synthesised all findings to develop a guidance statement – the MORECare statement on the best methods to research EoLC. The statement provides a first step in setting common, much needed standards for evaluative research in EoLC and may be used alongside existing statements for reporting studies. The statement is relevant to those undertaking research, trainee researchers, research funders, ethical committees and editors.


The statement provides 36 best practice solutions for research evaluating services and treatments in EoLC to improve study quality and set the standard for future research. Key recommendations: Show/Hide


MORECare statement:

36 best practice solutions to develop and evaluate complex interventions in palliative and EoLC: [Link to Paper] [Reference


Methods Review

MRC guidance on developing and evaluating complex interventions (NIHR School for Social Care Research Methods Review): Application to research on palliative and end of life care. [Link to full Review] [Reference]

aSystematic reviews


bTransparent Expert Consultations


MORECare Elearning: MORECare Elearning is currently being developed and will be piloted during the autumn 2014. We anticipate six modules covering the following areas1) introduction to complex interventions and MRC framework  ; 2) Selection of outcome measures; 3) Use of outcome measure; 4) Missing Data, attrition and response shift in palliative care; 5) Mixed methods; 6) Ethics. For more information or questions, please contact Hamid Benalia

We would like to thank the workshop participants for their time and contributions to developing the guidance statement Show/Hide names

The Methods Of Researching End of Life Care (MORECare) is a collaboration between: Show/Hide


MORECare was funded by the NIHR and managed by the MRC as part of the Methodology Research Programme (MRP) (number: G0802654/1). MORECare aimed to identify, appraise and synthesise ‘best practice’ methods to develop and evaluate palliative and EoLC, particularly focusing on complex service-delivery interventions and reconfigurations. Principal investigator: Irene J Higginson. Co-principal investigator: Chris Todd. The members of MORECare are: Co-investigators - Peter Fayers, Gunn Grande, Richard Harding, Matthew Hotopf, Penney Lewis, Paul McCrone, Scott Murray, Myfanwy Morgan; Project advisory group - Massimo Costantini, Steve Dewar, John Ellershaw, Claire Henry, William Hollingworth, Philip Hurst, Tessa Ing, Karl Lorenz, Rajan Madhok, Jane Maher, Irene McGill, Elizabeth Murray, Ann Netten, Alicia O'Cathain, Sheila Payne, Roland Petchey, Wendy Prentice, Deborah Tanner and Celia A Taylor; Researchers - Hamid Benalia, Catherine J Evans, Marjolein Gysels, Nancy J Preston and Vicky Short. Morag Farquhar was supported by a Macmillan Cancer Support Post-Doctoral Fellowship. Irene J Higginson is an NIHR Senior Investigator.