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Palliative Medicine

Katherine E Sleeman, Javiera Leniz, Irene J Higginson, Katherine Bristowe
BACKGROUND: Prioritisation of end-of-life care by policymakers has been the subject of extensive rhetoric, but little scrutiny. In England, responsibility for improving health and care lies with 152 regional Health and Wellbeing Boards. AIM: To understand the extent to which Health and Wellbeing Boards have identified and prioritised end-of-life care needs and their plans for improvement. DESIGN: Qualitative documentary analysis of Health and Wellbeing Strategies...
July 1, 2018: Palliative Medicine
Kelly Sebring, Jo Shattuck, Julie Berk, Isabel Boersma, Stefan Sillau, Benzi M Kluger
BACKGROUND: There is increasing interest in applying palliative care approaches for patients with Parkinson's disease. Methodological studies are needed to validate palliative care outcome measures for Parkinson's disease to build this evidence base. As many patients with Parkinson's disease have cognitive and/or communication issues, proxy outcome measures may improve the inclusivity and relevance of research. AIM: To assess the validity of proxy caregiver reports for several potential palliative care outcome measures...
July 1, 2018: Palliative Medicine
Kirstine Skov Benthien, Mathilde Adsersen, Morten Aagaard Petersen, Eva Soelberg Vadstrup, Per Sjøgren, Mogens Groenvold
BACKGROUND: The use of chemotherapy in the last 14 days of life should be as low as possible. AIM: To study the factors related to the use of chemotherapy in the last 14 days of life and the factors related to concurrent antineoplastic treatment and specialized palliative care. DESIGN: This was a population-based cohort study. The data were collected from the Danish Register of Causes of Death, the Danish National Patient Register, and the Danish Palliative Care Database...
July 1, 2018: Palliative Medicine
Emily J Martin, Christina L Vaughan, Rabia Atayee, Jeremy M Hirst, Kaitlyn O'Donnell, Kyle P Edmonds
BACKGROUND: While opioid-induced myoclonus is well described, there are limited reports of opioid-induced chorea. Here we present the first case of chorea as a manifestation of opioid neurotoxicity due to hydromorphone. CASE PRESENTATION: A 20-year-old woman presenting with fevers and cutaneous lesions was diagnosed with hemophagocytic lymphohistiocytosis secondary to primary cutaneous lymphoma. Surgical resection of a cutaneous lesion was complicated by severe postoperative pain requiring rapid opioid dose escalation...
July 1, 2018: Palliative Medicine
Tinne Smets, Lara Pivodic, Ruth Piers, H Roeline W Pasman, Yvonne Engels, Katarzyna Szczerbińska, Marika Kylänen, Giovanni Gambassi, Sheila Payne, Luc Deliens, Lieve Van den Block
BACKGROUND: The provision of high-quality palliative care in nursing homes (NHs) is a major challenge and places demands on the knowledge and skills of the staff. AIM: This study assesses the palliative care knowledge of staff in NHs in Europe. DESIGN: Cross-sectional study using structured survey Setting/participants: Nurses and care assistants working in 322 representative samples of NHs in Belgium, the Netherlands, England, Finland, Poland and Italy...
July 1, 2018: Palliative Medicine
(no author information available yet)
10th World Research Congress of the European Association for Palliative Care (EAPC). Palliative Medicine, May 2018 32:1_suppl 3-330, doi: 10.1177/0269216318769196.
July 1, 2018: Palliative Medicine
Wan Lavender She, Holly G Prigerson
No abstract text is available yet for this article.
June 1, 2018: Palliative Medicine
Lucy Walker, Karen Neoh, Hazel Gilkes, Clare Rayment
BACKGROUND: Corneal transplantation can lead to sight restoration, but globally there is a donor shortage. Many palliative care patients can donate their corneas but think they are ineligible due to comorbidities. Healthcare professionals are reluctant to broach the topic, but studies have shown that relatives would be upset if they were not offered this chance. There is no existing research involving patients. AIM: To understand the views and feelings of patients in palliative care settings towards corneal donation and explore their opinions regarding the timing of its discussion...
June 1, 2018: Palliative Medicine
Dominique Wakefield, Jo Bayly, Lucy Ellen Selman, Alice M Firth, Irene J Higginson, Fliss Em Murtagh
BACKGROUND: Patient empowerment, defined as 'a process through which people gain greater control over decisions and actions affecting their health' (World Health Organization) is a key theme within global health and social care strategies. The benefits of incorporating empowerment strategies in care are well documented, but little is known about their application or impact for patients with advanced, life-limiting illness(s). AIM: To identify and synthesise the international evidence on patient empowerment for adults with advanced, life-limiting illness(s)...
June 1, 2018: Palliative Medicine
M Zwakman, L J Jabbarian, Jjm van Delden, A van der Heide, I J Korfage, K Pollock, Jac Rietjens, J Seymour, M C Kars
BACKGROUND: Advance care planning is seen as an important strategy to improve end-of-life communication and the quality of life of patients and their relatives. However, the frequency of advance care planning conversations in practice remains low. In-depth understanding of patients' experiences with advance care planning might provide clues to optimise its value to patients and improve implementation. AIM: To synthesise and describe the research findings on the experiences with advance care planning of patients with a life-threatening or life-limiting illness...
June 1, 2018: Palliative Medicine
Catherine Rl Brown, Amy T Hsu, Claire Kendall, Denise Marshall, Jose Pereira, Michelle Prentice, Jill Rice, Hsien-Yeang Seow, Glenys A Smith, Irene Ying, Peter Tanuseputro
BACKGROUND: To enable coordinated palliative care delivery, all clinicians should have basic palliative care skill sets ('generalist palliative care'). Specialists should have skills for managing complex and difficult cases ('specialist palliative care') and co-exist to support generalists through consultation care and transfer of care. Little information exists about the actual mixes of generalist and specialist palliative care. AIM: To describe the models of physician-based palliative care services delivered to patients in the last 12 months of life...
June 1, 2018: Palliative Medicine
Rossana De Palma, Daniela Fortuna, Sarah E Hegarty, Daniel Z Louis, Rita Maria Melotti, Maria Luisa Moro
BACKGROUND: Multiple studies demonstrate substantial utilization of acute hospital care and, potentially excessive, intensive medical and surgical treatments at the end-of-life. AIM: To evaluate the relationship between the use of home and facility-based hospice palliative care for patients dying with cancer and service utilization at the end of life. DESIGN: Retrospective, population-level study using administrative databases. The effect of palliative care was analyzed between coarsened exact matched cohorts and evaluated through a conditional logistic regression model...
June 1, 2018: Palliative Medicine
Sarah Hoare, Michael P Kelly, Larissa Prothero, Stephen Barclay
BACKGROUND: Hospital admissions for end-of-life patients, particularly those who die shortly after being admitted, are recognised to be an international policy problem. How patients come to be transferred to hospital for care, and the central role of decisions made by ambulance staff in facilitating transfer, are under-explored. AIM: To understand the role of ambulance staff in the admission to hospital of patients close to the end of life. DESIGN: Qualitative interviews, using particular patient cases as a basis for discussion, analysed thematically...
June 1, 2018: Palliative Medicine
Matthew J Allsop, Lucy E Ziegler, Matthew R Mulvey, Sarah Russell, Ros Taylor, Michael I Bennett
BACKGROUND: Understanding service provision for patients with advanced disease is a research priority, with a need to identify barriers that limit widespread integration of palliative care. AIM: To identify patient and organisational factors that influence the duration of hospice-based palliative care in the United Kingdom prior to death. DESIGN: This is a retrospective cohort study. SETTING/PARTICIPANTS: A total of 64 UK hospices providing specialist palliative care inpatient beds and community services extracted data for all adult decedents (aged over 17 years) with progressive, advanced disease, with a prior referral (e...
June 1, 2018: Palliative Medicine
Rachel Campbell, Nikki McCaffrey, Linda Brown, Meera R Agar, Katherine Clark, David C Currow
BACKGROUND: Translating research evidence into clinical practice often has a long lag time. AIM: To determine the impact of a phase III randomised controlled trial on palliative care clinicians' self-reported practice change. DESIGN: Online survey about use of octreotide in managing inoperable malignant bowel obstruction due to cancer or its treatments distributed in November 2016, 2 years after the first publication of the study in a peer-reviewed journal...
June 1, 2018: Palliative Medicine
Iain Yardley, Sarah Yardley, Huw Williams, Andrew Carson-Stevens, Liam J Donaldson
BACKGROUND: Patients receiving palliative care are vulnerable to patient safety incidents but little is known about the extent of harm caused or the origins of unsafe care in this population. AIM: To quantify and qualitatively analyse serious incident reports in order to understand the causes and impact of unsafe care in a population receiving palliative care. DESIGN: A mixed-methods approach was used. Following quantification of type of incidents and their location, a qualitative analysis using a modified framework method was used to interpret themes in reports to examine the underlying causes and the nature of resultant harms...
June 1, 2018: Palliative Medicine
Ingebrigt Røen, Hans Stifoss-Hanssen, Gunn Grande, Anne-Tove Brenne, Stein Kaasa, Kari Sand, Anne Kari Knudsen
BACKGROUND: Caring for advanced cancer patients affects carers' psychological and physical health. Resilience has been defined as "the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat." AIM: The aim of this study was to explore factors promoting carer resilience, based on carers' experiences with and preferences for health care provider support. DESIGN: Qualitative, semi-structured, individual interviews with family carers of advanced cancer patients were performed until data saturation...
May 1, 2018: Palliative Medicine
Bradley Chen, Chin-Chi Kuo, Nicole Huang, Victoria Y Fan
BACKGROUND: Costs of medical care have been found to be highest at the end of life. AIM: To evaluate the effect of provider reimbursement for hospice care on end-of-life costs. DESIGN: The policy expanded access to hospice care for end-stage renal disease patients, a policy previously limited to cancer patients only. This study employed a difference-in-differences analysis using a generalized linear model. The main outcome is inpatient expenditures in the last 30 days of life...
May 1, 2018: Palliative Medicine
Lisha Kuruvilla, Greg Weeks, Peter Eastman, Johnson George
BACKGROUND: Pharmacists have a key role to play in optimisation of medication regimens and promotion of medication safety. The role of specialist pharmacists as part of the multidisciplinary palliative care team, especially in the primary care setting, is not widely recognised. AIM: To explore the perspectives of stakeholders about the gaps in the current model of community palliative care services in relation to medication management and to assess their opinions pertaining to the role of a specialist palliative care pharmacist in addressing some of those gaps...
May 1, 2018: Palliative Medicine
Glenn Phair, Ashley Agus, Charles Normand, Kevin Brazil, Aine Burns, Paul Roderick, Alexander P Maxwell, Colin Thompson, Magdi Yaqoob, Helen Noble
BACKGROUND: Previous research has explored the cost of providing renal replacement therapies in patients with end-stage kidney disease and their quality of life. This is the first study to examine the healthcare costs of patients receiving conservative care without dialysis for end-stage kidney disease. This alternative to dialysis is an option for patients who prefer a supportive and palliative care approach. AIM: Descriptive cost and quality of life analyses alongside a UK-based multi-centre observational study in patients receiving conservative management for end-stage kidney disease...
May 1, 2018: Palliative Medicine
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