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BMJ Supportive & Palliative Care

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https://www.readbyqxmd.com/read/28935629/paediatric-advance-care-planning-survey-a-cross-sectional-examination-of-congruence-and-discordance-between-adolescents-with-hiv-aids-and-their-families
#1
Maureen E Lyon, Ronald H Dallas, Patricia A Garvie, Megan L Wilkins, Ana Garcia, Yao Iris Cheng, Jichuan Wang
OBJECTIVES: To identify patient-reported paediatric advance care planning (pACP) needs of adolescents living with HIV and to examine the congruence with their family's perception of their needs. METHODS: A cross-sectional survey among six paediatric hospital-based outpatient HIV specialty clinics. Participants included 48 adolescent/family dyads (n=96 participants) within a larger study facilitating pACP. The main outcome measure was the Lyon Advance Care Planning Survey - Adolescent and Surrogate Versions-Revised...
September 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28918387/prospective-comparative-effectiveness-cohort-study-comparing-two-models-of-advance-care-planning-provision-for-australian-community-aged-care-clients
#2
Karen Margaret Detering, Rachel Zoe Carter, Marcus William Sellars, Virginia Lewis, Elizabeth Anne Sutton
OBJECTIVES: Conduct a prospective comparative effectiveness cohort study comparing two models of advance care planning (ACP) provision in community aged care: ACP conducted by the client's case manager (CM) ('Facilitator') and ACP conducted by an external ACP service ('Referral') over a 6-month period. METHODS: This Australian study involved CMs and their clients. Eligible CM were English speaking, ≥18 years, had expected availability for the trial and worked ≥3 days per week...
September 16, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28904011/continuation-of-non-essential-medications-in-actively-dying-hospitalised-patients
#3
Beverly Rosa Williams, F Amos Bailey, Elizabeth Kvale, Neal Steil, Patricia S Goode, Richard E Kennedy, Kathryn L Burgio
OBJECTIVE: The objective of this analysis was to examine the use of 11 non-essential medications in actively dying patients. METHODS: This was a planned secondary analysis of data from the Best Practices for End-of-Life Care for Our Nation's Veterans trial, a multicentre implementation trial of an intervention to improve processes of end-of-life care in inpatient settings. Supported with an electronic comfort care decision support tool, intervention included training hospital staff to identify actively dying patients, communicate the prognosis to patients/families and implement best practices of traditionally home-based hospice care...
September 13, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28904010/vitamin-d-supplementation-to-palliative-cancer-patients-protocol-of-a-double-blind-randomised-controlled-trial-palliative-d
#4
Maria Helde-Frankling, Jenny Bergqvist, Caritha Klasson, Marie Nordström, Jonas Höijer, Peter Bergman, Linda Björkhem-Bergman
BACKGROUND: According to a small pilot study on palliative cancer patients at our ward, vitamin D supplementation had beneficial effects on pain (measured as opioid consumption), infections and quality of life (QoL) without having any significant side effects. OBJECTIVE: The primary objective of the 'Palliative-D' study is to test the hypothesis that vitamin D supplementation for 12 weeks reduces opioid consumption. The secondary objectives are to study if reduction of antibiotic consumption and fatigue as well as improvement in QoL assessments can be observed...
September 13, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28864449/feasibility-and-acceptability-of-a-patient-reported-outcome-intervention-in-chronic-heart-failure
#5
Pauline M Kane, Barbara A Daveson, Karen Ryan, Clare I Ellis-Smith, Niall G Mahon, Brendan McAdam, Regina McQuilllan, Cecelia Tracey, Christine Howley, Geraldine O'Gara, Caroline Raleigh, Irene J Higginson, Jonathan Koffman, Fliss E M Murtagh
Patients with chronic heart failure (CHF) have symptoms and concerns which are inadequately addressed. Patient-reported outcome measures (PROMs) can potentially improve the identification and management of advanced symptoms and palliative concerns. However, these have not been used in CHF. OBJECTIVES: To examine the feasibility and acceptability of using a PROM-the Integrated Palliative care Outcome Scale (IPOS)-together with heart failure nurse education and training to improve the identification and management of symptoms and concerns among patients with CHF...
September 1, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28864448/discussion-and-documentation-of-future-care-a-before-and-after-study-examining-the-impact-of-an-alternative-approach-to-recording-treatment-decisions-on-advance-care-planning-in-an-acute-hospital
#6
Alexandra C Malyon, Julia R Forman, Jonathan P Fuld, Zoë Fritz
OBJECTIVE: To determine whether discussion and documentation of decisions about future care was improved following the introduction of a new approach to recording treatment decisions: the Universal Form of Treatment Options (UFTO). METHODS: Retrospective review of the medical records of patients who died within 90 days of admission to oncology or respiratory medicine wards over two 3-month periods, preimplementation and postimplementation of the UFTO. A sample size of 70 per group was required to provide 80% power to observe a change from 15% to 35% in discussion or documentation of advance care planning (ACP), using a two-sided test at the 5% significance level...
September 1, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28864447/use-of-parecoxib-by-continuous-subcutaneous-infusion-for-cancer-pain-in-a-hospice-population
#7
Peter Armstrong, Pauline Wilkinson, Noleen K McCorry
OBJECTIVES: To characterise the use of the parenteral non-steroidal anti-inflammatory drug parecoxib when given by continuous subcutaneous infusion (CSCI) in a hospice population. Clinical experience suggests parecoxib CSCI may be of benefit in this population, but empirical evidence in relation to its safety and efficacy is lacking. METHODS: Retrospective chart review of patients with a cancer diagnosis receiving parecoxib CSCI from 2008 to 2013 at the Marie Curie Hospice, Belfast...
September 1, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28860112/risk-factors-for-falls-in-older-patients-with-cancer
#8
Xiaotao Zhang, Ming Sun, Suyu Liu, Cheuk Hong Leung, Linda Pang, Uday R Popat, Richard Champlin, Holly M Holmes, Vicente Valero, Colin P Dinney, Debu Tripathy, Beatrice J Edwards
OBJECTIVES: A rising number of patients with cancer are older adults (65 years of age and older), and this proportion will increase to 70% by the year 2020. Falls are a common condition in older adults. We sought to assess the prevalence and risk factors for falls in older patients with cancer. METHODS: This is a single-site, retrospective cohort study. Patients who were receiving cancer care underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, falls in the prior 6 months and comorbidity assessment...
August 31, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28847854/a-multidisciplinary-rehabilitation-programme-for-cancer-cachexia-improves-quality-of-life
#9
Monica P Parmar, Brandy L Vanderbyl, Mary Kanbalian, Tamara Y Windholz, Anh-Thi Tran, R Thomas Jagoe
OBJECTIVES: Patients with cancer cachexia have severely impaired quality of life (QoL). Multidisciplinary, multimodal treatment approaches have potential for stabilising weight and correcting other features of this syndrome, but the impact on QoL is unknown. METHODS: A retrospective analysis of QoL in patients with advanced cancer, referred for the management of cachexia by a specialised multidisciplinary clinic (The McGill Cancer Nutrition Rehabilitation Program clinic at the Jewish General Hospital (CNR-JGH))...
August 28, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28847853/holistic-needs-assessment-and-care-plans-for-women-with-gynaecological-cancer-do-they-improve-cancer-specific-health-related-quality-of-life-a-randomised-controlled-trial-using-mixed-methods
#10
Catherine Sandsund, Richard Towers, Karen Thomas, Ruth Tigue, Amyn Lalji, Andreia Fernandes, Natalie Doyle, Jake Jordan, Heather Gage, Clare Shaw
OBJECTIVES: Holistic needs assessment (HNA) and care planning are proposed to address unmet needs of people treated for cancer. We tested whether HNA and care planning by an allied health professional improved cancer-specific quality of life for women following curative treatment for stage I-III gynaecological cancer. METHODS: Consecutive women were invited to participate in a randomised controlled study (HNA and care planning vs usual care) at a UK cancer centre...
August 28, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28838932/consultation-for-total-pain-in-high-risk-obstetrics
#11
Warren Mackie-Jenkins, Regina M Tosca, Hunter Groninger
Palliative care (PC) consultation rarely takes place in the clinical setting of high-risk obstetrics, where 'total pain' may be undermanaged. Here, we present a case of a young woman carrying twins and hospitalised for acute abdominal pain. Workup for her pain revealed non-viable fetal tissue positioned in the uterine horn; the remaining fetus was viable. Initial attempts to control the patient's pain with strong parenteral opioids by the obstetrics team and the acute pain service failed. The PC service was consulted to assist...
August 24, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28838931/end-of-life-prescribing-of-aspirin-in-patients-with-breast-or-colorectal-cancer
#12
Laura Murphy, Chris Brown, Amelia Smith, Faith Cranfield, Linda Sharp, Kala Visvanathan, Kathleen Bennett, Thomas Ian Barron
OBJECTIVES: The aim of this study was to evaluate the influence of an approaching cancer death on end-of-life aspirin use, a frequently prescribed medication for cardiovascular disease prevention. METHODS: This study was conducted using linked cancer registry and prescribing data. Breast (n=1151) and colorectal (n=1859) cancer decedents were matched to cancer survivors and the probability of either initiating aspirin, or continuing established aspirin use, was estimated in consecutive periods over the 5 years approaching a cancer-specific death (decedents) or matched index date (survivors)...
August 24, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28838930/electronic-palliative-care-coordination-system-epaccs-interoperability-is-a-problem
#13
LETTER
Pablo Millares Martin
No abstract text is available yet for this article.
August 24, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28835456/systematic-review-of-pharmacological-therapies-for-the-management-of-ischaemic-pain-in-patients-with-non-reconstructable-critical-limb-ischaemia
#14
REVIEW
Áine Ní Laoire, Fliss E M Murtagh
BACKGROUND: Critical limb ischaemia (CLI) is a severe manifestation of peripheral arterial disease, characterised by chronic ischaemic rest pain, ulcers or gangrene. Management of ischaemic pain is challenging in patients with no options for revascularisation and optimal pharmacological therapies have not been established. OBJECTIVES: To identify and evaluate the effectiveness of pharmacological therapies to treat ischaemic pain secondary to non-reconstructable CLI...
August 23, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28835455/observational-study-of-sleep-disturbances-in-advanced-cancer
#15
Andrew Neil Davies, Shuchita D Patel, Amanda Gregory, Bernadette Lee
OBJECTIVES: To determine the prevalence of nightmares, sleep terrors and vivid dreams in patients with advanced cancer (and the factors associated with them in this group of patients). METHODS: The study was a multicentre, prospective observational study. Participants were patients with locally advanced/metastatic cancer, who were under the care of a specialist palliative care team. Data were collected on demographics, cancer diagnosis, cancer treatment, current medication, performance status, sleep quality (Pittsburgh Sleep Quality Index), dreams and nightmares, and physical and psychological symptoms (Memorial Symptom Assessment Scale-Short Form)...
August 23, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28835454/developing-design-principles-for-a-virtual-hospice-improving-access-to-care
#16
Andrea Taylor, Tara French, Sneha Raman
OBJECTIVES: Providing access to hospice services will become increasingly difficult due to the pressures of an ageing population and limited resources. To help address this challenge, a small number of services called Virtual Hospice have been established. This paper presents early-stage design work on a Virtual Hospice to improve access to services provided by a hospice (Highland Hospice) serving a largely remote and rural population in Scotland, UK. METHODS: The study was structured as a series of Experience Labs with Highland Hospice staff, healthcare professionals and patients...
August 23, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28801317/responses-to-assisted-suicide-requests-an-interview-study-with-swiss-palliative-care-physicians
#17
Claudia Gamondi, Gian Domenico Borasio, Pam Oliver, Nancy Preston, Sheila Payne
OBJECTIVES: Assisted suicide in Switzerland is mainly performed by right-to-die societies. Medical involvement is limited to the prescription of the drug and certification of eligibility. Palliative care has traditionally been perceived as generally opposed to assisted suicide, but little is known about palliative care physicians' involvement in assisted suicide practices. This paper aims to describe their perspectives and involvement in assisted suicide practices. METHODS: A qualitative interview study was conducted with 23 palliative care physicians across Switzerland...
August 11, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28801316/barriers-to-the-use-of-buccal-and-intranasal-fentanyl-for-breakthrough-pain-in-paediatric-palliative-care-an-exploratory-survey
#18
LETTER
Emily Harrop, Liz Jamieson, Tsun Ho Choy, Wing Hei Phoebe Ho, Ian C K Wong
No abstract text is available yet for this article.
August 11, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28774963/integrating-palliative-care-into-neurology-services-what-do-the-professionals-say
#19
Nilay Hepgul, Wei Gao, Catherine J Evans, Diana Jackson, Liesbeth M van Vliet, Anthony Byrne, Vincent Crosby, Karen E Groves, Fiona Lindsay, Irene J Higginson
OBJECTIVES: Evaluations of new services for palliative care in non-cancer conditions are few. OPTCARE Neuro is a multicentre trial evaluating the effectiveness of short-term integrated palliative care (SIPC) for progressive long-term neurological conditions. Here, we present survey results describing the current levels of collaboration between neurology and palliative care services and exploring the views of professionals towards the new SIPC service. METHODS: Neurology and palliative care teams from six UK trial sites (London, Nottingham, Liverpool, Cardiff, Brighton and Chertsey) were approached via email to complete an online survey...
August 3, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28768681/death-talk-and-relief-of-death-related-distress-in-patients-with-advanced-cancer
#20
Ekaterina An, Erica Wennberg, Rinat Nissim, Christopher Lo, Sarah Hales, Gary Rodin
OBJECTIVES: The circumstances of advanced cancer heighten the need for affected individuals to communicate mortality-related concerns, although there may be obstacles to such communication. Managing Cancer and Living Meaningfully(CALM) is a supportive-expressive therapy designed to address such barriers and to facilitate communication of mortality-related concerns in patients and caregivers facing advanced disease. This study explores death-related distress in patients with advanced cancer and the perceived influence of CALM therapy on overcoming barriers to communication of this distress...
August 2, 2017: BMJ Supportive & Palliative Care
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