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nausea and vomitting in palliative care

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https://www.readbyqxmd.com/read/29449241/simplified-guideline-for-prescribing-medical-cannabinoids-in-primary-care
#1
G Michael Allan, Jamil Ramji, Danielle Perry, Joey Ton, Nathan P Beahm, Nicole Crisp, Beverly Dockrill, Ruth E Dubin, Ted Findlay, Jessica Kirkwood, Michael Fleming, Ken Makus, Xiaofu Zhu, Christina Korownyk, Michael R Kolber, James McCormack, Sharon Nickel, Guillermina Noël, Adrienne J Lindblad
OBJECTIVE: To develop a clinical practice guideline for a simplified approach to medical cannabinoid use in primary care; the focus was on primary care application, with a strong emphasis on best available evidence and a promotion of shared, informed decision making. METHODS: The Evidence Review Group performed a detailed systematic review of 4 clinical areas with the best evidence around cannabinoids: pain, nausea and vomiting, spasticity, and adverse events. Nine health professionals (2 generalist family physicians, 2 pain management-focused family physicians, 1 inner-city family physician, 1 neurologist, 1 oncologist, 1 nurse practitioner, and 1 pharmacist) and a patient representative comprised the Prescribing Guideline Committee (PGC), along with 2 nonvoting members (pharmacist project managers)...
February 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29436433/updates-in-palliative-care-recent-advancements-in-the-pharmacological-management-of-symptoms
#2
Angela Star, Jason W Boland
Symptom management is an important part of both palliative care and end-of-life care. This article will examine the recent research evidence about drugs commonly used for symptom management in adult patients receiving palliative care. In particular, the management of symptoms where recent palliative care-based evidence has changed recommended practice will be reviewed. This includes: breathlessness, delirium, nausea and vomiting in bowel obstruction, opioid-induced constipation and upper respiratory tract secretions...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29372125/dilated-thoracic-esophagus-presenting-with-painful-progressive-persistent-dysphagia-and-leukocytosis-of-unknown-origin
#3
Kyawzaw Lin, Jamil Shah, Emmanuel Ofori, Vahe Shahnazarian, Madhavi Reddy
Esophageal cancer is the eighth-most common cause of cancer-related mortality worldwide. The most common presenting symptom in advanced distal esophageal cancer is the sensation of sticking food, but it may sometimes present with bleeding and related complications, or asymptomatic leukocytosis. We present the case of a 77-year-old afebrile man with chronic alcoholism and a dilated thoracic esophagus with painful, progressive, and persistent dysphagia and leukocytosis of unknown origin. A 77-year-old man with a past medical history of hypertension and colonic cancer status post right hemicolectomy (surveillance negative) presented to the emergency department with painful, progressive, persistent, and worsening dysphagia for the past three weeks...
November 16, 2017: Curēus
https://www.readbyqxmd.com/read/29343167/a-cluster-randomised-feasibility-trial-of-clinically-assisted-hydration-in-cancer-patients-in-the-last-days-of-life
#4
Andrew N Davies, Melanie Waghorn, Katherine Webber, Sigurd Johnsen, Jeewaka Mendis, Julia Boyle
BACKGROUND: The provision of clinically assisted hydration at the end-of-life is one of the most contentious issues in medicine. AIM: The aim of this feasibility study was to answer the question 'can a definitive (adequately powered) study be done?' DESIGN: The study was a cluster randomised trial, with sites randomised on a one-to-one basis to intervention 'A' (regular mouth care and usual other care) or intervention 'B' (clinically assisted hydration, mouth care and usual other care)...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29222203/type-and-frequency-of-side-effects-during-pc6-acupuncture-observations-from-therapists-and-patients-participating-in-clinical-efficacy-trials-of-acupuncture
#5
Anna Enblom, Anna Johnsson
BACKGROUND: Many therapists practise PC6 acupuncture for emesis (nausea and vomiting) during pregnancy, different cancer therapies, palliative care, after surgery, or to induce relaxing effects in general. Knowledge of side effects is central to shared decision-making. AIM: To describe the type and frequency of side effects and the level of needle-induced pain during PC6 acupuncture. METHODS: We included 1298 PC6 acupuncture treatments, delivered to 221 participants (77% women, mean age 52...
December 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29134767/availability-and-approval-of-cannabis-based-medicines-for-chronic-pain-management-and-palliative-supportive-care-in-europe-a-survey-of-the-status-in-the-chapters-of-the-european-pain-federation
#6
N Krcevski-Skvarc, C Wells, W Häuser
BACKGROUND: There is considerable public and political interest in the use of cannabis products for medical purposes. METHODS: The task force of the European Pain Federation (EFIC) conducted a survey with its national chapters representatives on the status of approval of all types of cannabis-based medicines, the covering of costs and the availability of a position paper of a national medical association on the use of medical cannabis for chronic pain and for symptom control in palliative/supportive care...
November 13, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29110573/the-impact-of-integrated-multidisciplinary-palliative-care-program-on-symptoms-in-patients-at-the-palliative-care-ward-an-audit-and-a-protocol-of-prospective-controlled-investigation
#7
Andreas Jülich, Thomas Spreu, Britta Buchhold, Taras Usichenko
An integrated multidisciplinary palliative care (IMPC) program is a promising tool to improve symptom control in patients at the end of life. The aim was to study the feasibility of the IMPC program in patients at the palliative care (PC) ward. A retrospective audit, using the extended Edmonton Symptom Assessment Scale (ESAS), was conducted on the PC ward of the university hospital. Consecutive patients who were admitted for the IMPC program during 1 year were considered. One hundred forty-eight cases (93% with underlying cancer) were analyzed...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/28866898/olanzapine-induced-delirium-a-probable-adverse-drug-reaction
#8
David MacKintosh
Olanzapine is an atypical antipsychotic indicated for the treatment of schizophrenia and known to be effective in the management of delirium. In addition to its use for these indications olanzapine has also been used in the management of chemotherapy induced nausea and vomiting and otherwise difficult to control nausea and vomiting in palliative care settings. Although considered to be well tolerated with a lower incidence of extrapyramidal effects than first generation antipsychotics there are a small number of reports of olanzapine inducing delirium...
December 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28866891/integration-of-hypnosis-into-pediatric-palliative-care
#9
Stefan J Friedrichsdorf, Daniel P Kohen
At least 8 million children would need specialized pediatric palliative care (PPC) services annually worldwide, and of the more than 42,000 children and teenagers dying annually in the United States, at least 15,000 children would require PPC. Unfortunately, even in resource-rich countries the majority of children dying from serious advanced illnesses are suffering from unrelieved, distressing symptoms such as pain, dyspnea, nausea, vomiting, and anxiety. State of the art treatment and prevention of those symptoms requires employing multi-modal therapies, commonly including pharmacology, rehabilitation, procedural intervention, psychology, and integrative modalities...
June 27, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28827941/analytical-study-of-short-and-long-term-results-of-home-based-palliative-care-services-to-cancer-patients
#10
Dhritiman Datta, Gautam Majumdar, Shiromani Debbarma, Badan Janapati, Amit Kumar Datta
AIMS AND OBJECT: Identification and selection of patients suffering from terminal stage in bed ridden condition upto village level and to determine the type of palliative care need. Also to asses the effectiveness of the palliative care provided at the bed side. MATERIALS: All registered patients under palliative care of Regional Cancer Centre, Agartala from 2014 April to 2016 March. METHODS: A retrospective study. Ten teams comprising of doctors, nurses, pharmacists & Social Workers were trained and engaged in this study for symptom assessment and pain relief of palliative patients...
July 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28821989/prevalence-of-hyponatremia-in-inpatients-with-incurable-and-life-limiting-diseases-and-its-association-with-physical-symptoms-a-retrospective-descriptive-study
#11
Kerstin Kremeike, Ricarda M L Wetter, Volker Burst, Raymond Voltz, Kathrin Kuhr, Steffen T Simon
PURPOSE: Hyponatremia is a common electrolyte abnormality seen in hospitalized patients. It may cause a variety of symptoms and is associated with longer hospitalizations and higher mortality. However, to date, only little is known about the extent of hyponatremia in patients with incurable diseases and whether it is associated with physical symptoms in this patient group. This study aims to describe the prevalence of hyponatremia, associated symptoms, and symptom intensity in inpatients with hyponatremia receiving specialist palliative care (SPC)...
January 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28807703/is-early-palliative-care-feasible-in-patients-with-multiple-myeloma
#12
Josep Porta-Sales, Maria Guerrero-Torrelles, Deborah Moreno-Alonso, Josep Sarrà-Escarré, Victòria Clapés-Puig, Jordi Trelis-Navarro, Anna Sureda-Balarí, Alberto Fernández De Sevilla-Ribosa
CONTEXT: Evidence for the benefits of early palliative care (EPC) in patients with solid tumors is strong, but EPC has received scant attention in hematologic malignancies. OBJECTIVE: To assess the benefits of outpatient-based EPC for symptom control in patients with multiple myeloma. METHODS: Retrospective study of patients attending the Multiple Myeloma Palliative Care Clinic at our hospital in the year 2013 (February 1-December 31). The following symptoms were assessed at baseline and at three follow-up consultations using a Numerical Visual Scale (0 = no symptoms; 10 = worst possible): pain, anorexia, constipation, insomnia, nausea/vomiting, dyspnea, anxiety, and sadness...
November 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28772094/pharmacovigilance-in-hospice-palliative-care-net-effect-of-haloperidol-for-nausea-or-vomiting
#13
Madeline Digges, Akram Hussein, Andrew Wilcock, Gregory B Crawford, Jason W Boland, Meera R Agar, Aynharan Sinnarajah, David C Currow, Miriam J Johnson
BACKGROUND: Haloperidol is widely prescribed as an antiemetic in patients receiving palliative care, but there is limited evidence to support and refine its use. OBJECTIVE: To explore the immediate and short-term net clinical effects of haloperidol when treating nausea and/or vomiting in palliative care patients. DESIGN: A prospective, multicenter, consecutive case series. SETTING/SUBJECTS: Twenty-two sites, five countries: consultative, ambulatory, and inpatient services...
August 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28695173/identification-of-symptom-clusters-in-cancer-patients-at-palliative-care-clinic
#14
Gülçin Şenel Özalp, Neşe Uysal, Gonca Oğuz, Nesteren Koçak, Şerife Karaca, Nihan Kadıoğulları
OBJECTIVE: Cancer patients often experience a large number of symptoms together. The aim of this study is to determine the symptom clusters in cancer patients at palliative care clinic. METHODS: Hundred and seventy consecutive patients were enrolled in the study. Memorial Symptom Assessment Scale was used for symptom assessment of the patients. RESULTS: The most experienced symptoms by the patients during the past week before hospitalization in palliative care clinic were lack of energy (95...
July 2017: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28671265/corticosteroids-for-adult-patients-with-advanced-cancer-who-have-nausea-and-vomiting-not-related-to-chemotherapy-radiotherapy-or-surgery
#15
REVIEW
Petra Vayne-Bossert, Alison Haywood, Phillip Good, Sohil Khan, Kirsty Rickett, Janet R Hardy
BACKGROUND: Nausea is a common symptom in advanced cancer, with a prevalence of up to 70%. While nausea and vomiting can be related to cancer treatments, such as chemotherapy, radiotherapy, or surgery, a significant number of people with advanced cancer also suffer from nausea unrelated to such therapies. Nausea and vomiting may also cause psychological distress, and have a negative impact on the quality of life of cancer patients; similarly to pain, nausea is often under-treated. The exact mechanism of action of corticosteroids on nausea is unclear, however, they are used to manage a number of cancer-specific complications, including spinal cord compression, raised intracranial pressure, and lymphangitis carcinomatosis...
July 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28651827/effects-of-nutrition-and-physical-exercise-intervention-in-palliative-cancer-patients-a-randomized-controlled-trial
#16
Alexandra Uster, Maya Ruehlin, Stefanie Mey, David Gisi, Ruud Knols, Reinhard Imoberdorf, Miklos Pless, Peter E Ballmer
BACKGROUND & AIMS: Cancer cachexia is multifactorial and should be targeted using a multimodal form of intervention. The purpose of the present trial was to test the effects of a combined nutrition and physical exercise program on cancer patients with metastatic or locally advanced tumors of the gastrointestinal and lung tracts. METHODS: Patients were randomized into two groups: One group received a minimum of three standardized individual nutritional counselling sessions and participated in a 60-min exercise program twice a week...
June 8, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28646590/randomized-controlled-double-blind-trial-comparing-haloperidol-combined-with-conventional-therapy-to-conventional-therapy-alone-in-patients-with-symptomatic-gastroparesis
#17
Carlos J Roldan, Kimberly A Chambers, Linda Paniagua, Sonali Patel, Marylou Cardenas-Turanzas, Yashwant Chathampally
OBJECTIVE: Gastroparesis is a debilitating condition that causes nausea, vomiting, and abdominal pain. Management includes analgesics and antiemetics, but symptoms are often refractory. Haloperidol has been utilized in the palliative care setting for similar symptoms. The study objective was to determine whether haloperidol as an adjunct to conventional therapy would improve symptoms in gastroparesis patients presenting to the emergency department (ED). STUDY DESIGN AND METHODS: This was a randomized, double-blind, placebo-controlled trial of adult ED patients with acute exacerbation of previously diagnosed gastroparesis...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28494643/randomised-clinical-trial-of-early-specialist-palliative-care-plus-standard-care-versus-standard-care-alone-in-patients-with-advanced-cancer-the-danish-palliative-care-trial
#18
Mogens Groenvold, Morten Aagaard Petersen, Anette Damkier, Mette Asbjoern Neergaard, Jan Bjoern Nielsen, Lise Pedersen, Per Sjøgren, Annette Sand Strömgren, Tove Bahn Vejlgaard, Christian Gluud, Jane Lindschou, Peter Fayers, Irene J Higginson, Anna Thit Johnsen
BACKGROUND: Beneficial effects of early palliative care have been found in advanced cancer, but the evidence is not unequivocal. AIM: To investigate the effect of early specialist palliative care among advanced cancer patients identified in oncology departments. SETTING/PARTICIPANTS: The Danish Palliative Care Trial (DanPaCT) (ClinicalTrials.gov NCT01348048) is a multicentre randomised clinical trial comparing early referral to a specialist palliative care team plus standard care versus standard care alone...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28427740/a-study-of-the-incidence-and-management-of-admissions-for-cancer-related-symptoms-in-a-district-general-hospital-the-potential-role-of-an-acute-oncology-service
#19
C M Bruce, J Smith, A Price
AIMS: The non-specialist management of cancer patients is becoming increasingly complex. Acute oncology services (AOS), aiming to provide rapid access to specialist advice, have been shown to improve patient experience and reduce length of inpatient stay. The present study aimed to inform service provision in a district general hospital (DGH) by investigating cancer patients, not on active anti-cancer treatment, where the disease itself precipitated admission. This is a vulnerable group who are potentially disenfranchised of focused oncological input due to having less robust care pathways established to date...
April 17, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28222994/palliative-care-and-palliative-radiation-therapy-education-in-radiation-oncology-a-survey-of-us-radiation-oncology-program-directors
#20
Randy L Wei, Lauren E Colbert, Joshua Jones, Margarita Racsa, Gabrielle Kane, Steve Lutz, Neha Vapiwala, Kavita V Dharmarajan
PURPOSE: The purpose of this study was to assess the state of palliative and supportive care (PSC) and palliative radiation therapy (RT) educational curricula in radiation oncology residency programs in the United States. METHODS AND MATERIALS: We surveyed 87 program directors of radiation oncology residency programs in the United States between September 2015 and November 2015. An electronic survey on PSC and palliative RT education during residency was sent to all program directors...
December 1, 2016: Practical Radiation Oncology
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