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palliative guidelines

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https://www.readbyqxmd.com/read/28224879/-palliative-sedation-because-it-s-what-the-patient-wants-pronouncement-of-disciplinary-court-cause-of-great-confusion
#1
A C Hendriks, B Keizer
The Medical Disciplinary Court of The Hague recently imposed an official warning on two physicians who did not yield to the pressure exerted by a 102-year-old patient and her family to start palliative sedation. This decision not only restricts the directing role of physicians with respect to the end-of-life phase, but is also inconsistent with the guideline from the Royal Dutch Medical Association (KNMG) on palliative sedation.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28222736/implementing-guidelines-and-training-initiatives-to-improve-cross-cultural-communication-in-primary-care-consultations-a-qualitative-participatory-european-study
#2
E Teunissen, K Gravenhorst, C Dowrick, E Van Weel-Baumgarten, F Van den Driessen Mareeuw, T de Brún, N Burns, C Lionis, F S Mair, C O'Donnell, M O'Reilly-de Brún, M Papadakaki, A Saridaki, W Spiegel, C Van Weel, M Van den Muijsenbergh, A MacFarlane
BACKGROUND: Cross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice. METHODS: We undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries...
February 10, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28220732/should-doctors-provide-futile-medical-treatment-if-patients-or-their-proxies-are-prepared-to-pay-for-it
#3
D J McQuoid-Mason
Ethically and legally doctors are not obliged to provide futile treatment to patients, even if the patient or their proxies are prepared to pay for it. However, it may be justified where such treatment is harmless and has a placebo effect. In deciding about a request for futile treatment, doctors should be guided by the ethical principles of patient autonomy, beneficence, non-maleficence and justice. Guidelines are provided to assist doctors in making such decisions. Where futile treatment is withdrawn or refused, palliative care must always be offered...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28220450/the-potential-role-of-symptom-questionnaires-in-palliative-and-supportive-cancer-care-delivery
#4
REVIEW
Angela M Stover, Ethan M Basch
PURPOSE OF REVIEW: The American Society of Clinical Oncology (ASCO) palliative care recommendations have been updated into a full guideline. Symptom questionnaires-completed and reviewed with patients during care delivery-are poised to play a large role in this guideline because they provide a more comprehensive understanding of symptoms. This article provides an overview of the guideline and describes how symptom questionnaires can be used to satisfy the guideline. RECENT FINDINGS: Standardized symptom questionnaires can be used for three purposes in care delivery: symptom management, referral to specialty palliative and supportive care, and to assess high-quality care...
February 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28218382/primary-cutaneous-non-hodgkin-lymphoma-results-of-a-retrospective-analysis-in-the-light-of-the-recent-ilrog-guidelines
#5
Sara Pedretti, Mauro Urpis, Carla Leali, Paolo Borghetti, Liliana Baushi, Raffaella Sala, Alessandra Tucci, Diana Greco, Nadia Pasinetti, Luca Triggiani, Giuseppe Rossi, Piergiacomo Calzavara-Pinton, Stefano Maria Magrini, Michela Buglione
PURPOSE: To analyze clinical outcome, local response, survival and toxicity in patients with primary cutaneous lymphoma (PCL) treated with radiotherapy. METHODS: From 1995 to 2014, 112 patients were treated. B-cell lymphomas (CBCLs; n = 86) and T-cell lymphomas (CTCLs; n = 23) were analyzed separately. Clinical and therapeutic characteristics (age, sex, histology, primary treatment and radiotherapy modality) were related to response to treatment, survival and toxicity...
February 14, 2017: Tumori
https://www.readbyqxmd.com/read/28216866/home-based-palliative-services-under-two-local-self-government-institutions-of-kerala-india-an-assessment-of-compliance-with-policy-and-guidelines-to-local-self-government-institutions
#6
Rajeev Jayalakshmi, Chatterjee Chopra Suhita
BACKGROUND: In contrast to India's poor performance in palliative and end-of-life care, the state of Kerala has gained considerable attention for its palliative care (PC) policy. This study tried to understand the structure, organization, and delivery of the program currently offered to the rural population, and its conformity to the state's PC policy and guidelines for Local Self-government Institutions (LSGIs). MATERIALS AND METHODS: A descriptive research design involving a review of Kerala palliative policy and guidelines for LSGIs was followed by direct field observation and interviews of stakeholders...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28193210/hepatectomy-for-liver-metastases-from-gastric-cancer-a-systematic-review
#7
Ying-Yang Liao, Ning-Fu Peng, Di Long, Peng-Cheng Yu, Sen Zhang, Jian-Hong Zhong, Le-Qun Li
BACKGROUND: Official guidelines recommend palliative treatments for patients with liver metastases from gastric cancer. However, many case series reported that hepatectomy for such cases is safe and effective. This systematic review compares the overall survival between hepatectomy and palliative therapy in patients with liver metastases from gastric cancer. METHODS: Two independent reviewers performed a systematic search of literature in EMBASE and PubMed, updated until 26 October 2016...
February 13, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28193104/multidisciplinary-training-on-spiritual-care-for-patients-in-palliative-care-trajectories-improves-the-attitudes-and-competencies-of-hospital-medical-staff
#8
Joep van de Geer, Nic Veeger, Marieke Groot, Hetty Zock, Carlo Leget, Jelle Prins, Kris Vissers
OBJECTIVES: Patients value health-care professionals' attention to their spiritual needs. However, this is undervalued in health-care professionals' education. Additional training is essential for implementation of a national multidisciplinary guideline on spiritual care (SC) in palliative care (PC). Aim of this study is to measure effects of a training program on SC in PC based on the guideline. METHODS: A pragmatic multicenter trial using a quasi-experimental pretest-posttest design as part of an action research study...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28192226/use-of-preventive-medication-in-patients-with-limited-life-expectancy-a-systematic-review
#9
REVIEW
Arjun Poudel, Patsy Yates, Debra Rowett, Lisa M Nissen
CONTEXT: Optimal prescribing in patients with limited life expectancy remains unclear. OBJECTIVES: This study systematically reviews the published literature regarding the use of preventive medication in patients with reduced life expectancy. METHODS: A systematic literature search was conducted using three databases (MEDLINE, EMBASE and CINAHL). Articles published in English from January 1995 to December 2015 were retrieved for analysis to identify peer-reviewed, observational studies assessing use of preventive medications in patients with limited life expectancy...
February 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28191605/integrating-palliative-care-into-routine-care-of-patients-with-heart-failure-models-for-clinical-collaboration
#10
REVIEW
Warren H Lewin, Kristen G Schaefer
Heart failure (HF) affects nearly 5.7 million Americans and is described as a chronic incurable illness carrying a poor prognosis. Patients living with HF experience significant symptoms including dyspnea, pain, anxiety, fatigue, and depression. As the illness advances into later stages, symptoms become more intense and refractory to standard treatments, leading to recurrent acute-care utilization and contributing to poor quality of life. Advanced HF symptoms have been described to be as burdensome, if not more than, those in cancer populations...
February 13, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28190381/guidance-on-conducting-and-reporting-delphi-studies-credes-in-palliative-care-recommendations-based-on-a-methodological-systematic-review
#11
Saskia Jünger, Sheila A Payne, Jenny Brine, Lukas Radbruch, Sarah G Brearley
BACKGROUND: The Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care. AIM: To systematically examine the application of the Delphi technique for the development of best practice guidelines in palliative care. DESIGN: A methodological systematic review was undertaken using the databases PubMed, CINAHL, Web of Science, Academic Search Complete and EMBASE...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28187096/a-call-for-new-communication-channels-for-gynecological-oncology-trainees-a-survey-on-social-media-use-and-educational-needs-by-the-european-network-of-young-gynecological-oncologists
#12
Kamil Zalewski, Kristina Lindemann, Michael J Halaska, Ignacio Zapardiel, Rene Laky, Elisabeth Chereau, David Lindquist, Stephan Polterauer, Vladislav Sukhin, Polat Dursun
OBJECTIVE: The aim of the study was to assess patterns in the use of social media (SM) platforms and to identify the training needs among European gynecologic oncology trainees. METHODS: In 2014, a web-based survey was sent to 633 trainees from the European Network of Young Gynaecological Oncologists (ENYGO) database. The 14-item questionnaire (partially using a 1- to 5-point Likert scale) assessed respondents' use of SM and preference for workshop content and organization...
March 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28166798/identifying-and-characterising-health-policy-and-system-relevant-documents-in-uganda-a-scoping-review-to-develop-a-framework-for-the-development-of-a-one-stop-shop
#13
Boniface Mutatina, Robert Basaza, Ekwaro Obuku, John N Lavis, Nelson Sewankambo
BACKGROUND: Health policymakers in low- and middle-income countries continue to face difficulties in accessing and using research evidence for decision-making. This study aimed to identify and provide a refined categorisation of the policy documents necessary for building the content of a one-stop shop for documents relevant to health policy and systems in Uganda. The on-line resource is to facilitate timely access to well-packaged evidence for decision-making. METHODS: We conducted a scoping review of Uganda-specific, health policy, and systems-relevant documents produced between 2000 and 2014...
February 6, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28164359/off-label-drug-use-in-oncology-a-systematic-review-of-literature
#14
REVIEW
M M Saiyed, P S Ong, L Chew
WHAT IS KNOWN AND OBJECTIVE: The off-label use of medicines is widespread in several diseases. This type of prescribing practice is particularly more acute in oncology. However, the suitability of anticancer medications for off-label use remains an issue of controversy, due to uncertainty around the clinical benefits and potential toxicities, limited evidence to support clinical decision-making, increased out-of-pocket costs for patients and ethical concerns around the lack of informed consent...
February 5, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28160116/family-caregiving-for-persons-with-heart-failure-at-the-intersection-of-heart-failure-and-palliative-care-a-state-of-the-science-review
#15
J Nicholas Dionne-Odom, Stephanie A Hooker, David Bekelman, Deborah Ejem, Gwen McGhan, Lisa Kitko, Anna Strömberg, Rachel Wells, Meka Astin, Zehra Gok Metin, Gisella Mancarella, Salpy V Pamboukian, Lorraine Evangelista, Harleah G Buck, Marie A Bakitas
Many of the 23 million individuals with heart failure (HF) worldwide receive daily, unpaid support from a family member or friend. Although HF and palliative care practice guidelines stipulate that support be provided to family caregivers, the evidence base to guide care for this population has not been comprehensively assessed. In order to appraise the state-of-the-science of HF family caregiving and recommend areas for future research, the aims of this review were to summarize (1) how caregivers influence patients, (2) the consequences of HF for caregivers, and (3) interventions directed at HF caregivers...
February 4, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28156654/recovery-of-cancer-patients-social-lives-upon-referral-to-palliative-care-units
#16
Yasuo Hirayama, Takayuki Machino, Toshiro Kusakabe, Kenji Nakamura, Hiroyoshi Mihara, Satoko Itoh, Kunihiko Ishitani
: 107 Background: Our hospital is a cancer-specific facility that treats patients from diagnosis to terminal care. We evaluate the possibility of effective cancer chemotherapies for patients referred to our palliative care unit from other hospitals through case conferences in our institution. Even the patients referred to the palliative care unit of our institution are sometimes assessed as "very likely to be improved by standard or semi-standard treatment" by the palliative care and oncologic teams in our institution...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156651/oams-at-the-end-the-end-of-the-beginning-or-the-beginning-of-the-end
#17
Barbara Marie Galligan, Chintan Shah, Iris Chen Zhao, Brian Paciotti, Nathan Fairman, Quy Tran
: 229 Background: In 2001, after three months of review, the FDA approved the oral anticancer agent imatinib, making it the fastest approval in FDA history. Since then, the FDA has approved over 40 oral anti-cancer medications (OAMs) and the number continues to rise, transforming cancer care, improving survival in specific cancers and providing new hope. However, the rapid development of OAMs has produced uncertainty over the best use of these new medications, particularly at the end of life...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156650/organizational-factors-influencing-specialty-palliative-care-utilization-at-academic-cancer-centers
#18
Michael W Rabow, Megan Crowley-Makota, Mallory Marie Waters, Michelle Nkumsah, Douglas B White, Edward Chu, Cardinale B Smith, Robert Arnold
: 109 Background: Rates of early specialty palliative care utilization remain low, despite increasing familiarity and favorable attitudes amongst cancer center oncologists. In this context, understanding organizational barriers to specialty palliative care use becomes critical. METHODS: We conducted a qualitative interview study with 74 medical oncologists practicing at 3 U.S. academic cancer centers with well-established specialty palliative care clinics. The in-depth interview guide elicited experiences and views related to outpatient palliative care...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156609/icu-deaths-in-patients-with-advanced-cancer-criteria-to-decrease-potentially-inappropriate-admissions-and-analysis-of-advance-planning-discussions
#19
Alva B Weir
: 47 Background: A significant number of advanced cancer admissions to intensive care unit (ICU) are inappropriate, as they do not prolonged survival. No clear consensus criteria for reasonable admissions of advanced cancer patients have been developed. METHODS: We established four criteria for ICU admissions in advanced cancer patients: post procedure complication, recent cancer diagnosis, good performance status and life expectancy of > 6 months. We reviewed charts of all patients who died in the ICU at a university-affiliated hospital between 2005-2010...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156582/a-model-of-early-integration-of-palliative-care-into-oncology-care-for-patients-with-metastatic-colorectal-cancer
#20
Laura Cantino, Ingrid Maravilla, Nicole Thompson, Chloe Evelyn Atreya, Kara Bischoff
: 142 Background: Current NCCN guidelines recommend that "institutions should develop processes for integrating palliative care into cancer care." However, it is not clear what the best method is for implementing this integrated care. Palliative care needs specific to patients with metastatic colorectal cancer (mCRC) and best practices for integration of outpatient palliative and oncologic care in mCRC are not well understood. METHODS: We conducted a pre-post prospective cohort study to evaluate the palliative care needs of mCRC patients and the implementation of an integrated palliative care program...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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