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Early intervention of palliative care

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https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#1
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29144172/disruptions-in-sleep-wake-cycles-in-community-dwelling-cancer-patients-receiving-palliative-care-and-their-correlates
#2
Marie Solange Bernatchez, Josée Savard, Hans Ivers
Significant disruptions in sleep-wake cycles have been found in advanced cancer patients in prior research. However, much remains to be known about specific sleep-wake cycle variables that are impaired in patients with a significantly altered performance status. More studies are also needed to explore the extent to which disrupted sleep-wake cycles are related to physical and psychological symptoms, time to death, maladaptive sleep behaviors, quality of life and 24-h light exposure. This study conducted in palliative cancer patients was aimed at characterizing patients' sleep-wake cycles using various circadian parameters (i...
November 16, 2017: Chronobiology International
https://www.readbyqxmd.com/read/29140772/role-of-patient-coping-strategies-in-understanding-the-effects-of-early-palliative-care-on-quality-of-life-and-mood
#3
Joseph A Greer, Jamie M Jacobs, Areej El-Jawahri, Ryan D Nipp, Emily R Gallagher, William F Pirl, Elyse R Park, Alona Muzikansky, Juliet C Jacobsen, Vicki A Jackson, Jennifer S Temel
Purpose The early integration of oncology and palliative care (EIPC) improves quality of life (QOL) and mood for patients with advanced cancer. However, the mechanisms by which EIPC benefits these outcomes remain unclear. We therefore examined whether EIPC improved patients' coping strategies and if changes in coping accounted for intervention effects on QOL and depressive symptoms. Patients and Methods For this secondary analysis of an EIPC trial, we examined data from 350 patients with newly diagnosed incurable lung or GI cancer...
November 15, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29130418/caregiver-quality-of-life-in-advanced-cancer-qualitative-results-from-a-trial-of-early-palliative-care
#4
Julie McDonald, Nadia Swami, Ashley Pope, Sarah Hales, Rinat Nissim, Gary Rodin, Breffni Hannon, Camilla Zimmermann
BACKGROUND: Early involvement of palliative care improves patient quality of life; however, quantitative studies have not yet demonstrated a similar effect for caregivers, for whom the construct of quality of life is less well developed. AIM: To conceptualise quality of life of caregivers from their own perspective and to explore differences in themes between those who did or did not receive an early palliative care intervention. DESIGN: Qualitative grounded theory study...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29121789/a-descriptive-analysis-of-end-of-life-conversations-with-long-term-glioblastoma-survivors
#5
Stephen P Miranda, Rachelle E Bernacki, Joanna M Paladino, Andrew D Norden, Jane E Kavanagh, Marissa C Palmor, Susan D Block
BACKGROUND: Early, high-quality serious illness (SI) conversations are critical for patients with glioblastoma (GBM) but are often mistimed or mishandled. OBJECTIVE: To describe the prevalence, timing, and quality of documented SI conversations and evaluate their focus on patient goals/priorities. DESIGN/PARTICIPANTS: Thirty-three patients with GBM enrolled in the control group of a randomized controlled trial of a communication intervention and were followed for 2 years or until death...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29081717/designing-and-testing-an-end-of-life-discussion-intervention-for-african-american-patients-with-heart-failure-and-their-families
#6
Ubolrat Piamjariyakul, Carol E Smith, Marilyn Werkowitch, Noreen Thompson, Maria Fox, Karin Porter Williamson, Lori Olson
There is an escalating prevalence of heart failure (HF) with high mortality. Compared with other races, African Americans face a higher incidence of HF at earlier age of onset, with more rapid progression, and with increased family care burden and greater care costs and disparity in health care services at the end of life (EOL). Concomitant out-of-pocket HF costs and care demands indicate the need for early discussion of palliative and EOL care needs. We therefore developed and pilot tested a culturally sensitive intervention specific to the needs of African American HF patients and their families at the EOL...
December 2016: Journal of Hospice and Palliative Nursing: JHPN
https://www.readbyqxmd.com/read/29048177/the-role-of-a-palliative-care-intervention-in-moderating-the-relationship-between-depression-and-survival-among-individuals-with-advanced-cancer
#7
Anna T Prescott, Jay G Hull, J Nicholas Dionne-Odom, Tor D Tosteson, Kathleen Doyle Lyons, Zhigang Li, Zhongze Li, Konstantin H Dragnev, Mark T Hegel, Karen E Steinhauser, Tim A Ahles, Marie A Bakitas
OBJECTIVE: Randomized controlled trials (RCTs) of early palliative care interventions in advanced cancer have positively impacted patient survival, yet the mechanisms remain unknown. This secondary analysis of 2 RCTs assessed whether an early palliative care intervention moderates the relationship between depressive symptoms and survival. METHOD: The relationships among mood, survival, and early palliative care intervention were studied among 529 advanced cancer patients who participated in 2 RCTs...
October 19, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/29037271/trajectories-of-caregiver-burden-in-families-of-adult-cystic-fibrosis-patients
#8
Ann Wojtaszczyk, Myra Glajchen, Russell K Portenoy, Maria Berdella, Patricia Walker, Malcolm Barrett, Jack Chen, Amy Plachta, Julie Balzano, Ashley Fresenius, Kenya Wilder, Elinor Langfelder-Schwind, Lara Dhingra
OBJECTIVES: Little is known about the experience of family caregivers of adults with cystic fibrosis (CF). This information is important for the identification of caregivers at risk for burden. METHODS: This was a longitudinal analysis of survey data obtained from caregivers of adult CF patients participating in an early intervention palliative care trial. Caregivers completed the validated Brief Assessment Scale for Caregivers (BASC) repeatedly over a 28-month period...
October 17, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29030206/the-impact-of-supporting-family-caregivers-pre-bereavement-on-outcomes-post-bereavement-adequacy-of-end-of-life-support-and-achievement-of-preferred-place-of-death
#9
Samar M Aoun, Gail Ewing, Gunn Grande, Chris Toye, Natasha Bear
OBJECTIVES: This study investigated the extent to which using the Carer Support Needs Assessment Tool (CSNAT) intervention during the caregiving period has affected bereaved family caregivers' perceptions of adequacy of support, their grief and wellbeing and achievement of their preferred place of death. METHOD: All family caregivers who participated in a stepped wedge cluster trial of the CSNAT intervention in Western Australia (2012-14) and completed the pre-bereavement study (n=322) were invited to take part in a caregiver survey by telephone 4-6 months post-bereavement (2015)...
October 10, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28993099/recognising-older-frail-patients-near-the-end-of-life-what-next
#10
Magnolia Cardona-Morrell, Ebony Lewis, Sanjay Suman, Cilla Haywood, Marcella Williams, Audrey-Anne Brousseau, Sally Greenaway, Ken Hillman, Elsa Dent
Frailty is a state of vulnerability resulting from cumulative decline in many physiological systems during a lifetime. It is progressive and considered largely irreversible, but its progression may be controlled and can be slowed down and its precursor -pre-frailty- can be treated with multidisciplinary intervention. The aim of this narrative review is to provide an overview of the different ways of measuring frailty in community settings, hospital, emergency, general practice and residential aged care; suggest occupational groups who can assess frailty in various services; discuss the feasibility of comprehensive geriatric assessments; and summarise current evidence of its management guidelines...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28984676/advances-in-understanding-and-management-of-lymphoedema-cancer-primary
#11
Vaughan Keeley
PURPOSE OF REVIEW: Despite being neglected both clinically and in research in the past, primary lymphoedema, and lymphoedema secondary to cancer treatment have been the subject of an increasing number of studies in recent years. This review will focus on new developments relevant to clinical practice. RECENT FINDINGS: The main themes covered by the review include the incidence and prevalence of lymphoedema, early detection and intervention in cancer-related lymphoedema, risk reduction for the development of cancer-related lymphoedema, surgical treatment, palliative care for lymphoedema in advanced cancer and developments in the genetics of primary lymphoedema...
December 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28969619/animal-assisted-therapy-at-a-university-centre-for-palliative-medicine-a-qualitative-content-analysis-of-patient-records
#12
Andrea Schmitz, Melanie Beermann, Colin R MacKenzie, Katharina Fetz, Christian Schulz-Quach
BACKGROUND: Animal-assisted therapy (AAT) is a therapeutic concept, which has only recently been explored in more detail within the palliative care setting. A programme of AAT was begun in June 2014 at the Interdisciplinary Centre for Palliative Medicine of the University Hospital Dusseldorf, Germany. The AAT sessions were performed by two trained and certified dog assistant therapy teams (DATT). To date only very limited scientific data are available with regard to feasibility, therapeutic indications and efficacy of AAT in palliative care...
October 2, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28952881/is-early-integration-of-palliative-care-feasible-and-acceptable-for-advanced-respiratory-and-gastrointestinal-cancer-patients-a-phase-2-mixed-methods-study
#13
Massimo Costantini, Giovanni Apolone, Silvia Tanzi, Francesco Falco, Ermanno Rondini, Monica Guberti, Silvia Fanello, Silvio Cavuto, Luisa Savoldi, Roberto Piro, Daniela Mecugni, Silvia Di Leo
BACKGROUND: There is evidence that early integration of palliative care improves quality of life, lowers spending and helps clarify preferences and goals for advanced cancer patients. Little is known about the feasibility and acceptability of early integration. AIM: Assessing feasibility of early integration of palliative care, and exploring concerns perceived and problems encountered by patients, relatives and oncologists. DESIGN: A phase 2 mixed-methods study ( ClinicalTrials...
September 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28945719/palliative-care-improving-nursing-knowledge-attitudes-and-behaviors%C3%A2
#14
Karen Harden, Deborah Price, Elizabeth Duffy, Laura Galunas, Cheryl Rodgers
BACKGROUND: Oncology nurses affect patient care at every point along the cancer journey. This creates the perfect opportunity to educate patients and caregivers about palliative care early and often throughout treatment. However, healthcare providers frequently do not have the knowledge and confidence to engage in meaningful conversations about palliative care.
. OBJECTIVES: The specific aims were to improve oncology nurses' palliative care knowledge, attitudes, and behaviors by providing a palliative care nursing education program...
October 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28935132/acute-leukemia-patients-needs-qualitative-findings-and-opportunities-for-early-palliative-care
#15
Nathan A Boucher, Kimberly S Johnson, Thomas W LeBlanc
BACKGROUND AND OBJECTIVE: Patients with acute leukemias likely have needs that palliative care can respond to, yet little is known about specific challenges they face, particularly during active treatment. We examined acute myeloid leukemia (AML) patients' expressed challenges and supports following intensive induction chemotherapy. We aimed to understand opportunities for palliative care interventions in this population. METHODS: A qualitative study of AML patients with high-risk disease at Duke University Hospital, Durham, NC...
September 18, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28898603/strange-bedfellows-no-more-how-integrated-stem-cell-transplantation-and-palliative-care-programs-can-together-improve-end-of-life-care
#16
Deena R Levine, Justin N Baker, Joanne Wolfe, Leslie E Lehmann, Christina Ullrich
In the intense, cure-oriented setting of hematopoietic stem-cell transplantation (HSCT), delivery of high-quality palliative and end-of-life care is a unique challenge. Although HSCT affords patients a chance for cure, it carries a significant risk of morbidity and mortality. During HSCT, patients usually experience high symptom burden and a significant decrease in quality of life that can persist for long periods. When morbidity is high and the chance of cure remote, the tendency after HSCT is to continue intensive medical interventions with curative intent...
September 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28894017/effects-of-early-integrated-palliative-care-on-caregivers-of-patients-with-lung-and-gastrointestinal-cancer-a-randomized-clinical-trial
#17
Areej El-Jawahri, Joseph A Greer, William F Pirl, Elyse R Park, Vicki A Jackson, Anthony L Back, Mihir Kamdar, Juliet Jacobsen, Eva H Chittenden, Simone P Rinaldi, Emily R Gallagher, Justin R Eusebio, Sarah Fishman, Harry VanDusen, Zhigang Li, Alona Muzikansky, Jennifer S Temel
BACKGROUND: The family and friends (caregivers) of patients with advanced cancer often experience tremendous distress. Although early integrated palliative care (PC) has been shown to improve patient-reported quality of life (QOL) and mood, its effects on caregivers' outcomes is currently unknown. MATERIALS AND METHODS: We conducted a randomized trial of early PC integrated with oncology care versus oncology care alone for patients who were newly diagnosed with incurable lung and noncolorectal gastrointestinal cancers and their caregivers...
September 11, 2017: Oncologist
https://www.readbyqxmd.com/read/28859648/engaging-patients-and-families-to-create-a-feasible-clinical-trial-integrating-palliative-and-heart-failure-care-results-of-the-enable-chf-pc-pilot-clinical-trial
#18
Marie Bakitas, J Nicholas Dionne-Odom, Salpy V Pamboukian, Jose Tallaj, Elizabeth Kvale, Keith M Swetz, Jennifer Frost, Rachel Wells, Andres Azuero, Konda Keebler, Imatullah Akyar, Deborah Ejem, Karen Steinhauser, Tasha Smith, Raegan Durant, Alan T Kono
BACKGROUND: Early palliative care (EPC) is recommended but rarely integrated with advanced heart failure (HF) care. We engaged patients and family caregivers to study the feasibility and site differences in a two-site EPC trial, ENABLE CHF-PC (Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare for Patients and Caregivers). METHODS: We conducted an EPC feasibility study (4/1/14-8/31/15) for patients with NYHA Class III/IV HF and their caregivers in academic medical centers in the northeast and southeast U...
August 31, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28842218/does-modality-matter-palliative-care-units-associated-with-more-cost-avoidance-than-consultations
#19
Peter May, Melissa M Garrido, Egidio Del Fabbro, Danielle Noreika, Charles Normand, Nevena Skoro, J Brian Cassel
CONTEXT: Inpatient palliative care is associated with reduced costs, but the optimal model for providing inpatient palliative care is unknown. OBJECTIVES: To estimate the effect of palliative care consultations (PCC) and care in a palliative care unit (PCU) on cost of care, in comparison with usual care (UC) only and in comparison with each other. METHODS: Retrospective cohort study, using multinomial propensity scoring to control for observed confounding between treatment groups...
August 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28839942/early-palliative-home-care-evaluation-of-an-interprofessional-educational-intervention-for-district-nurses-and-general-practitioners-about-nutritional-care
#20
Erika Berggren, Ann Ödlund Olin, Ylva Orrevall, Peter Strang, Sven-Erik Johansson, Lena Törnkvist
BACKGROUND: Teamwork is important in early palliative home care, and interprofessional education is required to achieve teamwork. It is thus crucial to ensure that interprofessional education works well for the members of all participating professions because levels of knowledge and educational needs may vary. AIM: To evaluate, by profession, the effectiveness of an interprofessional educational intervention for district nurses and general practitioners on three areas of nutritional care for patients in a palliative phase...
2017: SAGE Open Medicine
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