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Early intervention of palliative care

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https://www.readbyqxmd.com/read/28384214/care-of-cancer-patients-at-the-end-of-life-in-a-german-university-hospital-a-retrospective-observational-study-from-2014
#1
Burkhard Dasch, Helen Kalies, Berend Feddersen, Caecilie Ruderer, Wolfgang Hiddemann, Claudia Bausewein
BACKGROUND: Cancer care including aggressive treatment procedures during the last phase of life in patients with incurable cancer has increasingly come under scrutiny, while integrating specialist palliative care at an early stage is regarded as indication for high quality end-of-life patient care. AIM: To describe the demographic and clinical characteristics and the medical care provided at the end of life of cancer patients who died in a German university hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28365652/interstage-home-monitoring-after-newborn-first-stage-palliation-for-hypoplastic-left-heart-syndrome-family-education-strategies
#2
Jo Ann Nieves, Karen Uzark, Nancy A Rudd, Jennifer Strawn, Anne Schmelzer, Nancy Dobrolet
Children born with hypoplastic left heart syndrome are at high risk for serious morbidity, growth failure, and mortality during the interstage period, which is the time from discharge home after first-stage hypoplastic left heart syndrome palliation until the second-stage surgical intervention. The single-ventricle circulatory physiology is complex, fragile, and potentially unstable. Multicenter initiatives have been successfully implemented to improve outcomes and optimize growth and survival during the interstage period...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28364384/speaking-up-how-patient-and-physician-voices-shaped-a-trial-to-improve-goals-of-care-discussions
#3
Rachel Solomon, Cardinale Smith, Jay Kallio, Amy Fenollosa, Barbara Benerofe, Laurence Jones, Kerin Adelson, Jason P Gonsky, Carolyn Messner, Nina A Bickell
BACKGROUND: Patients with advanced cancer benefit from early goals-of-care (GoC) conversations, but few facilitators are known. OBJECTIVE: We describe the process and outcomes of involving patient and physician stakeholders in the design and development of a trial, funded by the Patient-Centered Outcomes Research Institute (PCORI), to enhance oncologists' communication skills and their propensity to facilitate productive, meaningful GoC discussions with patients with advanced cancer...
March 31, 2017: Patient
https://www.readbyqxmd.com/read/28360525/the-importance-of-a-multidisciplinary-approach-to-hepatocellular-carcinoma
#4
REVIEW
Osama Siddique, Eric R Yoo, Ryan B Perumpail, Brandon J Perumpail, Andy Liu, George Cholankeril, Aijaz Ahmed
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. The rising incidence, genetic heterogeneity, multiple etiologies, and concurrent chronic liver diseases make diagnosis, staging, and selection of treatment options challenging in patients with HCC. The best approach to optimize the management of HCC is one that utilizes a core multidisciplinary liver tumor board, consisting of hepatologists, pathologists, interventional radiologists, oncologists, hepatobiliary and transplant surgeons, nurses, and general practitioners...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28353374/prediction-of-poor-short-term-prognosis-and-unmet-needs-in-advanced-chronic-obstructive-pulmonary-disease-use-of-the-two-minute-walking-distance-extracted-from-a-six-minute-walk-test
#5
Han-Yee Neo, Hui-Ying Xu, Huei-Yaw Wu, Allyn Hum
OBJECTIVES: Prognostic challenges hinder the identification of patients with advanced chronic obstructive pulmonary disease (COPD) for timely palliative interventions. We postulate that a two-minute derivative (two-minute walking distance [2MWD]) of a standard six-minute walk test (6MWT) can identify frail subjects with poorer survival for early palliative intervention. The primary outcome of interest is mortality at 18 months. Secondary objectives include evaluation of the relationship between the 2MWD and ability to self-care, dyspnea-related disabilities, nutrition, forced expiratory volume in first second (FEV1), quality of life (QoL), and comorbidity burden...
March 29, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28346017/strong-in-the-face-of-adversity
#6
Simoni Binoy
Palliative care provides holistic care to individuals in life-threatening or life-limiting conditions. This narrative describes the journey of Kanchan. A strong lady and a doting mother, she came to the hospital by choice, in immense pain and with swelling. Her narrative illustrates how the palliative approach draws out the inner strengths of individuals by focusing on their issues and needs. Kanchan was able to benefit from physiotherapy to reduce the risk of lymphoedema after surgery for breast cancer. Her narrative illustrates how she found comfort and relief, ably supported by the dedicated hospital team...
March 27, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28341224/palliative-care-and-its-emerging-role-in-multiple-system-atrophy-and-progressive-supranuclear-palsy
#7
REVIEW
Louise Wiblin, Mark Lee, David Burn
Multiple System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP) are sporadic, neurodegenerative conditions and belong to a group known as the atypical Parkinsonian disorders. The atypical Parkinsonian (AP) disorders have some features of idiopathic Parkinson's disease (PD) but often with poor or transient levodopa response [1], distinct symptom profiles, more rapid progression and reduced survival. They have significant symptom burden [2]. It is beginning to be appreciated that AP disorders not only carry a heavy symptom burden equivalent to that of patients with advanced cancer but that AP patients experience significant morbidity for an extended period of time...
January 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28335910/management-strategies-for-cln2-disease
#8
REVIEW
Ruth E Williams, Heather R Adams, Martin Blohm, Jessica L Cohen-Pfeffer, Emily de Los Reyes, Jonas Denecke, Kristen Drago, Charlie Fairhurst, Margie Frazier, Norberto Guelbert, Szilárd Kiss, Annamaria Kofler, John A Lawson, Lenora Lehwald, Mary-Anne Leung, Svetlana Mikhaylova, Jonathan W Mink, Miriam Nickel, Renée Shediac, Katherine Sims, Nicola Specchio, Meral Topcu, Ina von Löbbecke, Andrea West, Boris Zernikow, Angela Schulz
CLN2 disease (neuronal ceroid lipofuscinosis type 2) is a rare, autosomal recessive, pediatric-onset, rapidly progressive neurodegenerative lysosomal storage disorder caused by tripeptidyl peptidase 1 (TPP1) enzyme deficiency, and is characterized by language delay, seizures, rapid cognitive and motor decline, blindness, and early death. No management guidelines exist and there is a paucity of published disease-specific evidence to inform clinical practice, which currently draws upon experience from the field of childhood neurodisability...
April 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28301279/integrating-palliative-care-services-in-ambulatory-oncology-an-application-of-the-edmonton-symptom-assessment-system
#9
Sherri L Rauenzahn, Susanne Schmidt, Ifeoma O Aduba, Jessica T Jones, Nazneen Ali, Laura L Tenner
PURPOSE: Research in palliative care demonstrates improvements in overall survival, quality of life, symptom management, and reductions in the cost of care. Despite the American Society of Clinical Oncology recommendation for early concurrent palliative care in patients with advanced cancer and high symptom burden, integrating palliative services is challenging. Our aims were to quantitatively describe the palliative referral rates and symptom burden in a South Texas cancer center and establish a palliative referral system by implementing the Edmonton Symptom Assessment Scale (ESAS)...
April 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28277698/does-educating-patients-about-the-early-palliative-care-study-increase-preferences-for-outpatient-palliative-cancer-care-findings-from-project-empower
#10
Michael Hoerger, Laura M Perry, Robert Gramling, Ronald M Epstein, Paul R Duberstein
OBJECTIVES: Randomized controlled trials, especially the Early Palliative Care Study (Temel et al., 2010), have shown that early outpatient palliative cancer care can improve quality of life for patients with advanced cancer or serious symptoms. However, fear and misconceptions drive avoidance of palliative care. Drawing from an empowerment perspective, we examined whether educating patients about evidence from the Early Palliative Care Study would increase preferences for palliative care...
March 9, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28242790/factors-associated-with-early-mortality-among-patients-with-de-novo-metastatic-breast-cancer-a-population-based-study
#11
Ines Vaz-Luis, Nancy U Lin, Nancy L Keating, William T Barry, Eric P Winer, Rachel A Freedman
BACKGROUND: Although improvements in survival have been achieved for patients with metastatic breast cancer, some patients experience early death after diagnosis. PATIENTS AND METHODS: Using Surveillance, Epidemiology, and End Results data, we identified 26,538 patients with de novo metastatic breast cancer diagnosed between January 1, 2000 and June 30, 2011. We evaluated time trends for deaths at 1 and 6 months after diagnosis. We then restricted the cohort to patients diagnosed between 2010 and 2011 (n = 3,317), when human epidermal growth factor receptor 2 was routinely collected, and examined factors associated with early death...
April 2017: Oncologist
https://www.readbyqxmd.com/read/28209067/barriers-to-nausea-management-end-of-life-conversations-early-palliative-care-interventions-and-patient-education
#12
Charles B Simone
No abstract text is available yet for this article.
January 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28208923/long-term-outcome-in-patients-with-esophageal-stenting-for-cancer-esophagus-our-experience-at-a-rural-hospital-of-punjab-india
#13
Parvinder Singh, Abhitesh Singh, Anantbir Singh, Ghansham Sharma, Parmod Kumar Bhatia, Amarjeet Singh Grover
INTRODUCTION: Cancer of the esophagus is among the leading cause of cancer deaths in Punjab, India. Patients generally present with dysphagia as their first symptom and more often they have advanced disease at the time of presentation to a tertiary care centre. Palliative procedures have important roles in this setting. Stenting is the best option to palliate the symptoms of dysphagia, from which patient is suffering the most. AIM: To know the success rate, early and long term complications and mortality in esophageal stenting, when it was done in malignant esophageal stricture patients...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
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
#14
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/28156634/randomized-trial-of-early-integrated-palliative-and-oncology-care
#15
Areej El-Jawahri, William F Pirl, Vicki A Jackson, Elyse R Park, Anthony Back, Alona Muzikansky, Mihir Kamdar, Simone Rinaldi, Juliet Jacobsen, Emily R Gallagher, Joel Fishbein, Justin Eusebio, Harry VanDusen, Jennifer S Temel
104 Background: Early palliative care (PC) improves outcomes in patients with newly diagnosed metastatic non-small cell lung cancer (NSCLC) and in patients identified by clinicians as having poor prognosis, advanced cancer. We evaluated the impact of early, integrated palliative and oncology care in patients with newly diagnosed lung and gastrointestinal (GI) cancer. METHODS: Between 5/2/11 and 7/20/15, we randomly assigned patients with newly diagnosed incurable lung (NSCLC, small cell, mesothelioma) or GI (pancreas, hepatobiliary, gastric, esophageal) cancer to PC integrated with oncology care (monthly visits with PC) or usual oncology care...
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
#16
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
https://www.readbyqxmd.com/read/28156564/advance-care-planning-and-specialty-palliative-care-utilization-for-patients-with-hematologic-malignancies-who-undergo-allogeneic-hematopoietic-cell-transplant
#17
Lisa M McNey, Erik Eckhert, Derek Galligan, Gabriel N Mannis
18 Background: Unlike most metastatic solid tumors, many advanced hematologic malignancies are treated with curative intent. Accordingly, aggressive interventions often continue until late in the disease course because it can be difficult to discern when cure is no longer possible. This is particularly true for recipients of allogeneic hematopoietic cell transplant (alloHCT). We hypothesized that alloHCT recipients and their providers would be less likely to utilize specialty Palliative Care (PC) services or to engage in early communication regarding advance care planning...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156557/a-pilot-trial-of-early-specialty-palliative-care-for-patients-with-advanced-pancreatic-cancer-challenges-encountered-and-lessons-learned
#18
Nathan Bahary, Rene Claxton, Julie Childers, Dio Kavalieratos, Linda King, Barry C Lembersky, Seo Young Park, Greer A Tiver, Robert Arnold
110 Background: Palliative care trials face implementation barriers. We describe challenges encountered in a pilot trial of early specialty palliative care for patients with pancreatic cancer. METHODS: We conducted a mixed-methods pilot randomized controlled trial of early specialty physician-led palliative care in advanced pancreatic cancer. Recently diagnosed patients with borderline, locally-advanced, or metastatic pancreatic cancer and their caregivers (total N=60) were recruited from clinic at a comprehensive cancer center and randomized (2:1) to receive monthly specialty palliative care visits for 3 months in addition to standard oncology care vs...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156551/effect-of-early-integrated-palliative-care-on-family-caregivers-fc-outcomes-for-patients-with-gastrointestinal-and-lung-cancer
#19
Vicki A Jackson, Joseph A Greer, William F Pirl, Elyse R Park, Anthony Back, Alona Muzikansky, Mihir Kamdar, Simone Rinaldi, Juliet Jacobsen, Joel Fishbein, Justin Eusebio, Harry VanDusen, Ryan David Nipp, David P Ryan, Jennifer S Temel
234 Background: Patients with newly diagnosed advanced cancers who receive early palliative care (PC) integrated with oncology care report improvement in their quality of life (QOL) and mood. While a telephone-based psycho-educational intervention for FC decrease depression, the impact of early, integrated outpatient PC models on FC outcomes remains unknown. METHODS: We conducted a randomized trial of early PC integrated with oncology care versus oncology care alone for newly diagnosed patients with incurable lung and gastrointestinal cancers and their FC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156543/oncology-patients-in-the-health-care-safety-net-is-it-too-late-for-early-palliative-care
#20
Anne Kinderman, Leslie Safier
128 Background: Studies have suggested that uninsured and Medicaid patients are more likely to present with late-stage cancer than Medicare patients, and may be more likely to be admitted urgently or emergently. However, studies of palliative care interventions for cancer patients suggest that the greatest impact can be achieved if these services begin "early" (≥ 90 days prior to death). In our urban public hospital, we examined where patients receive their initial cancer diagnosis, and at what stage they are diagnosed, in order to determine how to best implement community-based palliative care services...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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