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Early intervention of palliative care

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https://www.readbyqxmd.com/read/28097649/hospital-variation-in-utilization-of-life-sustaining-treatments-among-patients-with-do-not-resuscitate-orders
#1
Allan J Walkey, Janice Weinberg, Renda Soylemez Wiener, Colin R Cooke, Peter K Lindenauer
OBJECTIVE: To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. DATA SOURCES/SETTING: United States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database. STUDY DESIGN: Retrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in-hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28097515/distress-is-interdependent-in-patients-and-caregivers-with-newly-diagnosed-incurable-cancers
#2
Jamie M Jacobs, Kelly M Shaffer, Ryan D Nipp, Joel N Fishbein, James MacDonald, Areej El-Jawahri, William F Pirl, Vicki A Jackson, Elyse R Park, Jennifer S Temel, Joseph A Greer
BACKGROUND: Individuals with advanced, incurable cancer often experience high physical and psychological symptom burden. Family and friend caregivers are at risk for emotional distress. PURPOSE: The aim of the study is to investigate the interrelationship of distress in patient-caregiver dyads at the time of newly diagnosed incurable cancer. METHODS: From May 2011 to July 2015, within 8 weeks of diagnosis of advanced lung or noncolorectal gastrointestinal cancer, 350 patients and 275 family caregivers were enrolled in a randomized controlled trial of early palliative care...
January 17, 2017: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/28095941/preparation-for-the-end-of-life-and-life-completion-during-late-stage-lung-cancer-an-exploratory-analysis
#3
Gail Adorno, Cara Wallace
OBJECTIVE: Our aim was to explore preparation for the end of life (EoL) and life closure among persons with advanced metastatic lung cancer. Understanding quality of life through the lens of preparation and completion is important since the trajectory of lung cancer can be relatively short, often leading to application of cancer-directed therapies near death without the opportunity for advance planning or palliative care. Clinical research is needed to understand the kinds of distress specific to older adults with advanced lung cancer that are amendable to palliative care interventions...
January 18, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28042068/empowering-bereaved-parents-through-the-development-of-a-comprehensive-bereavement-program
#4
Jennifer M Snaman, Erica C Kaye, Deena R Levine, Brittany Cochran, Robin Wilcox, Charlene K Sparrow, Nancy Noyes, Lisa Clark, Wendy Avery, Justin N Baker
Parents who experience the loss of a child have unique and valuable insights into the grief journey and can help healthcare providers identify key components intrinsic to the development, implementation, and maintenance of a comprehensive bereavement program. The bereavement program at St. Jude Children's Research Hospital was developed by pediatric palliative care experts in collaboration with bereaved parents to standardize and improve the institutional support provided to families around and after the death of a child...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28029308/effects-of-early-integrated-palliative-care-in-patients-with-lung-and-gi-cancer-a-randomized-clinical-trial
#5
Jennifer S Temel, Joseph A Greer, Areej El-Jawahri, 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, Zhigang Li, Alona Muzikansky, David P Ryan
Purpose We evaluated the impact of early integrated palliative care (PC) in patients with newly diagnosed lung and GI cancer. Patients and Methods We randomly assigned patients with newly diagnosed incurable lung or noncolorectal GI cancer to receive either early integrated PC and oncology care (n = 175) or usual care (n = 175) between May 2011 and July 2015. Patients who were assigned to the intervention met with a PC clinician at least once per month until death, whereas those who received usual care consulted a PC clinician upon request...
December 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27981164/inclusion-of-palliative-care-in-indian-undergraduate-physiotherapy-curriculum-course-guidelines-and-content
#6
Zubia Veqar
According to the guidelines published by the WHO in 2010, palliative care has been defined as "an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual." Intervention provided as a part of the palliative care has to be by health professionals who strictly work as a part of the multidisciplinary team and have been specifically trained to an optimal level of competency in the field...
July 2016: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/27943444/frequency-and-intensity-of-symptoms-and-treatment-interventions-in-hospitalized-older-palliative-cancer-patients-a-multicentre-cross-sectional-study
#7
Aurélie Van Lancker, Dimitri Beeckman, Nele Van Den Noortgate, Sofie Verhaeghe, Ann Van Hecke
AIM: To increase the knowledge of the frequency and intensity of symptoms and the treatment interventions in older palliative cancer patients. BACKGROUND: Research on symptoms and the treatment modalities in older palliative cancer patients is scarce. Insight into these aspects is needed to enable healthcare professionals to alleviate the burden. DESIGN: A cross-sectional study. METHODS: Four hundred hospitalized older palliative cancer patients participated in the study between March 2013 - February 2015...
December 10, 2016: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/27920233/pilot-evaluation-of-a-palliative-and-end-of-life-communication-intervention-for-parents-of-children-with-a-brain-tumor
#8
Verna L Hendricks-Ferguson, Kamnesh Pradhan, Chie-Schin Shih, Karen M Gauvain, Javier R Kane, Jingxia Liu, Joan E Haase
Providing timely palliative and end-of-life care (PC/EOL) information to parents of children with a serious illness is a national health care priority. The goals of this study were to determine feasibility, acceptability, and parent responses related to a PC/EOL communication intervention, titled "Communication Plan: Early through End of Life (COMPLETE)" to parents of children with a brain tumor. The study was a 2-site prospective, single-group pilot study targeting parents' stress and coping outcomes. The sample included 13 parents of 11 children (ie, 11 families)...
December 4, 2016: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/27871024/is-it-time-to-address-survivorship-in-advanced-breast-cancer-a-review-article
#9
REVIEW
Simona Di Lascio, Olivia Pagani
The outcome of advanced breast cancer has significantly improved over recent decades. As a consequence, the complex needs of patients living with the disease and their care-givers should be addressed not only in terms of supportive and palliative care but also of "survivorship" requirements. The multidisciplinary approach to advanced breast cancer should encompass - early in the history of the disease - not only physical but also functional, social, psychological and spiritual domains. It is important to clearly define the disease context with patients and families ("chronic" preferred to "incurable"), addressing the concept of uncertainty, and tailoring the treatment strategy according to both disease status and individual priorities...
February 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#10
Jon Kaufman, Daniel Phadke, Suhong Tong, Jennifer Eshelman, Sarah Newman, Christopher Ruzas, Eduardo M da Cruz, Suzanne Osorio
: Dysnatremias (DN) are common electrolyte disturbances in cardiac critical illness and are known risk factors for adverse outcomes in certain populations. Little information exists on DN in children with cardiac disease admitted to the cardiac intensive care unit (CICU) after undergoing cardiac surgery, either corrective or palliative. The aim was to determine the incidence and adverse outcomes associated with DN in neonates and infants undergoing cardiac surgery. Retrospective cohort and single center study performed at Children's Hospital Colorado from May 2013 to May 2014, in children under 1 year old admitted to the CICU after undergoing surgery for congenital or acquired cardiac disease...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27821313/systematic-versus-on-demand-early-palliative-care-a-randomised-clinical-trial-assessing-quality-of-care-and-treatment-aggressiveness-near-the-end-of-life
#11
Marco Maltoni, Emanuela Scarpi, Monia Dall'Agata, Stefania Schiavon, Claudia Biasini, Carla Codecà, Chiara Maria Broglia, Elisabetta Sansoni, Roberto Bortolussi, Ferdinando Garetto, Luisa Fioretto, Maria Teresa Cattaneo, Alice Giacobino, Massimo Luzzani, Giovanna Luchena, Sara Alquati, Silvia Quadrini, Vittorina Zagonel, Luigi Cavanna, Daris Ferrari, Paolo Pedrazzoli, Giovanni Luca Frassineti, Antonella Galiano, Andrea Casadei Gardini, Manlio Monti, Oriana Nanni
AIM: Early palliative care (EPC) in oncology has shown sparse evidence of a positive impact on patient outcomes, quality of care outcomes and costs. PATIENTS AND METHODS: Data for this secondary analysis were taken from a trial of 207 outpatients with metastatic pancreatic cancer randomly assigned to receive standard cancer care plus on-demand EPC (standard arm) or standard cancer care plus systematic EPC (interventional arm). After 20 months' follow-up, 149 (80%) had died...
November 4, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27815954/development-of-a-middle-age-and-geriatric-trauma-mortality-risk-score-a-tool-to-guide-palliative-care-consultations
#12
Sanjit R Konda, Rachel Seymour, Arthur Manoli, Jordan Gales, Madhav A Karunakar
INTRODUCTION: This study aimed to develop a tool to quantify risk of inpatient mortality among geriatric and middleaged trauma patients. This study sought to demonstrate the ability of the novel risk score in the early identification of high risk trauma patients for resource-sparing interventions, including referral to palliative medicine. MATERIALS AND METHODS: This retrospective cohort study utilized data from a single level 1 trauma center. Regression analysis was used to create a novel risk of inpatient mortality score...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27797240/prevalence-and-survival-patterns-of-patients-with-bone-metastasis-from-common-cancers-in-thailand
#13
Areerak Phanphaisarn, Jayantorn Patumanond, Jongkolnee Settakorn, Parunya Chaiyawat, Jeerawan Klangjorhor, Dumnoensun Pruksakorn
BACKGROUND: Bone metastasis is a single condition but presents with various patterns and severities. Skeletal- related events (SREs) deteriorate overall performance status and reduce quality of life. However, guidelines for early detection and management are limited. This study includes a survey of the prevalence of bone metastasis in cases with common cancers in Thailand as well as a focus on survival patterns and SREs. MATERIALS AND METHODS: A retrospective cohort analysis was conducted using a database of the Chiang Mai Cancer Registry and the Musculoskeletal Tumor Registry of the OLARN Center, Chiang Mai University...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27775842/a-karnofsky-performance-status-based-score-predicts-death-after-hospital-discharge-in-patients-with-cirrhosis
#14
Puneeta Tandon, K Rajender Reddy, Jacqueline G O'Leary, Guadalupe Garcia-Tsao, Juan G Abraldes, Florence Wong, Scott W Biggins, Benedict Maliakkal, Michael B Fallon, Ram M Subramanian, Paul Thuluvath, Patrick S Kamath, Leroy R Thacker, Jasmohan S Bajaj
: Identification of patients with cirrhosis at risk for death within 3 months of discharge from the hospital is essential to individualize postdischarge plans. The objective of the study was to identify an easy-to-use prognostic model based on the Karnofsky Performance Status (KPS). The North American Consortium for the Study of End-Stage Liver Disease consists of 16 tertiary-care hepatology centers that prospectively enroll nonelectively admitted cirrhosis patients. Patients enrolled had KPS assessed 1 week postdischarge...
January 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27768613/a-randomized-trial-of-palliative-care-discussions-linked-to-an-automated-early-warning-system-alert
#15
David Picker, Maria Dans, Kevin Heard, Thomas Bailey, Yixin Chen, Chenyang Lu, Marin H Kollef
OBJECTIVE: To determine whether an Early Warning System could identify patients wishing to focus on palliative care measures. DESIGN: Prospective, randomized, pilot study. SETTING: Barnes-Jewish Hospital, Saint Louis, MO (January 15, 2015, to December 12, 2015). PATIENTS: A total of 206 patients; 89 intervention (43.2%) and 117 controls (56.8%). INTERVENTIONS: Palliative care in high-risk patients targeted by an Early Warning System...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27734541/evidence-practice-gaps-in-lung-cancer-a-scoping-review
#16
N M Rankin, D McGregor, E Stone, P N Butow, J M Young, K White, T Shaw
Lung cancer is a significant international health problem. Aligning clinical practice with evidence-based guideline recommendations has the potential to improve patient outcomes. This scoping review describes evidence-practice gaps across the diagnostic and management care pathway for lung cancer. We conducted searches of online databases Medline, PsychInfo, Cinahl and the Cochrane Library to identify studies published between 2008 and 2012. Of 614 articles screened, 65 met inclusion criteria. We identified seven evidence-practice gaps: (1) delays in timely diagnosis and referral; (2) curative and (3) palliative treatments are under-utilised; (4) older age and co-morbidities influence the use of treatments; (5) the benefits of multidisciplinary team review are not available to all lung cancer patients; (6) psychosocial needs are unmet; and (7) early referral to palliative care services is under-utilised...
October 13, 2016: European Journal of Cancer Care
https://www.readbyqxmd.com/read/27720791/impact-of-palliative-care-screening-and-consultation-in-the-icu-a-multihospital-quality-improvement-project
#17
Robert J Zalenski, Spencer S Jones, Cheryl Courage, Denise R Waselewsky, Anna S Kostaroff, David Kaufman, Afzal Beemath, John Brofman, James W Castillo, Hicham Krayem, Anthony Marinelli, Bradley Milner, Maria Teresa Palleschi, Mona Tareen, Sheri Testani, Ayman Soubani, Julie Walch, Judy Wheeler, Sonali Wilborn, Hanna Granovsky, Robert D Welch
CONTEXT: There are few multicenter studies that examine the impact of systematic screening for palliative care and specialty consultation in the intensive care unit (ICU). OBJECTIVE: To determine the outcomes of receiving palliative care consultation (PCC) for patients who screened positive on palliative care referral criteria. METHODS: In a prospective quality assurance intervention with a retrospective analysis, the covariate balancing propensity score method was used to estimate the conditional probability of receiving a PCC and to balance important covariates...
January 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27701880/palliative-care-units-in-lung-cancer-in-the-real-world-setting-a-single-institution-s-experience-and-its-implications
#18
Eva Katharina Masel, Sophie Schur, Romina Nemecek, Michael Mayrhofer, Patrick Huber, Feroniki Adamidis, Bruno Maehr, Matthias Unseld, Herbert Hans Watzke, Robert Pirker
OBJECTIVE: Palliative care plays a crucial role in the overall management of patients with advanced lung cancer and was shown to lead to clinically meaningful improvement in quality of life, less aggressive endof-life care, and potentially prolonged survival. Here we summarize our single institution experience on palliative care in patients with lung cancer. METHODS: The data of patients with lung cancer treated at the palliative care unit of the Medical University of Vienna between June 2010 and March 2013 were retrospectively reviewed...
September 1, 2016: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/27687308/impact-of-early-palliative-care-on-caregivers-of-patients-with-advanced-cancer-cluster-randomised-trial
#19
J McDonald, N Swami, B Hannon, C Lo, A Pope, A Oza, N Leighl, M K Krzyzanowska, G Rodin, L W Le, C Zimmermann
BACKGROUND: Early palliative care improves the quality of life (QoL) and satisfaction with care of patients with advanced cancer, but little is known about its effect on caregivers. Here, we report outcomes of caregiver satisfaction with care and QoL from a trial of early palliative care. PATIENTS AND METHODS: Twenty-four medical oncology clinics were cluster-randomised, stratified by tumour site (lung, gastrointestinal, genitourinary, breast and gynaecological), to early palliative care team referral, or to standard oncology care with palliative care only as needed...
September 29, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27676853/pediatric-rehabilitation-and-pediatric-oncology-a-winner-association-the-experience-of-grenoble-pediatric-hospital
#20
Véronique Bourg, Anne Descotes, Anne Pagnier, Jacques Griffet, Dominique Plantaz
The Child and Family Hospital of Grenoble is one of the rare university hospitals in France to benefit from the presence of a physician specializing in rehabilitation medicine. This hospital includes both inpatient and outpatient units. During the temporary closure of one department, certain members of the rehabilitation unit were reassigned to the acute care wards of the pediatric department, including physical therapists, occupational therapists, and speech therapists. Over the course of one year, these therapists completed more than 150 interventions in this department, more than half of which were in the hematology and oncology ward...
September 2016: Annals of Physical and Rehabilitation Medicine
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