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Early intervention of palliative care

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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
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28836960/the-feasibility-and-benefit-of-a-brief-psychosocial-intervention-in-addition-to-early-palliative-care-in-patients-with-advanced-cancer-to-reduce-depressive-symptoms-a-pilot-randomized-controlled-clinical-trial
#6
Thamires Monteiro do Carmo, Bianca Sakamoto Ribeiro Paiva, Cleyton Zanardo de Oliveira, Maria Salete de Angelis Nascimento, Carlos Eduardo Paiva
BACKGROUND: The aim of this study was to assess the feasibility and potential benefit of a brief psychosocial intervention based on cognitive-behavioral therapy performed in addition to early palliative care (PC) in the reduction of depressive symptoms among patients with advanced cancer. METHODS: An open-label randomized phase II clinical trial with two intervention arms and one control group. Patients with advanced cancer starting palliative chemotherapy and who met the selection criteria were included...
August 23, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28835218/a-parallel-group-randomized-clinical-trial-of-individually-tailored-multidisciplinary-palliative-rehabilitation-for-patients-with-newly-diagnosed-advanced-cancer-the-pal-rehab-study-protocol
#7
Lise Nottelmann, Mogens Groenvold, Tove Bahn Vejlgaard, Morten Aagaard Petersen, Lars Henrik Jensen
BACKGROUND: The effect of early palliative care and rehabilitation on the quality of life of patients with advanced cancer has been only sparsely described and needs further investigation. In the present trial we combine elements of early, specialized palliative care with cancer rehabilitation in a 12-week individually tailored, palliative rehabilitation program initiated shortly after a diagnosis of advanced cancer. METHODS: This single center, randomized, controlled trial will include 300 patients with newly diagnosed advanced cancer recruited from the Department of Oncology, Vejle Hospital...
August 23, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28829002/supporting-wellbeing-in-motor-neurone-disease-for-patients-carers-social-networks-and-health-professionals-a-scoping-review-and-synthesis
#8
Melanie Harris, Geoff Thomas, Mary Thomas, Paul Cafarella, Allegra Stocks, Julia Greig, R Doug McEvoy
OBJECTIVE: Disease management in motor neurone disease (MND) is focused on preserving quality of life. However, the emphasis has so far been on physical symptoms and functioning and not psychosocial wellbeing. MND affects the wellbeing of carers, of family and social network members, and of healthcare providers, as well as of the patients. We therefore aimed to assess and synthesize the knowledge about maximizing MND-related psychosocial wellbeing across all these groups. METHOD: We used a systematic search and selection process to assess the scope of the literature along with a narrative synthesis of recent high-quality reviews...
August 22, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28822393/identifying-futile-interfacility-surgical-transfers
#9
Kristy Kummerow Broman, Sharon E Phillips, Jesse M Ehrenfeld, Mayur B Patel, Oscar M Guillamondegui, Kenneth W Sharp, Richard A Pierce, Benjamin K Poulose, Michael D Holzman
Surgeons perceive that some surgical transfers are futile, but the incidence and risk factors of futile transfer are not quantified. Identifying futile interfacility transfers could save cost and undue burdens to patients and families. We sought to describe the incidence and factors associated with futile transfers. We conducted a retrospective cohort study from 2009 to 2013 including patients transferred to a tertiary referral center for general or vascular surgical care. Futile transfers were defined as resulting in death or hospice discharge within 72 hours of transfer without operative, endoscopic, or radiologic intervention...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820518/living-with-hepatocellular-carcinoma-near-the-end-of-life-family-caregivers-perspectives
#10
Lissi Hansen, Susan J Rosenkranz, Kathleen Wherity, Anna Sasaki
PURPOSE/OBJECTIVES: To explore family caregivers' perspectives of caring for patients with terminal hepatocellular carcinoma (HCC) as patients approached the end of life.
. RESEARCH APPROACH: Longitudinal, qualitative descriptive design.
. SETTING: Oregon Health and Science University in Portland and Veterans Affairs Portland Health Care System in Oregon.
. PARTICIPANTS: 13 family caregivers with a mean age of 56 years (range = 22-68 years)...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28814378/mhealth-technologies-for-palliative-care-patients-at-the-interface-of-in-patient-to-outpatient-care-protocol-of-feasibility-study-aiming-to-early-predict-deterioration-of-patient-s-health-status
#11
Gudrun Theile, Vanessa Klaas, Gerhard Tröster, Matthias Guckenberger
BACKGROUND: Palliative care patients are a particularly vulnerable population and one of the critical phases in patients' trajectories is discharge from specialized in-patient palliative care into outpatient care, where availability of a palliative care infrastructure is highly variable. A relevant number of potentially avoidable readmissions and emergency visits of palliative patients is observed due to rapid exacerbation of symptoms indicating the need for a closer patient monitoring...
August 16, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28805571/palliative-care-and-nonmotor-symptoms-in-parkinson-s-disease-and-parkinsonism
#12
Nataliya Titova, K Ray Chaudhuri
The term palliative care (PC) is defined as a collection of interventions and strategies that helps to improve and sustain the quality of life of patients and caregivers in situations and scenarios associated with life-threatening illness. This is usually implemented by means of early identification and treatment of relevant motor and nonmotor issues such as pain, sleep, and autonomic dysfunction, dementia, and depression. In addition, a holistic PC program also includes delivery of physical, psychosocial, and spiritual support...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28801004/temporary-removal-the-palliative-care-journey-in-kenya-and-uganda
#13
Emmanuel S Kamonyo
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28800276/enhancing-informed-consent-for-physician-aid-in-dying-potential-role-of-handout-on-possible-benefits-of-palliative-care
#14
Harry Peled, Kathleen E Bickel, Christina Puchalski
In the United States, physician aid in dying (PAD) is now legal in several states. However, neither a requirement for a palliative care (PC) consultation nor a defined education in PC exists for physicians participating in PAD or patients requesting assistance. Patients with advanced chronic and serious illness often experience complex physical, psychosocial, and spiritual distress. PC focuses on relieving this distress and improving patient quality of life through early identification and intervention in all domains of suffering, including physical, psychological, social, and spiritual...
August 11, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28795860/access-to-palliative-care-consultation-and-advance-care-planning-for-adults-with-high-risk-leukemia
#15
Ashley T Freeman, William A Wood, Alexandra Fox, Laura C Hanson
BACKGROUND: Although strong evidence supports early palliative care (PC) and consistent advance care planning (ACP) for patients with poor-prognosis Stage IV solid tumors, best practice standards have not been established for hematologic malignancies. Our primary objective was to describe current access to specialty PC consultation and ACP for inpatients with high-risk leukemia. Secondary objectives were to describe components of ACP and PC practices. METHODS: We enrolled all patients with high-risk leukemia (acute leukemia ≥65 years or relapsed leukemia >18 years) admitted to the University of North Carolina Cancer Hospital from October 1, 2015, to August 1, 2016...
August 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28793184/survey-highlights-the-need-for-specific-interventions-to-reduce-frequent-conflicts-between-healthcare-professionals-providing-paediatric-end-of-life-care
#16
Marie-Anne Archambault-Grenier, Marie-Hélène Roy-Gagnon, France Gauvin, Hubert Doucet, Nago Humbert, Sanja Stojanovic, Antoine Payot, Sylvie Fortin, Annie Janvier, Michel Duval
AIMS: This study explored how paediatric healthcare professionals experienced and coped with end-of-life conflicts and identified how to improve coping strategies. METHODS: A questionnaire was distributed to all 2,300 professionals at a paediatric university hospital, covering the frequency of end-of-life conflicts, participants, contributing factors, resolution strategies, outcomes and the usefulness of specific institutional coping strategies. RESULTS: Of the 946 professionals (41%) who responded, 466 had witnessed or participated in paediatric end-of-life discussions: 73% said these had led to conflict, more frequently between professionals (58%) than between professionals and parents (33%)...
August 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28790278/-perioperative-care-for-patients-with-hypoplastic-left-heart-syndrome
#17
Yujiro Ide, Kisaburo Sakamoto
Hypoplastic Left Heart Syndrome (HLHS) is one of the most challenging congenital heart defects which require surgical interventions during neonatal period. In normal risk cohort, its surgical outcome has been improved dramatically since Dr. William Norwood reported the 1st successful case more than 30 years ago. The introduction of routine bilateral pulmonary artery banding with subsequent Norwood operation during early infantile( we call it as "rapid 2 stage Norwood operation") has brought an earlier hemodynamic stabilization after Norwood operation...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28780728/predictive-model-of-complexity-in-early-palliative-care-a-cohort-of-advanced-cancer-patients-palcom-study
#18
Albert Tuca, Mónica Gómez-Martínez, Aleix Prat
PROPOSAL: Model of early palliative care (PC) integrated in oncology is based on shared care from the diagnosis to the end of life and is mainly focused on patients with greater complexity. However, there is no definition or tools to evaluate PC complexity. The objectives of the study were to identify the factors influencing level determination of complexity, propose predictive models, and build a complexity scale of PC. PATIENTS AND METHOD: We performed a prospective, observational, multicenter study in a cohort of advanced cancer patients with an estimated prognosis ≤ 6 months...
August 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28772092/a-pilot-trial-of-early-specialty-palliative-care-for-patients-with-advanced-pancreatic-cancer-challenges-encountered-and-lessons-learned
#19
Yael Schenker, Nathan Bahary, Rene Claxton, Julie Childers, Edward Chu, Dio Kavalieratos, Linda King, Barry Lembersky, Greer Tiver, Robert M Arnold
BACKGROUND: Patients with advanced pancreatic cancer suffer from high morbidity and mortality. Specialty palliative care may improve quality of life. OBJECTIVE: Assess the feasibility, acceptability, and perceived effectiveness of early specialty physician-led palliative care for patients with advanced pancreatic cancer and their caregivers. DESIGN: A mixed-methods pilot randomized controlled trial in which patient-caregiver pairs were randomized (2:1) to receive specialty palliative care, in addition to standard oncology care versus standard oncology care alone...
August 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28760818/research-protocol-on-early-palliative-care-in-patients-with-acute-leukaemia-after-one-relapse
#20
Cécile Barbaret, Julien Berthiller, Anne-Marie Schott Pethelaz, Mauricette Michallet, Gilles Salles, Stéphane Sanchez, Marilène Filbet
OBJECTIVES: According to the American Society of Clinical Oncology palliative care referrals are made within the last 3 weeks of patients' lives and most frequently when oncological treatments have ceased especially for patients with haematological malignancies. Recent publications indicate that patients with acute leukaemia are prone to symptoms, an indication for which a close collaboration between the patient's haematologist and a palliative care team might result in improved symptom management...
July 31, 2017: BMJ Supportive & Palliative Care
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