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palliative care, evidence-based medicine

Chloé Rancoule, Cécile Pacaut-Vassal, Alexis Vallard, Benoite Mery, Jane-Chloé Trone, Anis El Meddeb Hamrouni, Nicolas Magné
Recent innovations in oncology area helped to improve the prognosis of certain cancers including metastatic ones with a decrease in mortality. Recommendations describe the treatment of metastatic cancer as systemic therapy or complementary care and the role of locoregional treatment in the treatment plan only occurs in a palliative context. Currently, in the clinical practice, out of "the evidence based medicine", an early locoregional therapy (surgery or radiation therapy) can be proposed in several cases of metastatic cancers...
December 9, 2016: Bulletin du Cancer
Kimberly K Garner, Patricia Dubbert, Shelly Lensing, Dennis H Sullivan
CONTEXT: The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. OBJECTIVES: To better understand the potential implementation of this Measuring What Matters quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker...
January 2017: Journal of Pain and Symptom Management
Simon Noble
Simon Noble speaks to Sebastian Dennis-Beron, Commissioning Editor: Simon Noble is Clinical Professor in Palliative Medicine at Cardiff University and honorary consultant at the Royal Gwent Hospital in Newport. His main research interests are in the management of venous thromboembolism in advanced cancer, quality of life effects of venous thromboembolism and their therapies, clinical decision-making in venous thromboembolism management and the patient journey. He is involved at a national level in the delivery of evidence-based thromboprophylaxis for hospitalized patients through the All Party Thrombosis Group and sits on the NICE Guideline development group for thromboprophylaxis...
January 2017: Future Oncology
Liz Jamieson, Ian C K Wong, Finella Craig, Nanna Christiansen, Karen Brombley, Catherine Tuleu, Emily Harrop
OBJECTIVES: This paper seeks to highlight from a UK perspective the current lack of a research evidence base in paediatric palliative care that has resulted in a paucity of available medicines with appropriate formulations (strength and dosage form) to provide symptom management for children with life-limiting illnesses and to raise awareness of this group of 'therapeutic orphans'. Currently, clinicians have limited, often unsuitable medication choices for their paediatric palliative care patients, with little hope of moving away from the status quo...
October 13, 2016: Journal of Pharmacy and Pharmacology
Fiona Runacres, Heidi Gregory, Anna Ugalde
BACKGROUND: Palliative care patients have numerous rehabilitation needs that increase with disease progression. Palliative rehabilitation practices and perceptions of palliative medicine physicians towards the role of rehabilitation are largely unstudied. AIM: To explore palliative medicine physicians' attitudes and perceptions towards rehabilitation delivered within inpatient palliative care units. DESIGN: Qualitative study utilizing semi-structured interviews...
September 26, 2016: Palliative Medicine
Takashi Higashiguchi, Junichi Ikegaki, Kazuya Sobue, Yoichiro Tamura, Nobuhisa Nakajima, Akihiko Futamura, Mitsunori Miyashita, Naoharu Mori, Akio Inui, Keiichiro Ohta, Toyoshi Hosokawa
BACKGROUND: Japan's first guidelines for parenteral fluid management for terminal cancer patients were issued in 2006. These guidelines focused on the fluid levels to administer to patients with a remaining life expectancy of 1-2 months. However, recent refinement of the concept of cachexia is prompting caregivers worldwide to rethink parenteral fluid management for terminal cancer patients. OBJECTIVE: Our objective was to develop guidelines for parenteral fluid management for terminal cancer patients with a remaining life expectancy of 1 month, a point when cachexia generally begins to severely adversely affect the body...
August 12, 2016: Japanese Journal of Clinical Oncology
Julian Abel, Allan Kellehear
Palliative care, since its inception over 60 years ago, has set the standard of how to care for people who are dying. Key features among these standards have been the professional development of clinical specialisms such as palliative medicine and palliative nursing; the essential addition of the multidisciplinary team to these two new specialisms that included social, spiritual and allied health workers-an outgrowth of the recognition that routine work with the dying, their carers, and the bereaved required more than solely clinical skills; and the unique partnership with communities that yielded the volunteer movement within palliative care...
March 2016: BMJ Supportive & Palliative Care
Pedro Grilo Diogo, Joselina Barbosa, Maria Amélia Ferreira
BACKGROUND: The Tuning Project is an initiative funded by the European Commission that developed core competences for primary medical degrees in Europe. Students' grouped self-assessments are used for program evaluation and improvement of curricula. The TEST study aimed to assess how do Portuguese medical graduates self-assess their acquisition of core competences and experiences of contact with patients in core settings according to the Tuning framework. METHODS: Translation of the Tuning's competences (Clinical Practice - CP), Knowledge (K) items and Clinical Settings (CS) was performed...
2015: BMC Medical Education
Eran Ben-Arye, Noah Samuels
In this editorial, the authors comment on a recently published review paper by Molassiotis et al. on the developments made over the past 40 years in supportive care for patients with lung cancer. During this period, a paradigm shift promoting patient-centered care (PCC) has led to an important change in the approach of supportive cancer care, from a purely disease-centered approach, measuring survival-related outcomes, to recognizing the importance of quality of life outcomes as well. This change of understanding in supportive and palliative care for patients with lung cancer can be further advanced through the understanding that there is a need to address bio-psycho-spiritual concerns and health belief models, within the context of the family socio-cultural environment, for both patients and their caregivers...
October 2015: Translational Lung Cancer Research
Erica C Kaye, Sarah Friebert, Justin N Baker
Despite increasing data to support pediatric palliative care (PPC) as an integral component of high-quality care for children with life-threatening conditions and their families, timely integration of PPC is offered inconsistently to children with high-risk cancer. In this review, we summarize the growing body of literature in support of early integration of PPC for children with high-risk cancer and their families, advocating that PPC principles and resources are imperative to holistic cancer-directed care and rooted in evidence-based medicine...
April 2016: Pediatric Blood & Cancer
(no author information available yet)
The 2015 American Geriatrics Society (AGS) Beers Criteria are presented. Like the 2012 AGS Beers Criteria, they include lists of potentially inappropriate medications to be avoided in older adults. New to the criteria are lists of select drugs that should be avoided or have their dose adjusted based on the individual's kidney function and select drug-drug interactions documented to be associated with harms in older adults. The specific aim was to have a 13-member interdisciplinary panel of experts in geriatric care and pharmacotherapy update the 2012 AGS Beers Criteria using a modified Delphi method to systematically review and grade the evidence and reach a consensus on each existing and new criterion...
November 2015: Journal of the American Geriatrics Society
Danijel Galun, Dragan Basaric, Marinko Zuvela, Predrag Bulajic, Aleksandar Bogdanovic, Nemanja Bidzic, Miroslav Milicevic
Hepatocellular carcinoma (HCC) is one of the major malignant diseases in many healthcare systems. The growing number of new cases diagnosed each year is nearly equal to the number of deaths from this cancer. Worldwide, HCC is a leading cause of cancer-related deaths, as it is the fifth most common cancer and the third most important cause of cancer related death in men. Among various risk factors the two are prevailing: viral hepatitis, namely chronic hepatitis C virus is a well-established risk factor contributing to the rising incidence of HCC...
September 18, 2015: World Journal of Hepatology
Alison M Heru
Although family research supports family-centered care for all medical specialties, the benefit of family-centered care has not been fully realized in outpatient practice. Physicians, including psychiatrists, are not routinely taught how to work with families and may not be aware of the evidence-base for family interventions. However, some medical specialties, such as family medicine and palliative care, have a clinical practice that routinely includes the family. Clinicians working in medical clinics, such as diabetes clinics, know that successful management of chronic illness requires family involvement...
September 2015: Journal of Psychiatric Practice
Shohreh Shahabi, Hooman Fazlalizadeh, Jennifer Stedman, Linus Chuang, Ahmad Shariftabrizi, Regina Ram
BACKGROUND: In 2012, Iranian's economy collapsed under strain from sanctions instituted to stop Iran from violating the International Nuclear Non-Proliferation Treaty. Sanctions have indirectly led to serious healthcare concerns, specifically cancer treatment. This is the first report to evaluate Iranian cancer healthcare while under international economic sanctions. METHODS: Data and information were identified by searches of MEDLINE, PubMed, and references from relevant articles using the search terms: "Iran", "health policy", "sanctions", "ethics", and "cancer"...
October 2015: Health Policy
Arif Nazir, William D Smucker
Heart failure (HF) is highly prevalent among older patients in skilled nursing facilities (SNFs). HF outcomes for SNF patients suffer because of many factors, including staff training, lack of physician availability, and failure to implement evidence-based care. AMDA - The Society for Post-Acute and Long-Term Care Medicine has recently updated the Clinical Practice Guidelines for Heart Failure Management in SNFs. This review supplements the Guidelines with a robust focus on best practices for transitional care, symptom management, treatment and monitoring, and palliative care in patients with HF...
October 1, 2015: Journal of the American Medical Directors Association
Deborah Dillon McDonald, Christina Soutar, Maria Agudelo Chan, Angela Afriyie
OBJECTIVE: To describe alternative non-pharmaceutical non-nutraceutical pain self-management strategies used by people with heart failure (HF) in order to reduce chronic non-cardiac pain. BACKGROUND: Little is known about alternative pain self-treatments used by HF patients with chronic pain. METHODS: A cross-sectional descriptive design was used with 25 hospitalized HF patients who had chronic pain and used at least one alternative pain treatment...
September 2015: Heart & Lung: the Journal of Critical Care
T Whitburn, C Walshe, Ke Sleeman
INTRODUCTION: @hpmJC (hospice and palliative medicine Journal Club, #hpmJC) was launched in February 2014 on the social networking service Twitter, as a regular international journal club for palliative care. The journal club aims to encourage critical analysis of research methods and findings, and to promote evidence based practice, by providing a forum to discuss latest research findings. AIMS AND METHODS: To analyse the use and reach of #hpmJC, from the first journal club in February 2014, to date...
March 2015: BMJ Supportive & Palliative Care
Sushma Bhatnagar, Mayank Gupta
A 'need-supply' and 'requirement-distribution mismatch' along with a continuingneed explosion are the biggest hurdles faced by palliative medicine today. It is the need of the hour to provide an unbiased, equitable and evidence-based palliative care to those in need irrespective of the diagnosis, prognosis, social and economic status or geographical location. Palliative care as a fundamental human right, ensuring provision throughout the illness spectrum, global as well as region-specific capacity building, uniform availability of essential drugs at an affordable price, a multidisciplinary team approachand caregiver-support are some of the achievable goals for the future...
January 2015: Indian Journal of Palliative Care
Philip J Wiffen
The Cochrane library of systematic reviews is published quarterly as a DVD and monthly online ( ). The October 2014 issue (4th DVD for 2014) contains 6157 complete reviews, 2,353 protocols for reviews in production and 32,000 short summaries of systematic reviews published in the general medical literature. In addition, there are citations of 807,000 randomized controlled trials, and 15,700 cited papers in the Cochrane Methodology Register. The Health Technology Assessment database contains some 14,000 citations...
March 2015: Journal of Pain & Palliative Care Pharmacotherapy
William H Frist, Martha K Presley
There is a common misperception that palliative care is just another term for hospice care. Although it includes hospice, palliative care is also the long-term coordinated care of the chronically ill, which is delivered at a cost savings. Why does it matter that the average American understand what palliative care means? Because the evidence shows that U.S. patients near the end of life are spending exorbitant amounts of money on health care they do not want and the country cannot afford. To better understand why palliative care is an important issue in the current debate about health care reform, the authors first briefly review landmark legal cases in the area of end-of-life care...
March 2015: Academic Medicine: Journal of the Association of American Medical Colleges
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