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Palliative care, end of life care, hospice

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https://www.readbyqxmd.com/read/28220023/early-palliative-care-reduces-end-of-life-intensive-care-unit-icu-use-but-not-icu-course-in-patients-with-advanced-cancer
#1
Andrew M Romano, Kristine E Gade, Gradon Nielsen, Robert Havard, James H Harrison, Josh Barclay, George J Stukenborg, Paul W Read, Leslie J Blackhall, Patrick M Dillon
BACKGROUND: Early palliative care for advanced cancer patients improves quality of life and survival, but less is known about its effect on intensive care unit (ICU) use at the end of life. This analysis assessed the effect of a comprehensive early palliative care program on ICU use and other outcomes among patients with advanced cancer. PATIENTS AND METHODS: A retrospective cohort of patients with advanced cancer enrolled in an early palliative care program (n = 275) was compared with a concurrent control group of patients receiving standard care (n = 195) during the same time period by using multivariable logistic regression analysis...
February 20, 2017: Oncologist
https://www.readbyqxmd.com/read/28193270/the-experience-of-providing-end-of-life-care-at-a-children-s-hospice-a-qualitative-study
#2
Tracey McConnell, Sam Porter
BACKGROUND: More attention is being paid to the wellbeing of staff working in stressful situations. However, little is known about staff experience of providing end-of-life care to children within a hospice setting. This study aims to explore the experiences of care team staff who provide end-of-life care within a children's hospice. METHODS: Qualitative research incorporating interviews and a focus group. Data were analysed using thematic analysis. Purposeful sampling led to a total of 15 care team staff recruited from a children's hospice offering palliative and specialist care to life-limited children and young people...
February 13, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28186928/collecting-biological-material-from-palliative-care-patients-in-the-last-weeks-of-life-a-feasibility-study
#3
Séamus Coyle, Aileen Scott, Amara Callistus Nwosu, Richard Latten, James Wilson, Catriona R Mayland, Stephen Mason, Chris Probert, John Ellershaw
OBJECTIVE: To assess the feasibility of prospectively collecting biological samples (urine) from palliative care patients in the last weeks of life. SETTING: A 30-bedded specialist hospice in the North West of England. PARTICIPANTS: Participants were adults with a diagnosis of advanced disease and able to provide written informed consent. METHOD: Potential participants were identified by a senior clinician over a 12-week period in 2014...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28169946/differences-in-utilization-of-life-support-and-end-of-life-care-for-medical-icu-patients-with-versus-without-cancer
#4
Geoffrey Koff, Urvashi Vaid, Edward Len, Albert Crawford, David A Oxman
OBJECTIVES: To explore differences in the utilization of life support and end-of-life care between patients dying in the medical ICU with cancer compared with those without cancer. DESIGN: Retrospective review of 403 deaths or hospice transfers in the medical ICU from January 1, 2012, to June 30, 2013. SETTING: Urban tertiary care university hospital. PATIENTS: Consecutive medical ICU deaths or hospice transfers over an 18-month period...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28160875/understanding-palliative-care-and-hospice-a%C3%A2-review-for-primary-care-providers
#5
REVIEW
Mary K Buss, Laura K Rock, Ellen P McCarthy
Palliative care provides invaluable clinical management and support for patients and their families. For most people, palliative care is not provided by hospice and palliative medicine specialists, but rather by their primary care providers. The recognition of hospice and palliative medicine as its own medical subspecialty in 2006 highlighted the importance of palliative care to the practice of medicine, yet many health care professionals harbor misconceptions about palliative care, which may be a barrier to ensuring that the palliative care needs of their patients are identified and met in a timely fashion...
February 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28156627/making-treatment-decisions-at-end-of-life-in-a-comprehensive-cancer-center
#6
Lee Ellington, Kathi Mooney
: 51 Background: End of life treatment decisions are challenging for cancer patients and oncology providers. Patients must understand their prognosis and options, deciding if and when to increase palliative care and decrease tumor-focused therapy. Cancer centers committed to offering clinical trials and evaluate new therapies add complexity to these decisions. To better define crucial points for decision making, we reviewed the care patients received during the last 6 months of life at one comprehensive cancer center...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156625/clinical-and-health-care-setting-of-patients-admitted-at-pain-control-center-hospice-of-solofra-a-feasibility-model-of-end-of-life-care-in-the-avellino-province-of-italy
#7
Carmela Fasano, Luisa M Rizzo, A M Strollo, Elena De Vinco, Vincenzo Landolfi, Elena Altieri, Mario Nicola Vittorio Ferrante, Sergio Canzanella, Giuseppe Servillo, Lucia Genua, Maddalena Zampi, Gaetano D'Onofrio
: 59 Background: The Pain Control Center Hospice of Solofra (Italy) is managed with a mixed public / private, the first experience in the Campania region.We have evaluated the treatment procedures and the clinical outcome to make a comparison by between 123 evaluable patients in palliative care in 2015 and 232 evaluable patients in the biennium 2012-2014. METHODS: The following characteristics: patient gender, mean hospitalization time, differentiation between cancer and non cancer patients, medical weapon use, venous access type, enteral and parenteral feeding, pain killer use,Karnofsky scale...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156613/what-does-palliative-care-mean-diverse-definitions-from-cancer-care-providers
#8
Rebecca A Ferrer, Michelle Mollica, Grace Huang, Angela Falisi, Wen-Ying Sylvia Chou
: 40 Background: Existing literature on the epistemology of palliative care has mostly centered on patient/family perspectives. Understanding how multi-disciplinary healthcare providers themselves define palliative care is a critical step towards addressing barriers and harnessing facilitators that affect optimal delivery. METHODS: Semi-structured key informant interviews (N = 19) were conducted with members of healthcare provider teams as part of a qualitative study on goals of care for cancer patients enrolled in clinical trials...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156608/when-home-means-another-nation-the-power-and-pitfalls-of-repatriation-at-the-end-of-life-from-a-tertiary-cancer-centre
#9
(no author information available yet)
: 46 Background: How people die lives on in the memory of those who survive. It is therefore pivotal for palliative teams to help craft an ending in line with patient and family goals. It has been observed in a tertiary cancer centre that there is often a spiritual imperative for patients to return to their nation of birth, once treatment is stopped and mortality accepted. METHODS: Retrospective chart review of 3 patients repatriated for end of life care to their nation of birth (Romania, Portugal, Ireland), focusing on: the conversations about the goal of repatriation and its meaning to the patient; the practical barriers and enablers of repatriation of patients with advanced cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156601/what-s-in-the-special-sauce-of-protocol-driven-outpatient-palliative-care-consultations
#10
Marie Bakitas, J Nicholas Dionne-Odom, Jennifer Frost, Margaret Plunkett, Lisa A Lisa A Stephens, Peggy Bishop
: 139 Background: Initial outpatient palliative care consultations (OPCC) in clinics are usually requested for uncontrolled symptoms. The purpose of this substudy was to determine the nature of recommendations made in early PC (EPC) protocol-driven OPCC. METHODS: Using a standardized tool, we conducted a content analysis on the assessment and plan components of protocol-driven OPCCs. OPCCs were conducted as a component of the ENABLE [Educate, Nurture, Advise, Before Life Ends] RCT (10/2010-9/2013) consisting of an OPCC and 6 structured weekly telephone coaching sessions and monthly follow up either at study entry (early) or 12 weeks later (delayed)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156590/healthcare-utilization-among-cancer-patients-prior-to-hospice
#11
Richard F Riedel, Christel N Rushing, Anthony N Galanos
: 135 Background: The integration of palliative medicine in oncologic care has become increasingly recognized and supported. We have previously reported improved health system and quality of care outcomes for solid tumor patients admitted to our novel, fully-integrated palliative care (PC) and medical oncology inpatient service at Duke University Medical Center (DUMC). In this study, we explored healthcare utilization in patients specifically discharged to hospice pre- and post-PC integration...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156585/pilot-study-of-incorporating-a-supportive-care-program-into-a-small-community-oncology-practice
#12
Kelly Schultz, Jennifer Thompson, Michael Thomas Byrne, Andrew J Buresh, Brendan F Curley
: 149 Background: Incorporation of supportive care has become standard of care in patients with advanced or metastatic cancer undergoing palliative chemotherapy. Implementation of a supportive care program is often difficult in a small community practice due to a multitude of factors. METHODS: We piloted a supportive care program with the partnership of Sage Hospice & Palliative Care in which patients with advanced or metastatic cancer undergoing chemotherapy would be evaluated by a certified nurse practitioner (CNP)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156579/snapshot-of-an-outpatient-supportive-care-center-at-a-comprehensive-cancer-center
#13
Maxine Grace De la Cruz, Angelique Wong, Debra Castro, Eduardo Bruera
: 145 Background: Integration of Palliative Care (PC) in oncology has been found to improve symptom distress, quality of life and survival in patients with advanced cancer. Early integration is most appropriate in the outpatient (OP) setting. However, most PC services in the U.S. do not have an OP component. Our study aims to provide a snapshot of the type of patients that are referred to this novel setting for the delivery of early PC. METHODS: We reviewed a day in the SCC to illustrate the structure and process involved in the delivery of outpatient PC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156575/using-a-values-assessment-as-a-bridge-to-advance-care-planning-results-of-1286-patient-reports
#14
Cynthia Taniguchi, Kathryn J Eagye, Susan Ash-Lee, Angela Kalisiak, Sabrina Q Mikan, Nicole Hartung
: 12 Background: Recent studies have shown that formal Palliative Care (PC) improves care at the end of life for cancer patients. The role of communication in PC is not defined. Other studies have shown that communication alone can be associated with better end of life outcomes. The US Oncology Network developed and tested a Values Assessment (VA) instrument for routinely broaching difficult topics to facilitate more formal advance care planning (ACP). The results of the first 28 months of the program on over 1200 patients are reported here...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156559/palliative-care-consultation-and-advance-care-planning-for-adults-with-poor-risk-leukemia-admitted-to-an-academic-medical-center
#15
William A Wood, Alexandra Fox, Laura C Hanson
: 13 Background: Despite high mortality for certain patients with hematologic malignancies, integration of palliative care (PC) and documentation of advance care planning (ACP) is lacking. Our primary objective was to determine the frequency of PC consultation and ACP for inpatients with poor-risk leukemia at our institution. Our secondary objectives were to describe the content of goals of care (GOC) discussions and to characterize PC and end-of-life quality measures. METHODS: Chart reviews were conducted for patients with poor risk leukemia (acute leukemia ≥ 65 years or relapsed leukemia > 18 years) admitted to the University of North Carolina from October 1, 2015 to March 31, 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156511/end-of-life-discussions-with-advanced-cancer-patients-and-their-effects-on-bereaved-families-mental-health
#16
Isseki Maeda, Yutaka Hatano, Masanori Mori, Yasuo Shima, Satoru Tsuneto, Yoshiyuki Kizawa, Tatsuya Morita, Takuhiro Yamaguchi, Maho Aoyama, Mitsunori Miyashita
: 3 Background: End-of-life (EOL) discussions are important for providing appropriate care to patients with advanced cancer at the end of their life. To explore the relationship between EOL discussions and bereaved families' mental health, as well as the quality of the patient's death and quality of care at the end of life. METHODS: This was a nationwide questionnaire survey of bereaved families of deceased cancer patients who died at 75 sites (20 inpatient palliative care teams in acute hospitals, 33 palliative care units/inpatient hospices, and 22 outpatient clinics that provide home palliative care service) in Japan...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156486/referral-patterns-among-patients-with-metastatic-breast-cancer-in-an-integrated-palliative-care-program
#17
Jeffrey Belkora, Melanie Catherine Majure, Amy Jo Chien, Michelle E Melisko, Hope S Rugo, Michael W Rabow
: 163 Background: ASCO recommends palliative care (PC) concurrently with oncologic treatment for patients with metastatic disease and there is emerging data about the benefits of early PC. However, little is known about referral patterns to specialty PC among patients who die of metastatic breast cancer. METHODS: After years of offering a stand-alone outpatient PC consult service in our comprehensive cancer center, we established an integrated PC program in breast oncology (the "Advanced Breast Cancer (ABC) Program") with a care coordinator, PC physician, and co-location with oncology...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156485/palliative-care-interventions-and-end-of-life-care-outcomes-for-hepatocellular-patients-pts-at-two-veterans-affairs-va-medical-centers
#18
Sarah Lee, Sejal Kothadia, Yucai Wang, Victor Tsu-Shih Chang, Yeun-Hee Anna Park, Ellen Olson, David Klein, Fengming Zhong
: 164 Background: Palliative care interventions and their effect on EOL outcomes for liver cancer pts have not been described. We investigated the association between palliative care intervention and EOL care outcomes. METHODS: We reviewed the charts of pts with hepatocellular carcinoma and who were seen by palliative care at 2 VA medical centers from 2006 to 2012. We investigated the association between EOL outcomes (number of ER visits, ICU visits, chemotherapy, place of death, number of hospitalizations during their last 30 days), and interventions such as early referral (within 30 days of diagnosis), defined goals of care, holding a family meeting, and symptom assessment and management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152860/using-information-technology-to-power-an-integrated-community-based-oncology-palliative-care-model
#19
Andrew Allan Hertler, Lianne Matthews, RaeLynn Carr
: 166 Background: There is a need to improve palliative care program access for patients with cancer. The identification of candidates for palliative care at the point of diagnose can improve care and reduce costs. This pilot program was launched in July 2015 by four stakeholders: Health plan; Regional palliative care provider; Community oncology practice; and Oncology quality management provider. METHODS: Objectives are to increase patient satisfaction, reduce unnecessary utilization and costs...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152749/end-of-life-care-for-glioblastoma-multiforme-patients-at-an-academic-institution
#20
Roy E Strowd, Anne Evans, Louise Knight, W Anthony Riley, Thomas J Smith
: 202 Background: End of life care for glioblastoma patients has not been studied in the United States. We studied 100 patients with GBM to examine use of advance directives (AD), symptom assessments, hospitalizations, chemotherapy use, and hospice use. METHODS: A single center retrospective cohort study of adult patients actively treated for GBM at Johns Hopkins Hospital from 2009-2014. 100 patients were randomly chosen from the group of 317 GBM patients. Information included documentation of AD, code status, hospitalizations, chemotherapy use, code status and symptom assessments...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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