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Outpatient palliative care

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https://www.readbyqxmd.com/read/29775603/genetic-and-extracardiac-anomalies-are-associated-with-inferior-single-ventricle-palliation-outcomes
#1
Bahaaldin Alsoufi, Courtney McCracken, Matthew Oster, Subhadra Shashidharan, Kirk Kanter
BACKGROUND: We aim to examine the effect of genetic syndromes and extracardiac anomalies (GS/EC) on single ventricle (SV) palliation with focus on hospital death, interstage mortality, and progression towards subsequent palliation stages. METHODS: 530 neonates with SV underwent first-stage palliation: Norwood (n=284,53%), shunt (n=173,33%), band (n=73,14%). Outcomes were compared between those with GS/EC (n=121,23%) and without GS/EC (n=409,77%). Regression analyses were adjusted for other risk factors (age, gender, prematurity, weight, SV anomaly, first-stage palliation surgery)...
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29774394/longitudinal-health-care-cost-in-hypoplastic-left-heart-syndrome-palliation
#2
Jesse E Hansen, Nicolas L Madsen, Laurie Bishop, David L S Morales, Jeffrey B Anderson
Management of hypoplastic left heart syndrome (HLHS) is resource intensive. Heath care systems are pressured to provide value to patients by improving outcomes while decreasing costs. A single-center retrospective cohort of infants with HLHS who underwent Norwood procedure or hybrid Norwood from 2004 to 2014 and survived to first outpatient follow up were studied. The primary outcome was total cost through 12 months with a sub-analysis of patients with 60 months of data. Costs were calculated using internal cost accounting system and reported by cost center...
May 17, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#3
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29736123/prognostic-factors-of-malignant-pleural-effusion-among-palliative-care-outpatients-a-retrospective-study
#4
Jenifer Jeba, Renitha M Cherian, Balamugesh Thangakunam, Reena George, J Visalakshi
Background: Malignant pleural effusion (MPE) has varied survival and indicates advanced disease. LENT prognostic score is the first validated score used for MPE. This study assessed the role of LENT among palliative care cancer patients and assessed different patient, tumor, and treatment related factors that may affect survival. Methods: A retrospective study of advanced cancer patients with MPE, seen in palliative care outpatient clinic (2013-2015) until death, was done...
April 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29732904/characterization-categorization-and-5-year-mortality-of-medicine-high-utilizer-inpatients
#5
Joyeeta G Dastidar, Min Jiang
BACKGROUND: Patients who are frequently admitted to Medicine inpatient services comprise a distinct subset of readmitted patients about whom not much is known. OBJECTIVE: We sought to characterize this group including mortality rates, with the goal of better understanding this population. DESIGN: Observational study of frequently hospitalized patients defined as 4 or more admissions over a 6-month period, with hospitalization defined as nonelective admission to the hospital...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29730713/predictors-of-outpatients-request-for-palliative-care-service-at-a-medical-oncology-clinic-of-a-german-comprehensive-cancer-center
#6
Mitra Tewes, Teresa Rettler, Nathalie Wolf, Jörg Hense, Martin Schuler, Martin Teufel, Mingo Beckmann
PURPOSE: Early integration of palliative care (PC) is recommended. The determination of predictors for patients' request for PC may guide implementation in clinical practice. Toward this end, we analyzed the symptom burden and distress of cancer patients in outpatient care and examined their need and request for PC. METHODS: Between October 2013 and March 2016, 705 patients receiving outpatient cancer treatment took part in the survey. We used the new MInimal DOcumentation System to detect symptom clusters...
May 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29727249/reasons-for-and-frequency-of-end-of-life-hospital-admissions-gps-perspective-on-reducing-end-of-life-hospital-referrals
#7
Stéphanie Giezendanner, Klaus Bally, Dagmar M Haller, Corinna Jung, Ina C Otte, Hans-Ruedi Banderet, Bernice S Elger, Elisabeth Zemp, Heike Gudat
BACKGROUND: Many palliative care patients are admitted to hospital shortly before death even though the acute hospital setting is not considered ideal for end-of-life care (EOLC). OBJECTIVES: This study aimed to evaluate General Practitioners' (GPs') perspective on the frequency of and reasons for hospital referrals of these patients. METHODS: Cross-sectional survey involving a stratified random sample of 2000 GPs in Switzerland in 2014...
May 4, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29703115/integrating-nurse-facilitated-advance-care-planning-for-patients-newly-diagnosed-with-advanced-lung-cancer
#8
Kristin Lara Ólafsdóttir, Helga Jónsdóttir, Nanna Fridriksdóttir, Valgerdur Sigurdardóttir, Erna Haraldsdóttir
BACKGROUND: Advance care planning (ACP) is well recognised as an important component of palliative care. However, there is still a need to explore ways in which it can become a part of routine practice, ensuring a timely and person-centred discussion. OBJECTIVES: To explore patients newly diagnosed with advanced lung cancer and their family members' experiences of engaging in a person-centred and structured ACP discussion facilitated by palliative care nurses in an outpatient oncology clinic at the University Hospital of Iceland...
April 2, 2018: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/29688843/cost-of-medical-care-of-patients-with-advanced-serious-illness-in-singapore-compass-prospective-cohort-study-protocol
#9
Irene Teo, Ratna Singh, Chetna Malhotra, Semra Ozdemir, Rebecca A Dent, Nesaretnam Barr Kumarakulasinghe, Wee Lee Yeo, Yin Bun Cheung, Rahul Malhotra, Ravindran Kanesvaran, Alethea Chung Pheng Yee, Noreen Chan, Huei Yaw Wu, Soh Mun Chin, Hum Yin Mei Allyn, Grace Meijuan Yang, Patricia Soek Hui Neo, Nivedita V Nadkarni, Richard Harding, Eric A Finkelstein
BACKGROUND: Advanced cancer significantly impacts quality of life of patients and families as they cope with symptom burden, treatment decision-making, uncertainty and costs of treatment. In Singapore, information about the experiences of advanced cancer patients and families and the financial cost they incur for end-of-life care is lacking. Understanding of this information is needed to inform practice and policy to ensure continuity and affordability of care at the end of life. The primary objectives of the Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS) cohort study are to describe changes in quality of life and to quantify healthcare utilization and costs of patients with advanced cancer at the end of life...
April 23, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29671705/explicit-versus-implicit-evaluation-to-detect-inappropriate-medication-use-in-geriatric-outpatients
#10
Gulistan Bahat, Birkan Ilhan, Ilker Bay, Cihan Kilic, Pinar Kucukdagli, Meryem Merve Oren, Mehmet Akif Karan
AIM: The rates and reasons why clinicians decide not to follow recommendations from explicit-criteria have been studied scarce. We aimed to compare STOPP version 2 representing one of the most commonly used excplicit tool with the implicit comprehensive geriatric assessment mediated clinical evaluation considered as gold standard. METHODS: Two hundred and six (n = 206) outpatients ≥65 years old were included. The study was designed as retrospective, cross-sectional, and randomised...
April 19, 2018: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/29650902/-the-significance-of-pharmacist-intervention-focused-on-improvement-of-adverse-events-and-cancer-pain
#11
Fumitaka Kawaguchi, Jun Watanabe, Takafumi Tsuneki, Akihiko Kikkawa
It was reported that focusing on palliative care for patients with cancer improved their anxiety and depression and prolonged their survival. Similarly, the pharmacist intervention for cancer patients suggested the improvement in anxiety and depression; but, such improvement has not yet been demonstrated by focusing on pharmacist attitudes and behaviors of which the patients were the primary beneficiaries. Therefore, we evaluated the significance of pharmacist intervention focusing on improvement of adverse events and cancer pain...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650872/-examination-of-patients-that-died-within-48-hours-after-urgent-hospitalization
#12
Kazuhiro Kawada, Ryota Yanaizumi, Osamu Takahashi
We offer inpatient support for end-stage cancer patients, not only in palliative care units, but also in general medical and long-term care units. We also provide outpatient palliative care and offer emergent backup for the regional home care clinics. From January 2014 to December 2016, 1,832 patients were hospitalized, and among them, 983 patients visited our hospital on an emergency basis. Among the urgent hospitalized patients, 378 patients returned home after adequate palliative care. But 605 patients had to stay admitted in the hospital until their time of death...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29649846/-palliative-home-care-teams-in-germany
#13
Friedemann Nauck, Maximiliane Jansky
Since 2007, patients with severe advanced life-limiting illnesses and high, complex symptom burdens have a right to receive specialized outpatient palliative care (SAPV). Multi-professional teams with heterogeneous organizational structures provide care in cooperation with primary care givers, not limited to cancer patients. The aim of SAPV is to foster patient's autonomy and quality of life. SAPV can be provided as counseling of patient and care givers, coordination of care, additional supportive and full care provision...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29649845/-early-palliative-care-in-emergency-medicine
#14
Maximilian Spickermann, Philipp Lenz
At the end of life patients with a life-limiting disease are often admitted to emergency departments (ED). Mostly, in the setting of an ED there may not be enough time to meet the needs for palliative care (PC) of these patients. Therefore, integration of PC into the ED offers a solution to improve their treatment. In the outpatient setting a cooperation between prehospital emergency services, the patient's general practitioner and specialized outpatient PC teams may allow the patient to die at home - this is what most patients prefer at the end of life...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29649405/economic-impact-of-early-inpatient-palliative-care-intervention-in-a-community-hospital-setting
#15
James Fitzpatrick, Matthew Mavissakalian, Tisha Luciani, Yijing Xu, Amber Mazurek
BACKGROUND: Inpatient palliative care programs have demonstrated financial benefit for the hospital and improved quality of care for patients with advanced disease. Previous studies on this subject have focused on comparisons between palliative and traditional care. The financial and clinical effects of early versus late palliative care intervention are less well documented. OBJECTIVE: The aims of this study are to review the financial and quality outcomes that early palliative care intervention has on appropriate inpatients in the community hospital setting...
March 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649399/a-rules-based-algorithm-to-prioritize-poor-prognosis-cancer-patients-in-need-of-advance-care-planning
#16
Christine M Bestvina, Kristen E Wroblewski, Bobby Daly, Brittany Beach, Selina Chow, Andrew Hantel, Monica Malec, Michael T Huber, Blase N Polite
BACKGROUND: Accurate understanding of the prognosis of an advanced cancer patient can lead to decreased aggressive care at the end of life and earlier hospice enrollment. OBJECTIVE: Our goal was to determine the association between high-risk clinical events identified by a simple, rules-based algorithm and decreased overall survival, to target poor prognosis cancer patients who would urgently benefit from advanced care planning. DESIGN: A retrospective analysis was performed on outpatient oncology patients with an index visit from April 1, 2015, through June 30, 2015...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29608385/the-efficacy-of-complementary-therapy-for-patients-receiving-palliative-cancer-care
#17
S H Cedar, Melanie White, Anita Atwal
Involving patients in their own care is associated with improved health outcomes. Complementary therapies are popular among patients and enable them to receive the palliative care they want and need. However, the range of complementary therapy services available to patients need to be evaluated for efficacy. This study evaluated the complementary therapy services offered at one cancer outpatient clinic in the UK, with the aim of evaluating the effect of complementary therapies on patient wellbeing and to systematise concerns and categories of wellbeing in order to improve service provision...
March 2, 2018: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/29606989/conservative-care-as-a-treatment-option-for-patients-aged-75-years-and-older-with-ckd-stage-v-a-national-survey-in-the-netherlands
#18
Christopher Susanto, J Kooman, A M Courtens, C J A M Konings
Background and objectives: Conservative care for patients aged 75 years and older with CKD stage 5 as a treatment option besides dialysis was proposed officially in the Netherlands in October 2016. This national survey showed the current implementation of this option in Netherlands nephrology departments. Design setting participants and measurement: A web-based survey was sent to medical managers of 60 nephrology departments in the Netherlands in August 2016. Results: Twenty-one medical managers (35%) completed the survey...
2018: European Geriatric Medicine
https://www.readbyqxmd.com/read/29584744/availability-of-patient-centered-cancer-support-services-a-statewide-survey-of-cancer-centers
#19
Kathleen B Cartmell, Katherine R Sterba, Kim Pickett, Jane Zapka, Anthony J Alberg, Amit J Sood, Nestor F Esnaola
The Institute of Medicine recommended in their landmark report "From Cancer Patient to Cancer Survivor: Lost in Transition" that services to meet the needs of cancer patients should extend beyond physical health issues to include functional and psychosocial consequences of cancer. However, no systems exist in the US to support state-level data collection on availability of support services for cancer patients. Developing a mechanism to systematically collect these data and document service availability is essential for guiding comprehensive cancer control planning efforts...
2018: PloS One
https://www.readbyqxmd.com/read/29582633/cancer-related-pain-prevalence-severity-and-management-in-a-tertiary-care-center-in-the-middle-east
#20
Nadine M Hamieh, Reem Akel, Bilal Anouti, Cindy Traboulsi, Iman Makki, Lana Hamieh, Arafat Tfayli
Background: Despite pain awareness and the development of treatment guidelines, cancer-related pain assessment and management remain suboptimal. Our objectives were to estimate the prevalence and severity of pain and its interference with daily activities, and evaluate adequacy of treatment in cancer patients in Lebanon. Methods: A total of 400 cancer patients aged 18 and above were interviewed at the American University of Beirut Medical Center surgical and medical oncology floors, outpatient clinics and chemotherapy units from March 2016-February 2017...
March 27, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
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