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Outpatient palliative care

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https://www.readbyqxmd.com/read/29326110/contemporary-management-and-outcomes-in-congenitally-corrected-transposition-of-the-great-arteries
#1
REVIEW
Shelby Kutty, David A Danford, Gerhard-Paul Diller, Oktay Tutarel
Congenitally corrected transposition of the great arteries (ccTGA) can occur in isolation, or in combination with other structural cardiac anomalies, most commonly ventricular septal defect, pulmonary stenosis and tricuspid valve disease. Clinical recognition can be challenging, so echocardiography is often the means by which definitive diagnosis is made. The tricuspid valve and right ventricle are on the systemic arterial side of the ccTGA circulation, and are therefore subject to progressive functional deterioration...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29325199/-efficacy-and-safety-of-indwelling-pleural-catheters
#2
Eva Lücke, Uwe Steffen, Sandra Riedel, Jens Schreiber
In symptomatic malignant pleural effusions, mostly in a palliative situation, therapeutic procedures should be chosen to improve dyspnoea and the concomitant impairment of quality of life. Indwelling pleural catheters (IPC) have played an increasing role in recent years. The efficacy and safety of this method have not been adequately clarified under real-life clinical conditions. 94 patients, in whom IPC had been implanted because of a clinical indication, were analysed retrospectively with respect to efficacy and safety, together with patient characteristics, peri- and postinterventional complications, e...
January 11, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29304799/study-protocol-evaluation-of-specialized-outpatient-palliative-care-sopc-in-the-german-state-of-hesse-elsah-study-work-package-ii-palliative-care-for-pediatric-patients
#3
Lisa-R Ulrich, Dania Gruber, Michaela Hach, Stefan Boesner, Joerg Haasenritter, Katrin Kuss, Hannah Seipp, Ferdinand M Gerlach, Antje Erler
BACKGROUND: In 2007, the European Association of Palliative Care (EAPC) provided a comprehensive set of recommendations and standards for the provision of adequate pediatric palliative care. A number of studies have shown deficits in pediatric palliative care compared to EAPC standards. In Germany, pediatric palliative care patients can be referred to specialized outpatient palliative care (SOPC) services, which are known to enhance quality of life, e.g. by avoiding hospitalization. However, current regulations for the provision of SOPC in Germany do not account for the different circumstances and needs of children and their families compared to adult palliative care patients...
January 5, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29298494/development-of-a-community-based-palliative-care-screening-tool-for-underserved-older-adults-with-chronic-illnesses
#4
Angela Ghesquiere, Daniel S Gardner, Caitlin McAfee, Cara Kenien, Elizabeth Capezuti, Elissa Kozlov, Jo Anne Sirey, M Carrington Reid
Although they experience high rates of chronic illness, low-income minority communities have traditionally underutilized palliative care services compared to whites and those with higher incomes. One reason for this trend is lack of screening by community providers. We utilized a community-based participatory research approach to develop and implement an innovative multidomain palliative care screening tool in aging service agencies. Participants were aging service providers and clients in the East and Central Harlem neighborhoods of New York City, which are characterized by high poverty, largely African American and Latino populations, disproportionally high rates of chronic conditions, and limited health-care access...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29298400/exploring-opportunities-for-primary-outpatient-palliative-care-for-adults-with-cystic-fibrosis-a-mixed-methods-study-of-patients-needs
#5
Mara R Hobler, Ruth A Engelberg, J Randall Curtis, Kathleen J Ramos, Miriam I Zander, Shacole S Howard, Christopher H Goss, Moira L Aitken
BACKGROUND: Persons with cystic fibrosis (CF) experience high morbidity and mortality, yet little is known about their palliative care needs and how clinicians may address these needs. OBJECTIVES: (1) To identify palliative care and advance care planning needs of patients with CF and their families; and (2) to identify clinicians' potential roles in meeting these needs. METHODS: A mixed-methods study of adult patients (age ≥18 years) with moderate-to-severe CF [forced expiratory volume in the first second (FEV1) <65% predicted] were recruited from a CF Center...
January 3, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29297082/enhancing-recovery-from-sepsis-a-review
#6
REVIEW
Hallie C Prescott, Derek C Angus
Importance: Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. Observations: Each year, more than 19 million individuals develop sepsis, defined as a life-threatening acute organ dysfunction secondary to infection. Approximately 14 million survive to hospital discharge and their prognosis varies. Half of patients recover, one-third die during the following year, and one-sixth have severe persistent impairments...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29295879/the-right-place-at-the-right-time-medical-oncology-outpatients-perceptions-of-location-of-end-of-life-care
#7
Amy Waller, Rob Sanson-Fisher, Nicholas Zdenkowski, Charles Douglas, Alix Hall, Justin Walsh
Background: Helping people achieve their preferred location of care is an important indicator of quality end-of-life (EOL) care. Using a sample of Australian medical oncology outpatients, this study examined (1) their preferred location of EOL care; (2) their perceived benefits and worries of receiving care in that location; (3) the percentage who had discussed preferences with their doctor and/or support person; and (4) whether they wanted their doctor to ask them where they wanted to die. Methods: Adults with a confirmed diagnosis of cancer were approached between September 2015 and January 2016 in the waiting room of an Australian oncology outpatient clinic...
January 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29288879/development-and-assessment-of-a-measure-of-parent-and-child-needs-in-pediatric-palliative-care
#8
James P Donnelly, Kim Downing, Jason Cloen, Patricia Fragen, Alyssa W Gupton, Jen Misasi, Kelly Michelson
CONTEXT: Pediatric palliative care has no evidence-based needs assessment measure. The Parent and Child Needs Survey (PCNeeds) is a new instrument designed to assess the needs of children in palliative care, including children receiving end-of-life care, and their families. OBJECTIVES: This study examines the psychometrics of and respondents' perceptions about the PCNeeds. METHODS: Parents of children in four outpatient pediatric palliative care programs completed the PCNeeds and the World Health Organization Quality of Life-Brief tool (WHOQOL-BREF)...
December 27, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29251778/advance-care-planning-acp-for-specialists-managing-cirrhosis-a-focus-on-patient-centered-care
#9
REVIEW
Amanda Brisebois, Kathleen P Ismond, Michelle Carbonneau, Puneeta Tandon
Advance care planning (ACP) and goals of care designation (GCD) are being integrated into modern health care. In cirrhosis, uptake and adoption of these practices have been limited with physicians citing many perceived barriers and limitations. Recognizing the many tangible benefits of ACP and GCD processes in patients with life-limiting chronic diseases, the onus is on health practitioners to initiate and direct these conversations with their patients and surrogates. Drawing upon the literature and our experiences in palliative care and cirrhosis, we provide an actionable framework that can be readily implemented into a busy clinic setting by a practitioner...
December 18, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29249906/the-potential-of-the-inodilator-levosimendan-in-maintaining-quality-of-life-in-advanced-heart-failure
#10
Markku S Nieminen, Cândida Fonseca, Dulce Brito, Gerhard Wikström
Maintaining adequate quality of life (QoL) is an important therapeutic objective for patients with advanced heart failure and, for some patients, may take precedence over prolonging life. Achieving good QoL in this context may involve aspects of patient care that lie outside the familiar limits of heart failure treatment. The inodilator levosimendan may be advantageous in this setting, not least because of its sustained duration of action, ascribed to a long-acting metabolite designated OR-1896. The possibility of using this drug in an outpatient setting is a notable practical advantage that avoids the need for patients to attend a clinic appointment...
March 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/29230475/improving-decisions-about-transport-to-the-emergency-department-for-assisted-living-residents-who-fall
#11
Jefferson G Williams, Michael W Bachman, Michael D Lyons, Benjamin B Currie, Lawrence H Brown, A Wooten Jones, Jose G Cabanas, Alan K Kronhaus, J Brent Myers
Background: Residents of assisted living facilities who fall may not be seriously ill or injured, but policies often require immediate transport to an emergency department regardless of the patient's condition. Objective: To determine whether unnecessary transport can be avoided. Design: Prospective cohort study. Setting: One large county with a single system of emergency medical services. Participants: Convenience sample of residents in 22 assisted living facilities served by 1 group of primary care physicians...
December 12, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29230124/oncology-and-palliative-medicine-providing-comprehensive-care-for-patients-with-cancer
#12
REVIEW
Laura Finn, Alva Roche Green, Sonia Malhotra
Background: Despite the evidence for the fundamental need for palliative medicine services in the practice of oncology, integration of these medical specialties remains a clinical challenge. Methods: We reviewed the current literature regarding the practice of palliative medicine in the field of oncology, examining randomized clinical trials of palliative medicine services in advanced cancer, models of palliative medicine delivery, studies of cost effectiveness, and national palliative medicine practice and referral guidelines...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29223401/palliative-care-need-and-availability-in-four-referral-hospitals-in-senegal-results-from-a-multi-component-assessment
#13
Hana Hamdi, Oumar Ba, Serigne Niang, Christian Ntizimira, Mouhadou Mbengue, Aminata Sophie Coulbary, Rokhaya Niang, Matthew Parsons, Joseph J Amon, Diederik Lohman
CONTEXT: With prevalence of non-communicable diseases and life expectancy rising in Senegal, the need for palliative care is likely growing. No national palliative care needs assessments have been carried out. OBJECTIVES: To assess the capacity and need for palliative care in Senegal. METHODS: A multi-component assessment of availability and demand for palliative care was conducted in two tertiary and two regional hospitals in Senegal in 2015 with approval from Senegal's National Ethics Committee for Health Research...
December 6, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29206564/advance-care-planning-in-an-accountable-care-organization-is-associated-with-increased-advanced-directive-documentation-and-decreased-costs
#14
William F Bond, Minchul Kim, Chris M Franciskovich, Jason E Weinberg, Jessica D Svendsen, Linda S Fehr, Amy Funk, Robert Sawicki, Carl V Asche
BACKGROUND: Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. OBJECTIVE: To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. DESIGN: This was a case-control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs...
December 5, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29169346/social-and-clinical-determinants-of-preferences-and-their-achievement-at-the-end-of-life-prospective-cohort-study-of-older-adults-receiving-palliative-care-in-three-countries
#15
Irene J Higginson, Barbara A Daveson, R Sean Morrison, Deokhee Yi, Diane Meier, Melinda Smith, Karen Ryan, Regina McQuillan, Bridget M Johnston, Charles Normand
BACKGROUND: Achieving choice is proposed as a quality marker. But little is known about what influences preferences especially among older adults. We aimed to determine and compare, across three countries, factors associated with preferences for place of death and treatment, and actual site of death. METHODS: We recruited adults aged ≥65-years from hospital-based multiprofessional palliative care services in London, Dublin, New York, and followed them for >17 months...
November 23, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29163800/end-of-life-care-in-children-with-hematologic-malignancies
#16
Jessica I Hoell, Jens Warfsmann, Stefan Balzer, Arndt Borkhardt, Gisela Janssen, Michaela Kuhlen
Introduction: Hematologic malignancies (HM) represent the most common neoplasms in childhood. Despite improved overall survival rates, they are still a major contributor to cancer death in children. Aims: To determine the proportion of children with HM in pediatric palliative care (PPC) and to identify the clinical characteristics and symptoms in comparison to children with extracranial solid tumors (non HM patients). Patients and Methods: This study was conducted as a single-center retrospective cohort study of patients in the care of a large specialized PPC team...
October 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/29155290/factors-associated-with-attrition-in-a-multicenter-longitudinal-observational-study-of-patients-with-advanced-cancer
#17
Pedro E Perez-Cruz, Omar Shamieh, Carlos Eduardo Paiva, Jung Hye Kwon, Mary Ann Muckaden, Eduardo Bruera, David Hui
CONTEXT: Attrition is common in longitudinal observational studies in palliative care. Few studies have examined predictors of attrition. OBJECTIVES: To identify patient characteristics at enrollment associated with attrition in palliative oncology outpatient setting. METHODS: In this longitudinal observational study, advanced cancer patients [ACP] enrolled in an outpatient multicenter study were assessed at baseline and 2-5 weeks later. We compared baseline characteristics between patients who returned for follow-up and those who dropped out...
November 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29154919/patient-reported-outcomes-and-opioid-use-by-outpatient-cancer-patients
#18
Natalie Moryl, Vinnidhy Dave, Paul Glare, Ali Bokhari, Vivek T Malhotra, Amitabh Gulati, Joseph Hung, Vinay Puttanniah, Yvona Griffo, Roma Tickoo, Alison Wiesenthal, Susan D Horn, Charles E Inturrisi
The Memorial Sloan Kettering Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 1,534 chronic pain cancer patients who were seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory) was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%. The patient's report of average percent pain relief and health state (EuroQOL 5 dimensions) was inversely related to average pain intensity category, whereas measures of pain interference, number of worst pain locations, and physical and psychological distress were directly related to pain intensity category...
November 14, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29131734/yoga-therapy-in-japan
#19
Keishin Kimura
This perspective piece gives an overview of the current situation of yoga therapy in Japan today. Traditional yoga in Japan suffered a serious setback in 1995 with a nerve gas terrorist attack on the Tokyo subway, which was carried out by a cult that recruited members through yoga classes. But with the increase in popularity with modern forms of yoga such as Iyengar yoga, Ashtanga yoga and hot yoga in the West, the general public in Japan today is forgetting its aversion to yoga and considers it to be something that can contribute to good health...
November 2017: International Journal of Yoga Therapy
https://www.readbyqxmd.com/read/29129738/timing-of-referral-and-characteristics-of-uninsured-medicaid-and-insured-patients-referred-to-the-outpatient-supportive-care-center-at-a-comprehensive-cancer-center
#20
Ahsan Azhar, Sriram Yennurajalingam, Aashraya Ramu, Haibo Zhang, Ali Haider, Janet L Williams, Seyedeh S Dibaj, Diane D Liu, Eduardo Bruera
CONTEXT: Low-income patients face barriers to palliative care access, which might negatively influence symptom management and advanced care planning. OBJECTIVE: Our aim was to compare time of referral and characteristics (level of symptom distress) among uninsured (indigent), low-insured (Medicaid), and insured patients presenting to our Supportive Care Center (SCC). METHODS: We conducted a retrospective review of randomly selected 100 indigent, 100 Medicaid and 300 insured outpatients referred during the same 5-year period...
November 9, 2017: Journal of Pain and Symptom Management
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