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Outpatient palliative care

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https://www.readbyqxmd.com/read/28337553/early-palliative-care-current-status-of-integration-within-german-comprehensive-cancer-centers
#1
Julia Berendt, Stephanie Stiel, Friedemann Nauck, Christoph Ostgathe
PURPOSE: The aim of this study is to describe how models of early integration (EI) of specialized palliative care (SPC) are applied to German comprehensive cancer center (CCCs). METHODS: Heads of SPC departments of the 15 German CCCs were asked by email to describe the situation of early SPC in their CCC. The responses were analyzed using MAXQDA. RESULTS: Thirteen answers were allowed to be analyzed. Most of the department heads report that EI models of SPC are partially applied in the CCC (responses with "yes" or "partly," n = 10)...
March 23, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28301921/health-care-utilization-and-complications-of-endoscopic-esophageal-dilation-in-a-national-population
#2
Abhinav Goyal, Kshitij Chatterjee, Sujani Yadlapati, Shailender Singh
Background/Aims: Esophageal stricture is usually managed with outpatient endoscopic dilation. However, patients with food impaction or failure to thrive undergo inpatient dilation. Esophageal perforation is the most feared complication, and its risk in inpatient setting is unknown. Methods: We used National Inpatient Sample (NIS) database for 2007-2013. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes were used to identify patients with esophageal strictures...
March 17, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28277698/does-educating-patients-about-the-early-palliative-care-study-increase-preferences-for-outpatient-palliative-cancer-care-findings-from-project-empower
#3
Michael Hoerger, Laura M Perry, Robert Gramling, Ronald M Epstein, Paul R Duberstein
OBJECTIVES: Randomized controlled trials, especially the Early Palliative Care Study (Temel et al., 2010), have shown that early outpatient palliative cancer care can improve quality of life for patients with advanced cancer or serious symptoms. However, fear and misconceptions drive avoidance of palliative care. Drawing from an empowerment perspective, we examined whether educating patients about evidence from the Early Palliative Care Study would increase preferences for palliative care...
March 9, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28264748/factors-associated-with-patient-reported-subjective-well-being-among-advanced-lung-or-non-colonic-gastrointestinal-cancer-patients
#4
Sriram Yennurajalingam, Yu Jung Kim, Yi Zhang, Jichan Park, Joseph Arthur, Gary B Chisholm, Janet L Williams, Eduardo Bruera
OBJECTIVE: The aim of this study was to determine the factors associated with a feeling of well-being using the Edmonton Symptom Assessment Scale (ESAS)-Feeling of Well-Being item (ESAS-FWB; where 0 = best and 10 = worst) among advanced lung or non-colonic gastrointestinal cancer patients who were referred to an outpatient palliative care clinic (OPCC). We also examined the association of performance on the ESAS-FWB with overall survival (OS). METHOD: We reviewed the records of consecutive patients with incurable advanced lung cancer and non-colonic gastrointestinal cancer presenting to an OPCC from 1 January 2008 through to 31 December 2013...
March 7, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28220314/supportive-care-organization-in-france-a-national-in-depth-survey-among-patients-and-oncologists
#5
Florian Scotté, Christian Hervé, Pauline Leroy, Jean-Marc Tourani, René-Jean Bensadoun, Marie-Eve Bugat, Fadila Farsi, Nicolas Jovenin, Moïse Namer, Christophe Tournigand, Sophie Morin, Cloé Brami, Stéphane Oudard, Alexandre Saadi, Ivan Krakowski
PURPOSE: Medical doctors' (MDs), but not patients', perception of supportive care in cancer (SCC) in France has been previously assessed in a national survey. This study evaluated MDs and patients' perceptions of the SCC organization and implementation in France. METHODS: The French SCC Association conducted two observational studies: study 1 (S1), containing a 30-point questionnaire sent to 2263 MDs, and study 2 (S2), containing a 40-point questionnaire sent to 2000 patients...
February 20, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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
#6
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/28175997/nothing-left-to-chance-the-impact-of-locus-of-control-on-physical-and-mental-quality-of-life-in-terminal-cancer-patients
#7
Alaina J Brown, Premal H Thaker, Charlotte C Sun, Diana L Urbauer, Eduardo Bruera, Diane C Bodurka, Lois M Ramondetta
PURPOSE: The purpose of this study is to evaluate if locus of control (LOC) predicts various quality of life (QOL) and mental well-being measures among terminally ill cancer patients at the time of palliative care consult. METHODS: Multi-site analysis of patients with advanced cancer being seen as new patients in a Palliative and Supportive Care outpatient clinic. Patients completed the following surveys: locus of control (LOC) scale, Functional Assessment of Chronic Illness Therapy-General (FACT-G), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), Hospital Anxiety Depression Scale (HADS), and Herth Hope Index (HHI)...
February 7, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28156658/changes-in-opioid-type-and-dose-among-cancer-patients-referred-to-outpatient-palliative-care
#8
Joseph Baidoo, Yee Choon Meng, Donna S Zhukovsky, Kimberson Cochien Tanco, Holly A Stewart, Tonya Edwards, Manju P Joy, Leela Kuriakose, Zhanni Lu, Diane D Liu, Janet L Williams, Eduardo Bruera
106 Background: Opioid prescriptions are regulated at both federal and state levels. Examples of such regulations include use of risk evaluation and mitigation strategies (REMS), mandatory sharing of prescription data with state prescription drug monitoring programs and the reclassification of hydrocodone as schedule II opioid in October 2014. One possible consequence of such changes would be earlier referral to palliative care (PC) for opioid management. Alternatively, primary oncologist may treat patients with weak opioids or use strong opioids with lower daily dose...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156650/organizational-factors-influencing-specialty-palliative-care-utilization-at-academic-cancer-centers
#9
Michael W Rabow, Megan Crowley-Makota, Mallory Marie Waters, Michelle Nkumsah, Douglas B White, Edward Chu, Cardinale B Smith, Robert Arnold
109 Background: Rates of early specialty palliative care utilization remain low, despite increasing familiarity and favorable attitudes amongst cancer center oncologists. In this context, understanding organizational barriers to specialty palliative care use becomes critical. METHODS: We conducted a qualitative interview study with 74 medical oncologists practicing at 3 U.S. academic cancer centers with well-established specialty palliative care clinics. The in-depth interview guide elicited experiences and views related to outpatient palliative care...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156645/perception-of-helpfulness-of-a-question-prompt-sheet-among-cancer-patients-attending-outpatient-palliative-care
#10
Sriram Yennu, Kresnier Perez Zapata, Hilda Cantu, Diane D Liu, Jimin Wu, Eduardo Bruera
25 Background: Data on the use of question prompt sheets (QPS) in palliative care is limited. Our team previously developed a single page QPS using a Delphi process. The main objective of this study was to determine the perception of helpfulness of a QPS in patient-physician communication among advanced cancer outpatients. METHODS: 104 eligible patients received the QPS for use during their first palliative care clinic. Patient and physician perceptions about the QPS were assessed at the end of the visit...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156644/barriers-to-patients-understanding-of-prognosis-in-advanced-cancer
#11
Jason Palopoli, Mark Maddox, Adonas Woodard, Kristine Marie Ward, Maneesh Rajiv Jain, Pamela A Crilley, Dave Topolsky, John King, Sigmund Benham Khan, Maelys Amat, Michael Styler
24 Background: An informed decision requires good communication between the patient and their oncologist in regards to diagnosis and prognosis, especially in patients with terminal cancer. This discussion entails education about their disease, treatment options, and potential outcomes. The purpose of this study was to assess advanced-stage cancer oncology patients' comprehension of their disease, treatment options and goals of therapy. METHODS: Subjects included patients with a diagnosis of metastatic cancer with an option for palliative or life extending chemotherapy in an out-patient office at Drexel University College of Medicine...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156627/making-treatment-decisions-at-end-of-life-in-a-comprehensive-cancer-center
#12
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/28156626/effect-of-a-communication-skills-intervention-on-resident-comfort-and-knowledge-of-discussing-goals-of-care-and-advance-care-planning
#13
Elizabeth Golding, Aaron Lampkin, Mary Walker Larach, Lawrence Klima
50 Background: Inpatient providers are sometimes challenged with advanced care planning for their patients. At a teaching hospital, resident physicians find themselves tasked with this responsibility for inpatients they may have only just met, as well as in their assigned outpatient panel. Education on communication skills though has been shown to improve resident comfort level and knowledge of discussing goals of care and advance care planning. METHODS: Internal medicine categorical residents (n = 15) and preliminary (n = 3) residents at a university-affiliated, community hospital learned the fundamentals of discussing goals of care and advance care planning using selected modules from the Center for Advancing Palliative Care's (CAPC) online curriculum in communication skills during their outpatient clinic rotation from February through June 2016...
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
#14
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/28156587/palliative-outpatient-hot-clinic-rapid-access-for-oncology-patients-visiting-emergency-department-in-a-tertiary-hospital-in-singapore-a-1-year-experience
#15
Mervyn Yong Hwang Koh, Jia Fang Lee
137 Background: Oncology patients often present with symptoms at Emergency Department (ED). While most patients require admission for further management, some patients can be discharged from ED with outpatient follow-up. However, most patients were given 4 to 6 week appointment. In the light of this service gap, our department collaborated with ED to facilitate rapid access to Palliative Outpatient Hot Clinic (POHC) within 3 working days from ED visit in 2015. METHODS: We performed a retrospective review of all patients seen in the ED who satisfied the referral criteria to POHC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156582/a-model-of-early-integration-of-palliative-care-into-oncology-care-for-patients-with-metastatic-colorectal-cancer
#16
Laura Cantino, Ingrid Maravilla, Nicole Thompson, Chloe Evelyn Atreya, Kara Bischoff
142 Background: Current NCCN guidelines recommend that "institutions should develop processes for integrating palliative care into cancer care." However, it is not clear what the best method is for implementing this integrated care. Palliative care needs specific to patients with metastatic colorectal cancer (mCRC) and best practices for integration of outpatient palliative and oncologic care in mCRC are not well understood. METHODS: We conducted a pre-post prospective cohort study to evaluate the palliative care needs of mCRC patients and the implementation of an integrated palliative care program...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156580/characteristics-of-patients-with-unscheduled-versus-scheduled-visits-to-outpatient-supportive-care-center-scc-at-a-comprehensive-cancer-center
#17
Ahsan Azhar, Maria Agustina Cerana, Vishidha Reddy Balankari, Madhuri Adabala, Diane D Liu, Janet L Williams, Eduardo Bruera
144 Background: There is limited literature regarding outpatient palliative care, and even more limited literature describing factors associated with unscheduled visits. Our aim was to identify clinical characteristics of patients who walk-in (present unscheduled) to the outpatient SCC with the hypothesize that the patients who present for unscheduled visits have more severe symptom distress as compared to those patients who present for scheduled appointments. METHODS: We compared 183 patients with unscheduled consults (CO) vs a random sample of 361 patients with scheduled CO and 159 patients with unscheduled follow-up (FU) visits vs a random sample of 318 patients with scheduled FU visits...
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
#18
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/28156576/embedded-palliative-medicine-model-for-inpatient-solid-tumor-oncology-patients-utilizing-corounding-and-consultation-criteria-a-quality-improvement-pilot
#19
Bassam N Estfan, Alberto J Montero
148 Background: Hospitalized patients (pts) on solid tumor oncology (STO) services have palliative needs including pain management. This quality improvement project sought to establish a new STO-specific co-rounding PM consult service, evaluate the use of consult criteria for STO inpatients, assess the impact/interest in an embedded service, improve access to PM for STO pts and improve palliative education to STO teams. METHODS: During October 2015 to January 2016, a new PM consult service was established for the 2 STO inpatient services at Cleveland Clinic...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156573/referral-patterns-and-characteristics-of-uninsured-versus-insured-patients-referred-to-the-outpatient-supportive-care-center-scc-at-a-comprehensive-cancer-center
#20
Sriram Yennu, Aashraya Ramu, Haibo Zhang, Ali Haider, Janet L Williams, Eduardo Bruera
116 Background: Multiple barriers exist in providing quality palliative care to low-income patients with cancer. Such disparities may negatively influence effective management of symptoms including pain. Our objective was to compare referral patterns and characteristics (level of symptom distress) of uninsured vs insured patients. METHODS: We reviewed randomly selected charts of 100 Indigent (IND) and 100 Medicaid (MC) patients and compared them with a random sample of 300 patients with insurance (INS) referred during the same time period (1/2010 to 12/2014) to our SCC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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