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Outpatient palliative care

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https://www.readbyqxmd.com/read/28444652/-establishment-of-specialized-pediatric-palliative-home-care-in-the-medical-valley-of-the-european-metropolitan-area-nuremberg
#1
Steven Hébert, Chara Gravou-Apostolatou, Wolfgang Rascher
Background As part of the 2007 health reform in Germany the structure of outpatient palliative care for children and adolescents was adopted for the first time and then implemented in Erlangen-Nuremberg in 2009. Methods The introduction of Pediatric Palliative Home Care (PPHC) at the Hospital for Children and Adolescents at the University of Erlangen-Nuremberg was retrospectively analyzed between the years 2009 to 2014. Referring medical records (paper-based and electronic) were evaluated systematically. Results Considering 69 patients within this study, 44 (63...
March 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28437210/factors-associated-with-length-of-stay-at-home-in-the-final-month-of-life-among-advanced-cancer-patients-a-retrospective-chart-review
#2
Masatomo Otsuka
BACKGROUND: Living at home is an important factor for maintaining high quality of life among patients. Many studies have discussed parameters associated with place of death, but no studies have yet clarified which factors influence the length of stay at home during the end of life. OBJECTIVE: The aim of this study was to identify factors influencing the amount of time spent at home during the final month of life among patients with advanced cancer. METHODS: A retrospective chart review was conducted for 415 patients with advanced cancer...
February 28, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436189/medication-appropriateness-for-patients-with-dementia-approaching-the-end-of-their-life
#3
Hsien-Yeh Chuang, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
AIM: To examine medication use among patients with dementia towards the end of their life and to evaluate the appropriateness of medication use by using a nationwide database. METHODS: Using Taiwan's National Health Insurance Research Database, we identified 6532 people with dementia that died between 2008 and 2012. For each person with dementia, data of medication use in the last month of outpatient setting (vs -12th month [baseline]) and last hospitalization (vs -3rd hospitalization [baseline]) before death were retrieved for study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28427868/potential-palliative-care-quality-indicators-in-heart-disease-patients-a-review-of-the-literature
#4
REVIEW
Atsushi Mizuno, Mitsunori Miyashita, Akitoshi Hayashi, Fujimi Kawai, Koichiro Niwa, Akemi Utsunomiya, Shun Kohsaka, Takashi Kohno, Takeshi Yamamoto, Morimasa Takayama, Toshihisa Anzai
In spite of the increasing interest in palliative care for heart disease, data on the detailed methods of palliative care and its efficacy specifically in heart disease are still lacking. A structured PubMed literature review revealed no quality indicators of palliative care in heart disease. Therefore, we performed a narrative overview of the potential quality indicators in heart disease by reviewing previous literature concerning quality indicators in cancer patients. We summarize seven potential categories of quality indicators in heart disease: (1) presence and availability of a palliative care unit, palliative care team, and outpatient palliative care; (2) human resources such as number of skilled staff; (3) infrastructure; (4) presence and frequency of documentation or family survey; (5) patient-reported outcome measure (PROM) data and disease-specific patient quality of life such as The Kansas City Cardiomyopathy Questionnaire (KCCQ); (6) questionnaires and interviews about the quality of palliative care after death, including bereaved family surveys; and (7) admission-related outcomes such as place of death and intensive care unit length of stay...
April 17, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28386787/prospective-evaluation-of-systematic-use-of-peripherally-inserted-central-catheters-picc-lines-for-the-home-care-after-allogeneic-hematopoietic-stem-cells-transplantation
#5
J Cornillon, J A Martignoles, E Tavernier-Tardy, M Gire, P Martinez, C Tranchan, A Vallard, K Augeul-Meunier, B Hacquard, D Guyotat
PURPOSE: Long-term catheters are often necessary for outpatient care after an allogeneic hematopoietic stem cell transplantation (HSCT), However, there is paucity of data on the use of peripherally inserted central catheter (PICC) in post-HSCT setting. METHODS: We prospectively evaluated the systematic use of PICC in 37 consecutive patients returning home after HSCT. RESULTS: In 6 out of 37 patients, the PICC was exclusively used for weekly blood controls...
April 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28386785/assessing-the-prognostic-features-of-a-pain-classification-system-in-advanced-cancer-patients
#6
Joseph Arthur, Kimberson Tanco, Ali Haider, Courtney Maligi, Minjeong Park, Diane Liu, Eduardo Bruera
PURPOSE: The Edmonton Classification System for Cancer Pain (ECS-CP) has been shown to predict pain management complexity based on five features: pain mechanism, incident pain, psychological distress, addictive behavior, and cognitive function. The main objective of our study was to explore the association between ECS-CP features and pain treatment outcomes among outpatients managed by a palliative care specialist-led interdisciplinary team. METHODS: Initial and follow-up clinical information of 386 eligible supportive care outpatients were retrospectively reviewed and analyzed...
April 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28379814/snapshot-of-an-outpatient-supportive-care-center-at-a-comprehensive-cancer-center
#7
Lindsey E Pimentel, Maxine De La Cruz, Angelique Wong, Debra Castro, Eduardo Bruera
BACKGROUND: Integration of palliative care (PC) in oncology have been found to improve symptom distress, quality of life, and survival in patients with advanced cancer. Early integration is most appropriate in the outpatient setting. However, most PC services in the United States do not have an outpatient component. Our study aims to provide a snapshot of the type of patients and families who are referred to this novel setting for the delivery of early PC. CONCLUSION: Traditionally, PC has been delivered predominantly to patients with advanced disease and to aid in transition to end of life...
April 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28375816/confidence-with-and-barriers-to-serious-illness-communication-a-national-survey-of-hospitalists
#8
Leah B Rosenberg, Jeff Greenwald, Bartho Caponi, Ami Doshi, Howard Epstein, Jeff Frank, Elizabeth Lindenberger, Nick Marzano, Lynnea M Mills, Rab Razzak, James Risser, Wendy G Anderson
OBJECTIVE: To describe the concerns, confidence, and barriers of practicing hospitalists around serious illness communication. BACKGROUND: Hospitalist physicians are optimally positioned to provide primary palliative care, yet their experiences in serious illness communication are not well described. METHODS: Web-based survey, conducted in May 2016. The survey link was distributed via email to 4000 members of the Society of Hospital Medicine...
April 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28337553/early-palliative-care-current-status-of-integration-within-german-comprehensive-cancer-centers
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
March 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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