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Outpatient palliative care

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https://www.readbyqxmd.com/read/28726065/automatic-referral-to-standardize-palliative-care-access-an-international-delphi-survey
#1
David Hui, Masanori Mori, Yee-Choon Meng, Sharon M Watanabe, Augusto Caraceni, Florian Strasser, Tiina Saarto, Nathan Cherny, Paul Glare, Stein Kaasa, Eduardo Bruera
PURPOSE: Palliative care referral is primarily based on clinician judgment, contributing to highly variable access. Standardized criteria to trigger automatic referral have been proposed, but it remains unclear how best to apply them in practice. We conducted a Delphi study of international experts to identify a consensus for the use of standardized criteria to trigger automatic referral. METHODS: Sixty international experts stated their level of agreement for 14 statements regarding the use of clinician-based referral and automatic referral over two Delphi rounds...
July 19, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28712988/the-spanish-adaptation-of-the-palliative-performance-scale-version-2-among-cancer-patients-at-the-end-of-life-psychometric-properties
#2
Eva Barallat, Maria Nabal, Jaume Canal, Javier Trujillano, Montse Gea-Sánchez, Philip J Larkin, Michael G Downing
BACKGROUND: Palliative Performance Scale (PPS) is a reliable tool to assess performance status in cancer patients receiving palliative care. Spanish validated and culturally adapted tools are needed. OBJECTIVES: To develop PPS translation and cross-cultural adaptation into Spanish. To assess its psychometric properties. DESIGN: Translation process with cross-cultural adaptation to produce Spanish Palliative Performance Scale (PPS-SPANISH)...
July 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28699996/quality-of-life-and-religious-spiritual-coping-in-palliative-cancer-care-patients
#3
Ticiane Dionizio de Sousa Matos, Silmara Meneguin, Maria de Lourdes da Silva Ferreira, Helio Amante Miot
Objectives: to compare the quality of life and religious-spiritual coping of palliative cancer care patients with a group of healthy participants; assess whether the perceived quality of life is associated with the religious-spiritual coping strategies; identify the clinical and sociodemographic variables related to quality of life and religious-spiritual coping. Method: cross-sectional study involving 96 palliative outpatient care patient at a public hospital in the interior of the state of São Paulo and 96 healthy volunteers, using a sociodemographic questionnaire, the McGill Quality of Life Questionnaire and the Brief Religious-Spiritual Coping scale...
July 10, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28695689/patterns-of-health-services-utilization-in-the-last-two-weeks-of-life-among-cancer-patients-experience-in-an-australian-academic-cancer-center
#4
Wee Loon Ong, Richard Khor, Mathias Bressel, Phillip Tran, Jo Tedesco, Keen Hun Tai, David Ball, Gillian Duchesne, Farshad Foroudi
AIM: To report the trend in end-of-life health services (HS) utilization among cancer patients treated in a large Australian academic cancer center over a 12-year period. METHODS: This is a retrospective study of cancer patients treated at the Peter MacCallum Cancer Centre (PMCC), who had documented death between January 2002 and December 2013. Using administrative and billing database, we report on the utilization of different categories of HS within two weeks of death: diagnostic investigations (pathology and radiology), inpatient and outpatient services, and potentially futile interventions (PFI, which include radiotherapy, chemotherapy and surgery)...
July 11, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28676557/effect-of-specialist-palliative-care-services-on-quality-of-life-in-adults-with-advanced-incurable-illness-in-hospital-hospice-or-community-settings-systematic-review-and-meta-analysis
#5
Jan Gaertner, Waldemar Siemens, Joerg J Meerpohl, Gerd Antes, Cornelia Meffert, Carola Xander, Stephanie Stock, Dirk Mueller, Guido Schwarzer, Gerhild Becker
Objective To assess the effect of specialist palliative care on quality of life and additional outcomes relevant to patients in those with advanced illness.Design Systematic review with meta-analysis.Data sources Medline, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and trial registers searched up to July 2016.Eligibility criteria for selecting studies Randomised controlled trials with adult inpatients or outpatients treated in hospital, hospice, or community settings with any advanced illness...
July 4, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28644706/advance-care-planning-and-palliative-care-integration-for-patients-undergoing-hematopoietic-stem-cell-transplantation
#6
Winnie S Wang, Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric J Roeland
PURPOSE: Advance care planning (ACP) in hematopoietic stem-cell transplantation (HSCT) is challenging, given the potential for cure despite increased morbidity and mortality risk.The aim of this study was to evaluate ACP and palliative care (PC) integration for patients who underwent HSCT. METHODS: A retrospective analysis was conducted and data were extracted from electronic medical records of patients who underwent HSCT between January 2011 and December 2015. Patients who received more than one transplant and who were younger than 18 years of age were excluded...
June 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28634973/the-role-of-a-surveillance-programme-for-intro-ducing-peripherally-inserted-central-catheters-a-2-year-observational-study-in-an-academic-hospital
#7
Elia Lo Priore, Monika Fliedner, Johannes T Heverhagen, Urban Novak, Jonas Marschall
AIMS OF THE STUDY: In our hospital, a previous attempt to introduce peripherally inserted central catheters (PICC) was aborted after a nonsystematic approach, seemingly accompanied by high rates of complications. The goal of this new interdisciplinary project was to introduce PICCs in an academic hospital, with an embedded interdisciplinary surveillance programme for both infectious and noninfectious outcomes. METHODS: We prospectively collected data for this surveillance study from all patients who underwent PICC insertion from 1 January 2014 and had the catheter removed by 31 December 2015 in our 950-bed academic hospital (Bern University Hospital, Switzerland)...
June 21, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28629462/treatment-decisions-for-older-adults-with-advanced-chronic-kidney-disease
#8
REVIEW
Steven J Rosansky, Jane Schell, Joseph Shega, Jennifer Scherer, Laurie Jacobs, Cecile Couchoud, Deidra Crews, Matthew McNabney
Dialysis initiation rates among older adults, aged 75 years or greater, are increasing at a faster rate than for younger age groups. Older adults with advanced CKD (eGFR < 30 ml/min/1.73 m(2)) typically lose renal function slowly, often suffer from significant comorbidity and thus may die from associated comorbidities before they require dialysis.A patient's pattern of renal function loss over time in relation to their underlying comorbidities can serve as a guide to the probability of a future dialysis requirement...
June 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28625164/the-effect-of-weekly-specialist-palliative-care-teleconsultations-in-patients-with-advanced-cancer-a-randomized-clinical-trial
#9
Patrick D Hoek, Henk J Schers, Ewald M Bronkhorst, Kris C P Vissers, Jeroen G J Hasselaar
BACKGROUND: Teleconsultation seems to be a promising intervention for providing palliative care to home-dwelling patients; however, its effect on clinically relevant outcome measures remains largely unexplored. Therefore, the purpose of this study was to determine whether weekly teleconsultations from a hospital-based specialist palliative care consultation team (SPCT) improved patient-experienced symptom burden compared to "care as usual". Secondary objectives were to determine the effects of these teleconsultations on unmet palliative care needs, continuity of care, hospital admissions, satisfaction with teleconsultations, and the burden experienced by informal caregivers...
June 19, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28614896/-quality-of-life-and-potential-incriminating-factors-among-palliative-care-givers-a-german-survey-of-the-kompact-working-group
#10
Deniz Gencer, Cornelia Meffert, Peter Herschbach, Matthias Hipp, Gerhild Becker
Aim of the study Due to the aging population in Germany, the need for palliative care institutions will increase. Considering the lack of resources, work stress of palliative care nurses could increase significantly. It was the aim of this study to identify risk factors for job overload and work stress of palliative care nurses in the inpatient and outpatient setting. Methods In cooperation with the KOMPACT Working Group, we conducted an anonymous survey of palliative care givers in Baden-Württemberg, Germany...
June 14, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28604233/distance-education-methods-are-useful-for-delivering-education-to-palliative-caregivers-a-single-arm-trial-of-an-education-package-palliative-caregivers-education-package
#11
Liz Forbat, Rowena Robinson, Rachel Bilton-Simek, Karemah Francois, Marsha Lewis, Erna Haraldsdottir
BACKGROUND: Face-to-face/group education for palliative caregivers is successful, but relies on caregivers travelling, being absent from the patient, and rigid timings. This presents inequities for those in rural locations. AIM: To design and test an innovative distance-learning educational package (PrECEPt: PalliativE Caregivers Education Package). DESIGN: Single-arm mixed-method feasibility proof-of-concept trial (ACTRN12616000601437). The primary outcome was carer self-efficacy, with secondary outcomes focused on caregiver preparedness and carer tasks/needs...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28598227/integration-of-a-palliative-care-intervention-into-community-practice-for-lung-cancer-a-study-protocol-and-lessons-learned-with-implementation
#12
Huong Q Nguyen, Thomas Cuyegkeng, Tieu O Phung, Karisa Jahn, Tami Borneman, Mayra Macias, Nora Ruel, Betty Ferrell
BACKGROUND: A notable gap in the evidence base for outpatient palliative care (PC) for cancer is that most trials were conducted in specialized oncology or academic centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance regarding the most effective and sustainable PC service models. OBJECTIVE: Describe the study protocol to evaluate the dissemination of a previously tested nurse-led PC intervention (PCI) for patients with lung cancer and their family caregiver in community-based settings, lessons learned in adapting and implementing the PCI, and implications for future dissemination-translational efforts Design: Two-group, prospective sequential, quasi-experimental design with Phase 1 (Usual care) followed by Phase 2 (Intervention) setting/subjects...
June 9, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28595446/life-perceptions-of-patients-receiving-palliative-care-and-experiencing-psycho-social-spiritual-healing
#13
Lingsheng Li, Danetta H Sloan, Ambereen K Mehta, Gordon Willis, Meaghann S Weaver, Ann C Berger
BACKGROUND: It is important to identify, from the patients' perspectives, the different factors that contribute toward psycho-social-spiritual healing. METHODS: This was a qualitative study that took place at a large research center, an underserved clinic, and a community hospital. We used a needs assessment questionnaire and open-ended questions to assess the constituents of psycho-social-spiritual healing: (I) how previous life experiences affected patients' present situations in dealing with their illnesses; (II) barriers to palliative care, and (III) benefits of palliative care...
June 3, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28595027/clinical-outcomes-of-start-low-go-slow-methadone-initiation-for-cancer-related-pain-what-s-the-hurry
#14
Pippa Hawley, Lawrance Chow, Gillian Fyles, Aria Shokoohi, Mary-Jane O'Leary, Matthew Mittelstadt
BACKGROUND: Methadone has been shown to be effective for cancer pain. Most published switching methods are complete in less than three days, requiring very close supervision, usually in an inpatient setting. This need for hospitalization is a barrier to access. We present a large retrospective study of slow outpatient methadone starts and describe our starting method. METHODS: Charts were reviewed of patients referred to the Pain and Symptom Management/Palliative Care clinics at the six BC Cancer Agency's regional centers that underwent initiation of methadone for analgesia over a 14-year period...
June 8, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28594585/impact-of-palliative-medicine-involvement-on-end-of-life-services-for-patients-with-cancer-with-in-hospital-deaths
#15
Alison Wiesenthal, Debra A Goldman, Deborah Korenstein
PURPOSE: Palliative care (PC) has been shown to improve the quality of care and resource utilization for inpatients. We examined the relationship between PC consultation before and during final admission and patterns of care for dying patients at our tertiary cancer center. METHODS: We retrospectively reviewed adult patients with solid tumor cancer with a length of stay ≥ 3 days who died in hospital between December 2012 and November 2014. We recorded services, including laboratory testing, imaging, blood products, medications, diet orders, do not resuscitate orders, and consultations, delivered within 3 days of death...
June 8, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28585274/junior-doctors-attitudes-to-opioids-for-refractory-breathlessness-in-patients-with-advanced-chronic-obstructive-pulmonary-disease
#16
Natasha Smallwood, Nicole Gaffney, Alexandra Gorelik, Louis Irving, Brian Le, Jennifer Philip
Refractory breathlessness is a common, distressing symptom in patients with advanced chronic obstructive pulmonary disease (COPD). The judicious, off-licence prescription of opioids, together with other management strategies, can improve breathlessness, however, internationally there is profound reluctance to prescribe opioids for breathlessness in COPD. AIMS: To understand Australian junior doctors' knowledge and attitudes regarding the management of refractory breathlessness and the role of opioids in COPD...
June 6, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28562197/improving-end-of-life-care-palliative-care-embedded-in-an-oncology-clinic-specializing-in-targeted-and-immune-based-therapies
#17
David J Einstein, Susan DeSanto-Madeya, Matthew Gregas, Jessica Lynch, David F McDermott, Mary K Buss
PURPOSE: Patients with advanced cancer benefit from early involvement of palliative care. The ideal method of palliative care integration remains to be determined, as does its effectiveness for patients treated with targeted and immune-based therapies. MATERIALS AND METHODS: We studied the impact of an embedded palliative care team that saw patients in an academic oncology clinic specializing in targeted and immune-based therapies. Patients seen on a specific day accessed the embedded model, on the basis of automatic criteria; patients seen other days could be referred to a separate palliative care clinic (usual care)...
May 31, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28562160/work-experiences-of-patients-receiving-palliative-care-at-a-comprehensive-cancer-center-exploratory-analysis
#18
Paul A Glare, Tanya Nikolova, Alberta Alickaj, Sujata Patil, Victoria Blinder
BACKGROUND: Employment-related issues have been largely overlooked in cancer patients needing palliative care. These issues may become more relevant as cancer evolves into more of a chronic illness and palliative care is provided independent of stage or prognosis. OBJECTIVE: To characterize the employment situations of working-age palliative care patients. DESIGN: Cross-sectional survey setting/subjects: Consecutive sample of 112 patients followed in palliative care outpatient clinics at a comprehensive cancer center...
July 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28558731/integration-and-activity-of-hospital-based-palliative-care-consultation-teams-the-insight-multicentric-cohort-study
#19
Pascale Vinant, Ingrid Joffin, Laure Serresse, Sophie Grabar, Hélène Jaulmes, Malika Daoud, Gabriel Abitbol, Pascale Fouassier, Isabelle Triol, Sylvie Rostaing, Marie-Dominique Brette, Isabelle Colombet
BACKGROUND: Hospital-based Palliative Care Consultation Teams (PCCTs) have a consulting role to specialist services at their request. Referral of patients is often late. Early palliative care in oncology has shown its effectiveness in improving quality of life, thereby questioning the "on request" model of PCCTs. Whether this evidence changed practice is unknown. This multicentre prospective cohort study aims to describe the activity and integration of PCCTs at the patient level. METHODS: For consecutive patients newly referred to participating PCCTs, the team collected the following data: circumstances of first referral, problems identified, number of interventions, patient's survival after first evaluation and place of death...
May 30, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28557661/opioids-in-cancer-pain-right-or-privilege
#20
Leanne K Jackson, Syed N Imam, Ursula K Braun
Opioid analgesia is a mainstay of the treatment of cancer pain. Treatment of pain in patients with cancer with an ongoing substance abuse disorder can be difficult. We report the ethical challenges of treating a patient with cancer with a concomitant substance abuse disorder in an outpatient palliative care setting. We present an analysis of ethical considerations for the palliative care physician and strategies to aid in the successful treatment of such patients. We argue that there are select patients with cancer for whom exclusion from treatment with opioid therapy is warranted if their health is endangered by prescription of these medications...
May 30, 2017: Journal of Oncology Practice
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