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Primary palliative care

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https://www.readbyqxmd.com/read/29774394/longitudinal-health-care-cost-in-hypoplastic-left-heart-syndrome-palliation
#1
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/29764891/developing-a-complex-intervention-to-support-timely-engagement-with-palliative-care-for-patients-with-advanced-cancer-in-primary-and-secondary-care-in-the-uk-a-study-protocol
#2
Julia Hackett, Hilary Bekker, Michael I Bennett, Paul Carder, Jean Gallagher, Claire Henry, Suzanne Kite, Sally Taylor, Galina Velikova, Lucy Ziegler
INTRODUCTION: For patients with advanced cancer, timely access to palliative care can improve quality of life and enable patients to participate in decisions about their end-of-life care. However, in a UK population of 2500 patients who died from cancer, one-third did not receive specialist palliative care, and of those who did, the duration of involvement was too short to maximise the benefits. Initiating a conversation about palliative care is challenging for some health professionals and patients often have unmet information needs and misconceptions about palliative care...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29764185/management-of-metastatic-spinal-cord-compression-among-veterans-health-administration-radiation-oncologists
#3
Ruchika Gutt, Sheeta Malhotra, Shruti Jolly, Drew Moghanaki, Alice V Cheuk, Helen Fosmire, Maria Kelly, Lori Hoffman-Hogg, Stephen Lutz, Mitchell Anscher, George Dawson
BACKGROUND: Optimal management of metastatic spinal cord compression (MSCC) improves functional outcomes in patients with metastatic disease. This survey study evaluated management of MSCC by Veterans Health Administration (VHA) radiation oncologists (ROs), to determine whether management of MSCC correlates with American College of Radiology (ACR) guidelines, and to compare times to initiation of treatment between surgery and radiotherapy (RT). METHODS: Surveys emailed to 79 VHA ROs included questions on steroid use, surgical care, palliative care, fractionation of irradiation, re-irradiation, and management of common MSCC case scenarios...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29763532/palliative-care-occupies-growing-presence-in-ed
#4
(no author information available yet)
As the benefits of palliative care become more evident in clinical trials, there is growing interest in making such resources available to patients at an earlier stage, such as the ED. However, experts note that emergency staff first must identify available resources and make sure that providers have the primary palliative care skills needed to effectively introduce the topic to appropriate patients and families. Research shows that initiating the call for a palliative care consult while the patient is in the ED can deliver quality-of-life benefits even three months later...
June 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29763515/individualized-breathlessness-interventions-may-improve-outcomes-in-patients-with-advanced-copd
#5
Mary Y Y Qian, John Politis, Michelle Thompson, Darren Wong, Brian Le, Louis Irving, Natasha Smallwood
BACKGROUND AND OBJECTIVE: Many patients with advanced COPD experience refractory breathlessness and individualized breathlessness interventions may improve management of this complex symptom. The aims of this study were to develop, implement and assess the efficacy of a breathlessness intervention for patients with COPD and refractory breathlessness and to evaluate patient acceptability. METHODS: An individualized breathlessness plan, information leaflets, breathlessness education and a hand-held fan were offered to consecutive patients with severe COPD and refractory breathlessness attending a tertiary integrated respiratory and palliative care service...
May 15, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29757917/nurse-practitioners-completion-of-physician-orders-for-scope-of-treatment-forms-in-west-virginia-a-secondary-analysis-of-12-months-of-data-from-the-state-registry
#6
Lori Anne Constantine, Toni Dichiacchio, Evan C Falkenstine, Alvin H Moss
BACKGROUND AND PURPOSE: Advanced care planning documents, such as the Physician Orders for Life-Sustaining Treatment (POLST), require authorized medical provider signatures; only recently have nurse practitioners (NPs) been authorized to sign these forms. Recent legislation in West Virginia (WV) granting NPs signatory authority on POLST forms and the creation of a statewide registry provides an opportunity to examine the completion rates. The aim of this study was to investigate how recent legislation allowing NPs signatory authority for POLST forms has affected POLST completion...
January 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29756013/colonic-stent-versus-emergency-surgery-as-treatment-of-malignant-colonic-obstruction-in-the-palliative-setting-a-systematic-review-and-meta-analysis
#7
REVIEW
Igor Braga Ribeiro, Wanderley Marques Bernardo, Bruno da Costa Martins, Diogo Touriani Hourneau de Moura, Elisa Ryoka Baba, Iatagan Rocha Josino, Nelson Tomio Miyahima, Martin Andrés Coronel Cordero, Thiago Arantes de Carvalho Visconti, Edson Ide, Paulo Sakai, Eduardo Guimarães Hourneau de Moura
Background and study aims : Colorectal cancer (CRC) is the third most common malignancy and the third leading cause of cancer death worldwide. Malignant colonic obstruction (MCO) due to CRC occurs in 8 % to 29 % of patients.The aim of this study was to perform a systematic review and meta-analysis of RCTs comparing colonic SEMS versus emergency surgery (ES) for MCO in palliative patients. This was the first systematic review that included only randomized controlled trials in the palliative setting...
May 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29755917/sharing-is-caring-minimizing-the-disruption-with-palliative-care
#8
EDITORIAL
Abd Moain Abu Dabrh, Robert P Shannon, Richard J Presutti
There is an upward trend incidence of multiple chronic life-limiting conditions with a well-documented associated impact on patients and their caregivers. When patients approach the end of life, they are often faced with a challenging multidimensional burden while navigating a complex health care system. Patients and families/caregivers are faced with daily decisions, often with little or no frame of reference or medical knowledge. The "what, how, when, and where" puzzle during this challenging time can be overwhelming for patients and their families, and when clinicians do not contemplate this associated workload's impact on patients and caregivers' capacity for self-care, patients and caregivers scramble to find compensatory solutions, often putting their health care at lower priority...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29751335/the-current-evidence-for-a-biomarker-based-approach-in-cancer-of-unknown-primary
#9
REVIEW
Elie El Rassy, Nicholas Pavlidis
Cancer of unknown primary (CUP) accounts for the seventh to eighth most frequently diagnosed cancer yet its prognosis remains poor with conventional chemotherapy. The spectrum of therapeutic management includes both locoregional and systemic therapy and should intend to offer optimal benefit to favorable CUP patients and palliative care to unfavorable cases. The recent molecular advances have revolutionized the armamentarium of cancer treatments though a biomarker-based approach. Unfortunately, solid data in CUP is lacking in the absence of a CUP-specific driver molecular signature...
May 2, 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29749803/laycarers-can-confidently-prepare-and-administer-subcutaneous-injections-for-palliative-care-patients-at-home-a-randomized-controlled-trial
#10
Sue Healy, Fiona Israel, Margaret Charles, Liz Reymond
BACKGROUND: Palliative care patients consistently nominate home as their preferred care environment. This is challenging without support from laycarers, especially if patients require subcutaneously administered symptom relief. Laycarers typically lack confidence with this task and request professional guidance. AIM: To explore differences in laycarers' confidence in administering subcutaneous injections depending upon whether a laycarer, registered nurse or pharmacist prepared injections for subsequent administration by laycarers...
May 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29745483/-oncological-patients-in-primary-care-ruptures-and-transitions
#11
Christopher Chung, Dagmar M Haller, Sophie Pautex, Johanna Sommer
Patients with severe cancer go through a journey requiring the involvement of several healthcare providers. Several transitions of care occur: from the general practitioner to the oncologist, and then depending on the outcomes of treatment, the patient enters a palliative care phase, and eventually end of life care. Lack of coordination of the different actors can lead to repeated loss of the continuum of care. Each transition requires better communication between healthcare providers and also with the patient...
May 9, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29743022/predictors-of-major-complications-after-elective-abdominal-surgery-in-cancer-patients
#12
Claudia M Simões, Maria J C Carmona, Ludhmila A Hajjar, Jean-Louis Vincent, Giovanni Landoni, Alessandro Belletti, Joaquim E Vieira, Juliano P de Almeida, Elisangela P de Almeida, Ulysses Ribeiro, Ana L Kauling, Celso Tutyia, Lie Tamaoki, Julia T Fukushima, José O C Auler
BACKGROUND: Patients undergoing abdominal surgery for solid tumours frequently develop major postoperative complications, which negatively affect quality of life, costs of care and survival. Few studies have identified the determinants of perioperative complications in this group. METHODS: We performed a prospective observational study including all patients (age > 18) undergoing abdominal surgery for cancer at a single institution between June 2011 and August 2013...
May 9, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29742292/timing-of-palliative-care-needs-reporting-and-aggressiveness-of-care-near-the-end-of-life-in-metastatic-lung-cancer-a-national-registry-based-study
#13
François Goldwasser, Pascale Vinant, Régis Aubry, Philippe Rochigneux, Yvan Beaussant, Olivier Huillard, Lucas Morin
BACKGROUND: Early integration of palliative care for patients with metastatic lung cancer improves their quality of life and survival and reduces the aggressiveness of care near the end of life. This study examined the association between the timing of palliative care needs reporting and the aggressiveness of end-of-life care. METHODS: This retrospective cohort study used the French National Hospital Registry to identify all hospitalized adults (≥20 years old) who died of metastatic lung cancer in France between 2010 and 2013...
May 9, 2018: Cancer
https://www.readbyqxmd.com/read/29740693/associated-factors-and-costs-of-avoidable-visits-to-the-emergency-department-among-cancer-patients-1-year-experience-in-a-tertiary-care-hospital-in-south-korea
#14
Tak Kyu Oh, You Hwan Jo, Jae Wook Choi
PURPOSE: Patients receiving palliative care make avoidable emergency department visits (AvED), which may increase economic and social costs. However, the proportion of AvED among all patients, including cancer patients after curation, and the resulting costs are unknown in Asia. This study aimed to investigate the proportion, characteristics, and costs regarding factors associated with AvED among cancer patients. METHODS: This retrospective cohort study analyzed the medical records of patients who visited the emergency department (ED) at a tertiary care hospital in Korea in 2016...
May 8, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29737903/prescribing-trends-of-palliative-care-team-s-use-of-dexamethasone-for-cancer-related-pain
#15
Katayoun Barghi, Kyle P Edmonds, Toluwalase A Ajayi, Rabia S Atayee
Opioids are first-line therapy for cancer-related pain. In addition, corticosteroids are commonly utilized as adjuvant analgesics for pain and other symptoms in the oncology setting with limited supporting data. A retrospective analysis was conducted evaluating adult hospitalized patients receiving opioids who received once-daily dexamethasone on the recommendation of a specialty palliative care team during their hospitalization from January 1, 2015, to January 1, 2016. Primary end point was to describe prescribing patterns of dexamethasone in this patient population and secondarily examining any effect on oral morphine equivalent daily dose (MEDD), numeric pain score (NPS), and unwanted effects at 24 and 48 hours after the first dose of dexamethasone...
May 8, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29736123/prognostic-factors-of-malignant-pleural-effusion-among-palliative-care-outpatients-a-retrospective-study
#16
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/29727364/national-trends-2009-2013-for-palliative-care-utilization-for-patients-receiving-prolonged-mechanical-ventilation
#17
Kshitij Chatterjee, Abhinav Goyal, Krishna Kakkera, Sarah Harrington, Howard L Corwin
OBJECTIVES: Patients requiring mechanical ventilation have high morbidity and mortality. Providing palliative care services has been suggested as a way to improve comprehensive management of critically ill patients. We examined the trend in the utilization of palliative care among adults who require prolonged mechanical ventilation. Primary objectives were to determine the trend in palliative care utilization over time, predictors for palliative care utilization, and palliative care impact on hospital length of stay...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29727261/virtual-telemedicine-visits-in-pediatric-home-parenteral-nutrition-patients-a-quality-improvement-initiative
#18
Bram P Raphael, Caitlin Schumann, Sara Garrity-Gentille, Jennifer McClelland, Carolyn Rosa, Christina Tascione, Mary Gallotto, Melissa Takvorian-Bené, Alexandra N Carey, Patrick McCarthy, Christopher Duggan, Al Ozonoff
BACKGROUND: Despite being less costly than prolonged hospitalization, home parenteral nutrition (HPN) is associated with high rates of post-discharge complications, including frequent readmissions and central line-associated bloodstream infections (CLABSIs). Telemedicine has been associated with improved outcomes and reduced healthcare utilization in other high-risk populations, but no studies to date have supported effectiveness of telemedicine in pediatric HPN. METHODS: We prospectively collected data on pediatric patients managed at a single HPN program who participated in postdischarge telemedicine visits from March 1, 2014 to March 30, 2016...
May 4, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29718210/long-term-trends-of-use-of-health-service-among-heart-failure-patients
#19
Ahsan Rao, Dani Kim, Ara Darzi, Azeem Majeed, Paul Aylin, Alex Bottle
Aims: We aimed to identify subgroups in the patient population with different trajectories of long-term readmission rates. The study also aimed to assess common causes and their sequences of readmissions for each subgroup. Methods: Patients with a primary diagnosis of heart failure (HF) in the period 2008-2009 were identified using nationally representative primary care data linked to national hospital data, which contain information on 10.5 million patients. HF patients were followed up for 5 years...
April 28, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29712691/what-proportion-of-patients-at-the-end-of-life-contact-out-of-hours-primary-care-a-data-linkage-study-in-oxfordshire
#20
Rachel Brettell, Rebecca Fisher, Helen Hunt, Sophie Garland, Daniel Lasserson, Gail Hayward
OBJECTIVES: Out-of-hours (OOH) primary care services are a key element of community care at the end of life, yet there have been no previous attempts to describe the scope of this activity. We aimed to establish the proportion of Oxfordshire patients who were seen by the OOH service within the last 30 days of life, whether they were documented in a palliative phase of care and the demographic and clinical features of these groups. DESIGN: Population-based study linking a database of patient contacts with OOH primary care with the register of all deaths within Oxfordshire (600 000 population) during 13 months...
April 30, 2018: BMJ Open
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