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Primary palliative care

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https://www.readbyqxmd.com/read/28209071/collaboration-between-primary-care-physicians-and-radiation-oncologists
#1
Elizabeth A Barnes, Edward Chow, Cyril Danjoux, May Tsao
Communication between physicians is required to ensure important patient information is relayed during the workup, treatment, follow-up and subsequent transition of care back to the primary care physician (PCP). In this review we discuss how survivorship care is being increasingly recognized as an important component of the patient's cancer journey, and one often provided by the PCP. Palliative care and symptom control for patients with non-curable malignancy is often provided by the PCP during and after cancer treatment...
January 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28186850/the-use-of-dexmedetomidine-in-pediatric-palliative-care-a-preliminary-study
#2
Jamie Burns, Kevin Jackson, Kathy A Sheehy, Julia C Finkel, Zenaide M Quezado
OBJECTIVE: To evaluate the effect of dexmedetomidine infusions in patients with advanced malignancies, advanced heart disease, or after stem cell transplantation (SCT), who during end-of-life care had pain and/or agitation unresponsive to conventional therapies. BACKGROUND: Pediatric patients with intractable advanced malignancies, end-stage congenital heart diseases, or after SCT can suffer a great deal during end of life. Pain, drowsiness, fatigue, irritability, and worrying are experienced frequently, considered distressing, and are strongly associated with reductions in health-related quality-of-life scores...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28183824/global-cancer-in-women-cancer-control-priorities
#3
Farhad Islami, Lindsey A Torre, Jeffrey M Drope, Elizabeth M Ward, Ahmedin Jemal
The global burden of cancer in women has recently received much attention, but there are few comprehensive reviews of the burden and policy approaches to reduce it. This paper, second in series of two, summarizes the most important cancer control priorities with specific examples of proven interventions, with a particular focus on primary prevention in low- and middle-income countries (LMICs). There are a number of effective cancer control measures available to countries of all resource levels. Many of these measures are extremely cost-effective, especially in the case of tobacco control and vaccination...
February 9, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28162789/primary-palliative-care-in-neonatal-intensive-care
#4
Krishelle L Marc-Aurele, Nancy K English
This article explores the 2014 Institute of Medicine׳s recommendation concerning primary palliative care as integral to all neonates and their families in the intensive care setting. We review trends in neonatology and barriers to implementing palliative care in intensive care settings. Neonatal primary palliative care education should address the unique needs of neonates and their families. The neonatal intensive care unit needs a mixed model of palliative care, where the neonatal team provides primary palliative care and the palliative subspecialist consults for more complex or refractory situations that exceed the primary team׳s skills or available time...
February 2, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28160875/understanding-palliative-care-and-hospice-a%C3%A2-review-for-primary-care-providers
#5
REVIEW
Mary K Buss, Laura K Rock, Ellen P McCarthy
Palliative care provides invaluable clinical management and support for patients and their families. For most people, palliative care is not provided by hospice and palliative medicine specialists, but rather by their primary care providers. The recognition of hospice and palliative medicine as its own medical subspecialty in 2006 highlighted the importance of palliative care to the practice of medicine, yet many health care professionals harbor misconceptions about palliative care, which may be a barrier to ensuring that the palliative care needs of their patients are identified and met in a timely fashion...
February 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28156674/patient-communication-prior-to-initial-consultation-for-palliative-radiotherapy
#6
Steve E Braunstein
: 30 Background: For patients undergoing radiation treatment for advanced cancer, coordination between multiple care teams is required. The radiation therapy care pathway is complex, with numerous components, including consultation, planning, treatment delivery, and follow up care. Fragmented care can result from suboptimal communication among referring providers and patients. Prior to initial consult with a radiation oncologist, many patients are unaware of the complex logistics, resulting in additional distress...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156672/attitude-and-support-to-inform-clinical-predictions-of-survival-in-patients-with-advanced-cancer
#7
David L Ma, Kim Paulson, Sunita Ghosh, Bronwen LeGuerrier, Karen P Chu, Diane Severin, Fleur Huang, Sharon Watanabe, Ann Huot, John Amanie, Samir Patel, Tirath Nijjar, Ericka Wiebe, Brita Lavender Danielson, Brock J Debenham
: 39 Background: Tumour factors (eg primary site, size) helpful in prognostication in early stage cancer may be less important than patient factors, such as Karnofsky performance status (KPS), later in the disease trajectory. We evaluated the utilization of the parameters attitude (ATT) and psychosocial support (PSS) in predicting remaining lifespan by two experienced multidisciplinary teams (MDT). METHODS: After clinical assessment of consecutive patients, a quantitative clinical prediction of survival (CPS) was made prospectively, independently and anonymously by each health care provider (HCP)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156671/a-novel-risk-stratification-model-for-patients-with-brain-metastasis-incorporating-with-physiological-signals
#8
Tsung-Ying Ho, Eng-Yen Huang, Chong-Jong Wang
: 38 Background: Brain metastasis (BM) develops in 10%-40% of patients with malignancies. Survival expectancy is critical for choosing an optimal treatment for BM patients. Previous reports have proposed different risk stratification systems based on clinical and image-related factors. Heart rate variability (HRV), a physiological factor, has also been reported as a novel prognosticator for BM patients. In this study, we proposed a novel risk stratification model for BM patients by incorporating HRV signals...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156665/efficacy-and-safety-of-methadone-in-the-treatment-of-pain-in-palliative-care-patients-with-cancer-the-equimeth2-national-randomized-open-phase-iii-study
#9
Marie Pierre Berleur, Shimsi Lefki, Daniele Lefebvre Kunt, Eric Serra, Gisele Chvetzoff, Alain Derniaux, Flora Tremellat, Marilène Filbet, Anna Simon, Bich Dang Vu, Cyril Guillaume
: 212 Background: Methadone is used more and more as a second-line treatment for refractory cancer pain in palliative care patients. METHODS: The study aimed to compare the effect of two methadone titration methods (Stop and Go vs progressive titration) in 146 palliative care cancer patients with pain inadequately relieved or intolerant to level 3 opioids. The primary endpoint was the rate of success/failure at Day 4 defined by pain relief (reduction of at least two points of the numerical scale (0 - 10) AND a pain score < 5 for 2 consecutive days) AND no overdose (Rudkin scale ≥ 3 AND respiratory rate < 8/min)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156663/evaluation-of-combined-argon-plasma-coagulation-and-savary-bougienage-for-the-relief-of-dysphagia-of-esophageal-squamous-cancer-patients-in-the-end-of-life
#10
Caihong Dong, Tanyou Shan, Xiaozhi Yuan, Shuoguo Li, Xuezhen Ding, Shegan Gao
: 214 Background: To relieve the dysphagia is a critical treatment for advanced esophageal cancer patients' palliative care in their end-of-life. The ideal way is to satisfy both the patient's nutrition supplement and self-taste. Although several endoscopic dilation techniques have been reported, the high incidence of dysphagia quickly relapsing remains. The aim of this study was to compare the effect of Argon Plasma Coagulation (APC) combined with Savary bougienage (SB) and SB alone for the relief of dysphagia of esophageal squamous cancer in the end-of-life...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156660/attitudes-of-radiation-oncologists-toward-palliative-and-supportive-care-in-the-united-states-report-on-national-membership-survey-by-the-american-society-for-radiation-oncology-astro
#11
James B Yu, Malcolm Mattes, Adrienne Thrasher, Hui-Kuo George Shu, Jennifer F De Los Santos, Harald Paganetti, Bridget F Koontz, Christopher Abraham, Tracy A Balboni
: 105 Background: Radiation oncologists are frequently involved in providing palliative and supportive care (PSC) for patients with advanced cancers through delivery of palliative radiation. Whether they are confident in their ability to assess and initiate treatments for pain, non-pain, and psychosocial distress is unknown. The American Society for Radiation Oncology (ASTRO) surveyed its practicing members in the United States on self-assessment of their primary PSC skills, and access to continuing medical education on PSC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156659/novel-tool-utilized-as-a-trigger-for-advance-care-planning-in-hospitalized-oncology-patients
#12
Sandhya Rao, Diane Sarnacki, Alexandra Dobie, Karla Damus, Gretchen Gignac
: 22 Background: Study Purpose: reduce inpatient oncology readmissions; determine if there is a need to standardize trigger for Advance Care Planning in the inpatient oncology population. METHODS: Investigational Quality Improvement Study January-June 2014. Retrospective chart review of oncology readmissions on the BMC Hematology and Oncology service during a 6 month period, January-June 2013 (N = 68). Data abstracted included: demographics (age, race/ethnicity, primary language, education, marital status, ECOG); type and stage of cancer; type of consults (palliative, spiritual, social services, integrative, PT/OT, hospice, visiting nurse)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156658/changes-in-opioid-type-and-dose-among-cancer-patients-referred-to-outpatient-palliative-care
#13
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/28156606/role-of-emergent-palliative-radiation-therapy-in-the-care-of-patients-with-cancer
#14
Michael Zhang, Steve E Braunstein, Shannon E Fogh
: 201 Background: Radiation therapy (RT) provides an important role in the palliative care of patients with cancer. For patients with metastatic spinal cord compression not amenable to surgery, the value of timely palliative RT is well established; however, the value of the rapid application of RT for other chief complaints is less clear. The importance of palliative care service (PCS) involvement in patients treated with RT is becoming increasingly recognized and rapidly instituted RT could compromise this involvement...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156559/palliative-care-consultation-and-advance-care-planning-for-adults-with-poor-risk-leukemia-admitted-to-an-academic-medical-center
#15
William A Wood, Alexandra Fox, Laura C Hanson
: 13 Background: Despite high mortality for certain patients with hematologic malignancies, integration of palliative care (PC) and documentation of advance care planning (ACP) is lacking. Our primary objective was to determine the frequency of PC consultation and ACP for inpatients with poor-risk leukemia at our institution. Our secondary objectives were to describe the content of goals of care (GOC) discussions and to characterize PC and end-of-life quality measures. METHODS: Chart reviews were conducted for patients with poor risk leukemia (acute leukemia ≥ 65 years or relapsed leukemia > 18 years) admitted to the University of North Carolina from October 1, 2015 to March 31, 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156555/strategies-for-introducing-outpatient-specialty-palliative-care-in-gynecologic-oncology
#16
Carolyn Lefkowits, Marie Bakitas, Megan Crowley-Makota, Renata Urban, Linda R Duska, Leslie Horn Clark, Stephanie L Creasy, Yael Schenker
: 111 Background: Concern that patients will react negatively to the idea of palliative care is cited as a barrier to timely referral. Strategies to successfully introduce specialty palliative care to patients have not been well-described. We sought to understand how gynecologic oncologists introduce outpatient specialty palliative care. METHODS: We conducted a national qualitative interview study at six geographically diverse academic cancer centers with well-established palliative care clinics between September 2015 and March 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156550/advance-care-planning-and-palliative-care-consultation-for-stem-cell-transplant-patients
#17
Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric Roeland
: 113 Background: Advance care planning (ACP) in stem cell transplantation (SCT) is particularly challenging given the potential for cure for patients with blood cancers despite an increased risk of suffering and even death. Data regarding ACP and palliative care (PC) integration in SCT is limited. METHODS: A retrospective chart review was conducted of patients with hematologic malignancies who underwent SCT at UCSD from January 2011 to December 2015. The primary objective was to determine the medical discipline of the initial and last code status documentation...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156549/psychosocial-distress-in-vulnerable-patient-populations-what-happens-after-screening
#18
Margot Albert, Leslie Safier, Heather A Harris, Anne Kinderman
: 114 Background: The Commission on Cancer mandates psychosocial distress screening for patients with cancer, as well as documentation of referrals made to address sources of distress. Patients in safety net settings, who are vulnerable to significant economic and social stressors, may benefit from such screening; however, it is unclear if patients can access needed services and if their needs change over time. We examined the experience of cancer patients in an urban safety-net healthcare system to identify areas of improvement in the provision of support services...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156533/palliative-care-always-as-a-massive-open-online-course-mooc-to-build-primary-palliative-care-in-a-global-audience
#19
Kavitha Ramchandran, Joshua Fronk, Judy Passaglia, Kelly Bugos, Manuela Kogon, Lori Klein, Ellen Brown, Sandy Chan, Lynn Hutton, Grace Lyo, Kimberly Frost Sickler
: 123 Background: Primary palliative care (PC) is critical to improve access to PC from the point of diagnosis. Still, barriers exist to providing primary PC worldwide, including a lack of awareness, time, and training. Interactive online learning experiences can help overcome these. This project describes a massive open online course (MOOC)--Palliative Care Always--designed to build primary PC skills in a global audience. METHODS: A team of PC providers and online instructional experts developed 12 modules that included: patient scenes, brief lectures, empathy exercises, and Google Hangout discussions...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156519/thirty-day-mortality-rate-in-oncology-patients-treated-with-palliative-radiotherapy
#20
Tomas Dvorak, Christopher G Morris, Anamaria R Yeung
: 172 Background: Thirty-day mortality is a well-established metric for surgical specialties, but there are limited data available for 30-day mortality after radiation therapy. Our aim was to specifically identify the 30-day mortality of patients treated with palliative radiotherapy for the purposes of establishing a baseline to improve upon. METHODS: We retrospectively reviewed the medical records of all patients treated with external-beam radiotherapy (EBRT) from January 1, 2012, to December 31, 2012, who died within 30 days of their last delivered radiation fraction...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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