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End of life care

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https://www.readbyqxmd.com/read/29656565/rural-urban-differences-in-costs-of-end-of-life-care-for-the-last-6-months-of-life-among-patients-with-breast-lung-or-colorectal-cancer
#1
Elizabeth Crouch, Jan M Eberth, Janice C Probst, Kevin Bennett, Swann A Adams
PURPOSE: The purpose of this study was to examine rural-urban differences in utilization and expenditures in the last 6 months of life for patients with breast, lung, or colorectal cancer. METHODS: The study used a 5% sample of the 2013 Medicare Research Identifiable Files to study utilization and expenditures for beneficiaries with breast, lung, or colorectal cancer during the last 6 months before death (n = 6,214). End of life expenditures were calculated as the sum of total Medicare expenditures for inpatient, outpatient, physician, home health, hospice, and skilled nursing facility costs during the last 6 months of life...
April 15, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29652733/circumstances-and-signs-of-approaching-death-in-patients-with-amyotrophic-lateral-sclerosis-undergoing-noninvasive-ventilation-in-home-care-settings
#2
Mitsuko Ushikubo
The purpose of this study was to elucidate the circumstances and symptoms of patients with amyotrophic lateral sclerosis (ALS) using noninvasive positive pressure ventilation (NPPV) in whom death was approaching, to understand how to provide palliative care to dying patients with ALS receiving NPPV management. The participants were 6 home visiting nurses who were head or subhead nurses of a home visiting nursing agency. Data were collected data conducting individual semistructured interviews and then group interviews...
April 12, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29652246/metformin-in-non-diabetic-hyperglycaemia-the-glint-feasibility-rct
#3
Simon J Griffin, M Angelyn Bethel, Rury R Holman, Kamlesh Khunti, Nicholas Wareham, Gwen Brierley, Melanie Davies, Andrew Dymond, Rose Eichenberger, Philip Evans, Alastair Gray, Colin Greaves, Kyla Harrington, Graham Hitman, Greg Irving, Sarah Lessels, Ann Millward, John R Petrie, Martin Rutter, Mike Sampson, Naveed Sattar, Stephen Sharp
BACKGROUND: The treatment of people with diabetes with metformin can reduce cardiovascular disease (CVD) and may reduce the risk of cancer. However, it is unknown whether or not metformin can reduce the risk of these outcomes in people with elevated blood glucose levels below the threshold for diabetes [i.e. non-diabetic hyperglycaemia (NDH)]. OBJECTIVE: To assess the feasibility of the Glucose Lowering In Non-diabetic hyperglycaemia Trial (GLINT) and to estimate the key parameters to inform the design of the full trial...
April 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29651244/ethical-challenges-for-an-understanding-of-suffering-voluntary-stopping-of-eating-and-drinking-and-the-wish-to-hasten-death-in-advanced-patients
#4
Andrea Rodríguez-Prat, Cristina Monforte-Royo, Albert Balaguer
Some persons with advanced disease but no significant cognitive impairments consciously decide to stop taking food and fluids orally, even though they remain physically able to do so. The question is to what extent voluntarily stopping eating and drinking (VSED) may be considered an expression of a wish to hasten death, in the sense that the latter has been defined recently. We analyze the data reported in some studies in relation to primary care patients who died as a result of VSED and examine their results in light of the qualitative findings of patients that expressed a wish to die...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29650882/-a-study-of-sustainable-end-of-life-care-in-a-depopulating-society
#5
Tokuko Okuda
In facing a society characterized by a decreasing population, I think that sustainability of end-of-life medical care needs to prevent death in isolation, offer optimal allocation of medical care providers, and ensure the centralization of urban functions. How do leading practitioners who actually practice advanced medical care view my hypotheses ?My survey showed that my hypotheses turned out to be unsupported, but on the other hand, it also indicated the concerns and resolve of leading medical practitioners and their views on venturing into unknown domains...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650880/-team-collaboration-in-home-medical-care-to-support-patients-at-the-end-of-life-review-of-service-personnel-meeting-on-discharge-day
#6
Miyoko Ogiwara, Hiromi Irino, Keita Yamaoka, Yoko Fujimaki, Mutsuko Watanabe, Takeshi Yamamoto, Masayoshi Hirohara, Kazuki Kushida
Due to the rising number of patients at the terminal stage or with high dependence on medical care, the cooperation of 2 teams, the hospital discharge support team and the home support team, has become very important. The recent spread of the Internet has enabled both patients and their families who have chosen home care to obtain a wide range of information about home services, as well as diseases, and form a picture of what will happen. However, there are actually many cases in which patients and families find that things are not as they imagined, and they are uneasy and unsure of what to do...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650872/-examination-of-patients-that-died-within-48-hours-after-urgent-hospitalization
#7
Kazuhiro Kawada, Ryota Yanaizumi, Osamu Takahashi
We offer inpatient support for end-stage cancer patients, not only in palliative care units, but also in general medical and long-term care units. We also provide outpatient palliative care and offer emergent backup for the regional home care clinics. From January 2014 to December 2016, 1,832 patients were hospitalized, and among them, 983 patients visited our hospital on an emergency basis. Among the urgent hospitalized patients, 378 patients returned home after adequate palliative care. But 605 patients had to stay admitted in the hospital until their time of death...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650861/-the-influence-of-the-timing-of-ceasing-or-withholding-chemotherapy-in-home-based-end-of-life-care-in-patients-with-incurable-solid-cancer-release-of-an-interim-report-of-the-questionnaire-survey-to-home-care-doctors-in-japan
#8
Toshikazu Sakuyama, Yoshikazu Asino, Masahito Tanimizu, Fumio Ogasawara, Akitaka Yoshizawa, Hiroshi Suzuki, Kunihiko Watanabe, Manabu Ohnuki, Mitsunori Nishikawa, Akemi Katami, Noriyasu Shirotani
BACKGROUND: The study analyzes a questionnaire on the potential discriminative characteristics of patients with incurable solidcancer, who either receivedor didnot receive palliative chemotherapy while receiving home-basedend -of-life care. From the standpoint of regional palliative care, we sought to investigate the influence of the timing of when chemotherapy was ceasedor withheldin home-basedend -of-life care in patients with incurable solidcancer. We plannedthe project to obtain scientific evidence about the timing of ceasing or withholding chemotherapy...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650860/-end-of-life-decision-making-support-in-palliative-homecare
#9
Akitaka Yoshizawa, Hiroyoshi Ikeda, Takayuki Yoshizawa
Advance care planning is important in end-of-life decision making in home-based palliative care for both cancer patients and non-cancer patients.
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650621/barriers-to-and-enablers-of-advance-care-planning-with-patients-in-primary-care-survey-of-health-care-providers
#10
Michelle Howard, Carrie Bernard, Doug Klein, Dawn Elston, Amy Tan, Marissa Slaven, Doris Barwich, John J You, Daren K Heyland
OBJECTIVE: To identify barriers to and enablers of advance care planning (ACP) perceived by physicians and other health professionals in primary care. DESIGN: Cross-sectional, self-administered survey. SETTING: Ontario, Alberta, and British Columbia. PARTICIPANTS: Family physicians (n = 117) and other health professionals (n = 64) in primary care. MAIN OUTCOME MEASURES: Perceived barriers relating to the clinician, characteristics of patients, and system factors, rated on a 7-point scale from 0 (not at all) to 6 (an extreme amount), and enablers reported using an open-ended question...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29649891/erratum
#11
(no author information available yet)
Singer AE, Ash T, Ochotorena C, Lorenz KA, Chong K, Shreve ST, Ahluwalia SC. A Systematic Review of Family Meeting Tools in Palliative and Intensive Care Settings. Am J Hosp Palliat Care. 2016; 33(8):797-806. (DOI: 10.1177/1049909115594353) It was noted that the following references were duplicated in the above mentioned article. (i) Billings JA, Block SD. The end-of-life family meeting in intensive care part III: A guide for structured discussions. J Palliat Med. 2011;14(9):1058-1064. (ii) Fineberg IC, Kawashima M, Asch SM...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29649845/-early-palliative-care-in-emergency-medicine
#12
Maximilian Spickermann, Philipp Lenz
At the end of life patients with a life-limiting disease are often admitted to emergency departments (ED). Mostly, in the setting of an ED there may not be enough time to meet the needs for palliative care (PC) of these patients. Therefore, integration of PC into the ED offers a solution to improve their treatment. In the outpatient setting a cooperation between prehospital emergency services, the patient's general practitioner and specialized outpatient PC teams may allow the patient to die at home - this is what most patients prefer at the end of life...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29649403/the-arianna-project-an-observational-study-on-a-model-of-early-identification-of-patients-with-palliative-care-needs-through-the-integration-between-primary-care-and-italian-home-palliative-care-units
#13
Gianlorenzo Scaccabarozzi, Emanuele Amodio, Giacomo Pellegrini, Fabrizio Limonta, Pierangelo Lora Aprile, Pietro Giorgio Lovaglio, Carlo Peruselli, Matteo Crippa
OBJECTIVE: The aim of this study was to illustrate the characteristics of patients with palliative care (PC) needs, early identified by general practitioners (GPs), and to analyze their care process in home PC services. BACKGROUND: Early identification and service integration are key components to providing quality palliative care (PC) services ensuring the best possible service for patients and their families. However, in Italy, PC is often provided only in the last phase of life and for oncological patients, with a fragmented service...
March 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649402/end-of-life-treatments-in-pediatric-patients-at-a-government-tertiary-cancer-center-in-india
#14
Jean Jacob, Jaskirt K Matharu, Gayatri Palat, Sudha Sinha, Eva Brun, Thomas Wiebe, Mikael Segerlantz
AIM: The primary objective of this study was to describe demographics and end-of-life treatments of children with cancer at a government tertiary cancer center in India. METHODS: A retrospective review was undertaken of medical charts of all children younger than 18 years, who died as inpatients while undergoing treatment at the pediatric oncology department between April and September 2016. Data were collected on demographics, diagnosis, treatments, survival, palliative care involvement, and symptoms at end of life...
March 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649400/impact-of-inpatient-palliative-care-on-quality-of-end-of-life-care-and-downstream-acute-and-postacute-care-utilization
#15
Peter S Khang, Susan E Wang, In-Lu Amy Liu, Heather L Watson, Sandra Y Koyama, Dan N Huynh, Janet S Lee, Huong Q Nguyen
BACKGROUND: Additional evidence is needed regarding the impact of inpatient palliative care (IPC) on the quality of end-of-life care and downstream utilization. AIM: Examine the effects of IPC on quality of end-of-life care and acute and postacute care use in a large integrated system. DESIGN: Retrospective cohort design. SETTING/PARTICIPANTS: Adult decedents from January 1, 2012, to December 31, 2014, who had at least one hospitalization at 11 Kaiser Permanente Southern California medical centers in the 12 months before death and not hospitalized for a trauma-related condition or receiving home-based PC or hospice were included in the cohort...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649399/a-rules-based-algorithm-to-prioritize-poor-prognosis-cancer-patients-in-need-of-advance-care-planning
#16
Christine M Bestvina, Kristen E Wroblewski, Bobby Daly, Brittany Beach, Selina Chow, Andrew Hantel, Monica Malec, Michael T Huber, Blase N Polite
BACKGROUND: Accurate understanding of the prognosis of an advanced cancer patient can lead to decreased aggressive care at the end of life and earlier hospice enrollment. OBJECTIVE: Our goal was to determine the association between high-risk clinical events identified by a simple, rules-based algorithm and decreased overall survival, to target poor prognosis cancer patients who would urgently benefit from advanced care planning. DESIGN: A retrospective analysis was performed on outpatient oncology patients with an index visit from April 1, 2015, through June 30, 2015...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649398/feasibility-and-patient-perceptions-of-video-declarations-regarding-end-of-life-decisions-by-hospitalized-patients
#17
Lisa M Quintiliani, Jessica E Murphy, Pablo Buitron de la Vega, Katherine R Waite, S Emily Armstrong, Lori Henault, Angelo E Volandes, Michael K Paasche-Orlow
BACKGROUND: A videotaped declaration by patients of their advance care planning preferences could be an opportunity to supplement advance directive forms and be a source of information for family, caregivers, and clinicians, yet research is needed to examine the content and acceptability of making declarations among patients. OBJECTIVE: To evaluate the content and acceptability of 'video declarations': the process of patients videotaping themselves describing their advance care planning preferences...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649396/surgeons-perceived-barriers-to-palliative-and-end-of-life-care-a-mixed-methods-study-of-a-surgical-society
#18
Pasithorn A Suwanabol, Ari C Reichstein, Z Tuba Suzer-Gurtekin, Jane Forman, Maria J Silveira, Lona Mody, Arden M Morris
BACKGROUND: Nearly 20% of colorectal cancer (CRC) patients present with potentially incurable (Stage IV) disease, yet their physicians do not integrate cancer treatment with palliative care. Compared with patients treated by primary providers, surgical patients with terminal diseases are significantly less likely to receive palliative or end-of-life care. OBJECTIVE: To describe surgeon perspectives on palliative and end-of-life care for patients with Stage IV CRCs...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649394/perspective-on-care-at-the-end-of-life-at-hospice-africa-uganda
#19
Joshua Campbell, Nasur Buyinza, Joshua Hauser
BACKGROUND: Since its beginning in 1993, Hospice Africa Uganda (HAU) has become a leader in palliative care in Africa. Despite this, there remains a sparsity of research elucidating the priorities of patients in their care at the end of life. This study aimed to identify those priorities in three groups: patients with life-limiting illness, their caregivers, and their healthcare providers at HAU, and thus to identify differences in what these groups find important in the last month of life...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649031/low-level-of-vegetative-state-after-traumatic-brain-injury-in-a-swiss-academic-hospital
#20
Federica Stretti, Stephanie Klinzing, Ulrike Ehlers, Peter Steiger, Reto Schuepbach, Tanja Krones, Giovanna Brandi
BACKGROUND: No standards exist regarding decision making for comatose patients, especially concerning life-saving treatments. The aim of this retrospective, single-center study was to analyze outcomes and the decision-making process at the end of life (EOL) in patients with traumatic brain injury (TBI) in a Swiss academic tertiary care hospital. METHODS: Consecutive admissions to the surgical intensive care unit (ICU) with stays of at least 48 hours between January 1, 2012 and June 30, 2015 in patients with moderate to severe TBI and with fatality within 6 months after trauma were included...
April 11, 2018: Anesthesia and Analgesia
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