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Latest & greatest articles for palliative care
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on palliative care or other clinical topics then use Trip today.
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Effect of Inpatient PalliativeCare During Hematopoietic Stem-Cell Transplant on Psychological Distress 6 Months After Transplant: Results of a Randomized Clinical Trial Purpose Inpatient palliativecare integrated with transplant care improves patients' quality of life (QOL) and symptom burden during hematopoietic stem-cell transplant (HCT). We assessed patients' mood, post-traumatic stress disorder (PTSD) symptoms, and QOL 6 months post-transplant. Methods We randomly assigned 160 patients (...) with hematologic malignancies who underwent autologous or allogeneic HCT to inpatient palliativecare integrated with transplant care (n = 81) or transplant care alone (n = 79). At baseline and 6 months post-transplant, we assessed mood, PTSD symptoms, and QOL with the Hospital Anxiety and Depression Scale and Patient Health Questionnaire, PTSD checklist, and Functional Assessment of Cancer Therapy-Bone Marrow Transplant. To assess symptom burden during HCT, we used the Edmonton Symptom Assessment Scale. We
PalliativeCare in Heart Failure: Rationale, Evidence, and Future Priorities Patients with heart failure (HF) and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliativecare is an interdisciplinary service and an overall approach to care that improves quality of life and alleviates suffering for those living with serious illness, regardless of prognosis. In this review, we synthesize the evidence from randomized clinical trials (...) of palliativecare interventions in HF. While the evidence base for palliativecare in HF is promising, it is still in its infancy and requires additional high-quality, methodologically sound studies to clearly elucidate the role of palliativecare for patients and families living with the burdens of HF. Yet, an increase in attention to primary palliativecare (e.g., basic physical and emotional symptom management, advance care planning), provided by primary care and cardiology clinicians, may be a vehicle
Integrated Outpatient PalliativeCare in Oncology Management Briefs eBrief-no134 -- Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no134 -- Health Services Research & Development Management eBrief no. 134 » Issue 134 November 2017 The report is a product of the VA/HSR&D Evidence Synthesis Program. Evidence Report: Integrated Outpatient PalliativeCare in Oncology More than (...) 500,000 Americans, including 40,000 Veterans, are diagnosed with advanced cancer annually in the United States. Often provided concurrently with oncology care, palliativecare improves quality of life by managing patients' physical symptoms, as well as psychosocial and spiritual distress. Palliativecare occurs across a continuum, ideally beginning at the time when a serious illness has been diagnosed and continuing until the end of life. Integration of palliativecare and oncology care is now
One Emergency Medicine Resident. One Month of PalliativeCare. Ten lessons. One Emergency Medicine Resident. Ten Lessons in PalliativeCare. One Emergency Medicine Resident. One Month of PalliativeCare. Ten lessons. In by Brittany Ellis October 17, 2017 As emergency medicine residents, we work side-by-side with a wealth of specialities to gain clinical and diagnostic skills and to learn what happens to our patients when they leave the ED. We strive to distill the information we need to make (...) ourselves better clinicians and improve the transition of patients from the ED to inpatient teams. However, only rarely do we get to see where our patients came from, what happened prior to their ED arrival, and where they will go when they leave the hospital. Over the past month I have done just that as a senior resident on community and in-patient palliativecare teams. It was more challenging and rewarding than I had ever imagined. Below I share my top ten lessons from these experiences that I hope
Guidelines on Management of Pain in Cancer and/or PalliativeCare | Cancer Care Ontario Google Tag Manager You are using an outdated browser. We suggest you update your browser for a better experience. for update. Browse Guidelines Browse Pathway Maps Sort by You are here / / Guidelines on Management of Pain in Cancer and/or PalliativeCare Guidelines & Advice Guidelines on Management of Pain in Cancer and/or PalliativeCare ID: ES 18-4 Sep 2017 Type of Content: Guidelines & Advice, Evidence (...) as a source of information for the Ontario PalliativeCare Network (OPCN). Patient Population Patients with cancer or other diseases requiring palliativecare. Intended Guideline Users The intended users of this evidence summary are staff of the Patient Reported Outcomes and Symptom Management Program of CCO and staff of the Ontario PalliativeCare Network. This evidence summary may also be of interest to physicians, nurses, caregivers, and patients dealing with cancer or palliativecare symptom
Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving PalliativeCare: A Randomized Clinical Trial. The use of benzodiazepines to control agitation in delirium in the last days of life is controversial.To compare the effect of lorazepam vs placebo as an adjuvant to haloperidol for persistent agitation in patients with delirium in the setting of advanced cancer.Single-center, double-blind, parallel-group, randomized clinical (...) trial conducted at an acute palliativecare unit at MD Anderson Cancer Center, Texas, enrolling 93 patients with advanced cancer and agitated delirium despite scheduled haloperidol from February 11, 2014, to June 30, 2016, with data collection completed in October 2016.Lorazepam (3 mg) intravenously (n = 47) or placebo (n = 43) in addition to haloperidol (2 mg) intravenously upon the onset of an agitation episode.The primary outcome was change in Richmond Agitation-Sedation Scale (RASS) score (range
Palliativecare and management of troublesome symptoms for people with chronic obstructive pulmonary disease. People with advanced chronic obstructive pulmonary disease (COPD) have distressing physical and psychological symptoms, often have limited understanding of their disease, and infrequently discuss end-of-life issues in routine clinical care. These are strong indicators for expert multidisciplinary palliativecare, which incorporates assessment and management of symptoms and concerns (...) , patient and caregiver education, and sensitive communication to elicit preferences for care towards the end of life. The unpredictable course of COPD and the difficulty of predicting survival are barriers to timely referral and receipt of palliativecare. Early integration of palliativecare with respiratory, primary care, and rehabilitation services, with referral on the basis of the complexity of symptoms and concerns, rather than prognosis, can improve patient and caregiver outcomes. Models
European Association for Neuro-Oncology (EANO) guidelines for palliativecare in adults with glioma Patients with glioma present with complex palliativecare needs throughout their disease trajectory. The life-limiting nature of gliomas and the presence of specific symptoms related to neurological deterioration necessitate an appropriate and early palliativecare approach. The multidisciplinary palliativecare task force of the European Association of Neuro-Oncology did a systematic review (...) of the available scientific literature to formulate the best possible evidence-based recommendations for the palliativecare of adult patients with glioma, with the aim to reduce symptom burden and improve the quality of life of patients and their caregivers, particularly in the end-of-life phase. When recommendations could not be made because of the scarcity of evidence, the task force either used evidence from studies of patients with systemic cancer or formulated expert opinion. Areas of palliativecare
Prevalence of burnout in health professionals working in palliativecare: a systematic review. More than ever, the current increasing need for palliativecare leads to health professionals providing this type of care which further leads to multiple challenges, and stressful and demanding situations. The multiple challenges of working in palliativecare put health professionals working in this context at the risk of burnout.To examine the evidence on the prevalence of burnout among health (...) professionals working in palliative care.The current review included studies that encompass qualified health professionals working in palliativecare, caring for patients 18 years of age or older.The current review considered studies reporting on the point prevalence of burnout, measured by a burnout scale, such as, but not limited to, the Maslach Burnout Inventory, Burnout Measure and Copenhagen Burnout Inventory.The current review considered studies conducted in the context of specialist palliativecare
PalliativeCare Development in Africa: Lessons From Uganda and Kenya Despite increased access to palliativecare in Africa, there remains substantial unmet need. We examined the impact of approaches to promoting the development of palliativecare in two African countries, Uganda and Kenya, and considered how these and other strategies could be applied more broadly.This study reviews published data on development approaches to palliativecare in Uganda and Kenya across five domains: education (...) and training, access to opioids, public and professional attitudes, integration into national health systems, and research. These countries were chosen because they are African leaders in palliativecare, in which successful approaches to palliativecare development have been used.Both countries have implemented strategies across all five domains to develop palliativecare. In both countries, successes in these endeavors seem to be related to efforts to integrate palliativecare into the national health
Raise the Bar, Not the Threshold Value: Meeting Patient Preferences for Palliative and End-of-Life Care 29623615 2018 11 14 2509-4254 2 2 2018 Jun PharmacoEconomics - open Pharmacoecon Open Raise the Bar, Not the Threshold Value: Meeting Patient Preferences for Palliative and End-of-Life Care. 93-95 10.1007/s41669-017-0039-y McCaffrey Nikki N http://orcid.org/0000-0003-3684-3723 Deakin Health Economics, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia. nikki.mccaffrey (...) 15904746 Patient. 2017 Jun;10(3):353-365 28271387 Palliat Med. 2008 Oct;22(7):787-95 18755830 Support Care Cancer. 2015 Jan;23(1):103-10 24996829 Palliat Med. 2017 Apr;31(4):291-292 28281407 PLoS One. 2015 Mar 09;10(3):e0115544 25751629 J Clin Oncol. 2012 Oct 10;30(29):3611-7 22965960 JAMA. 2000 Nov 15;284(19):2476-82 11074777 J Pain Symptom Manage. 2016 Aug;52(2):318-328.e5 27216362 BMC Palliat Care. 2013 Feb 15;12:7 23414145 Soc Sci Med. 2015 Jan;124:48-56 25461861 Int J Health Policy Manag. 2016 Jun
Experiences of non-specialist nurses caring for patients and their significant others undergoing transitions during palliative end-of-life cancer care: a systematic review. Non-specialist nurses, who are providing palliative end-of-life cancer care to patients and significant others undergoing psychosocial and existential transitions, may experience dissatisfaction, frustration and sorrow. On the other hand, they may also experience happiness, increased knowledge and personal growth.What (...) are non-specialist nurses' experiences when providing palliative end-of-life cancer care that involves the psychosocial and existential transitions of their patients and significant others?The current review considered studies that included a description of the experiences of non-specialist trained registered nurses (RNs) working in non-specialist wards.The current review considered studies that investigated experiences of RNs when providing palliative end-of-life cancer care that involves
Early palliativecare for adults with advanced cancer. Incurable cancer, which often constitutes an enormous challenge for patients, their families, and medical professionals, profoundly affects the patient's physical and psychosocial well-being. In standard cancer care, palliative measures generally are initiated when it is evident that disease-modifying treatments have been unsuccessful, no treatments can be offered, or death is anticipated. In contrast, early palliativecare is initiated (...) much earlier in the disease trajectory and closer to the diagnosis of incurable cancer.To compare effects of early palliativecare interventions versus treatment as usual/standard cancer care on health-related quality of life, depression, symptom intensity, and survival among adults with a diagnosis of advanced cancer.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, OpenGrey
Assessment tools for palliativecare Assessment tools for palliativecare Assessment tools for palliativecare Aslakson R, Dy SM, Wilson RF, Waldfogel JM, Zhang A, Isenberg SR, Blair A, Sixon J, Robinson KA Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Aslakson R, Dy SM, Wilson RF, Waldfogel JM, Zhang A, Isenberg SR, Blair A, Sixon J, Robinson KA. Assessment (...) tools for palliativecare. Rockville: Agency for Healthcare Research and Quality (AHRQ). Technical Brief No. 30. 2017 Authors' objectives To (1) provide an overview of palliativecare assessment tools designed to be completed by or with patients or caregivers, including which tools have been applied to clinical care, as quality indicators, or in evaluations of interventions, and (2) identify needs for future palliativecare assessment tool development and evaluation. Authors' conclusions We
Palliativecare for Parkinsonâ€™s disease: suggestions from a council of patient and carepartners In 2015, the Parkinson's Disease Foundation sponsored the first international meeting on PalliativeCare and Parkinson's disease and the Patient Centered Outcomes Research Institute funded the first comparative effectiveness trial of palliativecare for Parkinson's disease. A council of Parkinson's disease patients and carepartners was engaged to assist with both projects. This council wrote (...) the following manuscript as an opinion piece addressed to the clinical and research community on how palliativecare could be applied to people living with Parkinson's disease and their families. The council endorses palliativecare as an approach to the care of Parkinson's disease patients and their families that seeks to reduce suffering through spiritual, psychosocial, and medical support. This approach should start at the time of diagnosis, as this is a very challenging time for patients
Drug therapy for symptoms associated with anxiety in adult palliativecare patients. This is an update of a Cochrane Review first published in 2004 (Issue 1) and previously updated in 2012 (Issue 10). Anxiety is common in palliativecare patients. It can be a natural response to the complex uncertainty of having a life-limiting illness or impending death, but it may represent a clinically significant issue in its own right.To assess the effectiveness of drug therapy for treating symptoms (...) of drug therapy for the treatment of symptoms of anxiety in adult palliativecare patients, that is, people with a known progressive life-limiting illness that is no longer responsive to curative treatment, including advanced heart, respiratory and neurological diseases (including dementia). Comparator treatments included placebo; another drug therapy or different dose schedule; or a non-drug intervention such as counselling, cognitive behaviour therapies or relaxation therapies.Two review authors
Palliative and end-of-life care conversations in COPD: a systematic literature review Chronic obstructive pulmonary disease (COPD) is a chronic life-limiting disorder characterised by persistent airflow obstruction and progressive breathlessness. Discussions/conversations between patients and clinicians ensure palliativecare plans are grounded in patients' preferences. This systematic review aimed to explore what is known about palliativecare conversations between clinicians and COPD patients (...) . A comprehensive search of all major healthcare-related databases and websites was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were quality assessed, employing widely used quality-assessment tools, with only papers scoring moderate-to-high quality included. All relevant data were extracted. A narrative synthesis was used to analyse, process and present the final data. The findings indicated that the frequency and quality of palliativecare
Telemedicine in palliativecare: a review of systematic reviews. To evaluate the quality of systematic reviews on telemedicine applications in palliative care.A structured literature review was conducted to identify systematic reviews dealing with telemedicine in palliativecare; the AMSTAR (Assessment of Multiple Systematic Reviews) checklist was used to appraise the evidence related to the systematic reviews.405 records were initially identified; of these 14 were eligible for full-text (...) analysis. In summary, the research strategy allowed the identification of 6 reviews to be included which showed a medium quality (AMSTAR score in between 4 and 7). All the included systematic reviews considered telemedicine applications as a feasible means to be used in palliativecare; however, the positive findings are counterbalanced by several critical issues mainly related to the evidence from the primary studies included in each single review.Results of this first attempt to appraise the evidence
PalliativeCare for the Patient with Incurable Cancer or Advanced Disease: Part 2: Pain and Symptom Management Guidelines & Protocols Advisory Committee PalliativeCare for the Patient with Incurable Cancer or Advanced Disease Part 2: Pain and Symptom Management Effective Date: February 22, 2017 Scope This guideline presents strategies for the assessment and management of cancer pain, and symptoms associated with advanced disease, in patients = 19 years of age. Part 2 is divided into seven (...) • Nausea and Vomiting: Guideline | Medication Table • Pain: Guideline | Equianalgesic Conversion for Morphine | Medication Table For additional guidance on palliative pain and symptom management, see also the BC Inter-professional Palliative Symptom Management Guidelines produced by the BC Centre for PalliativeCare, available at: www.bc-cpc.ca/cpc/symptom-management-guidelines/ The inter-professional guidelines cover the following symptoms: - Hiccoughs - Twitching / myoclonus / seizures - Delirium