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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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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 3: Grief and Bereavement Guidelines & Protocols Advisory Committee PalliativeCare for the Patient with Incurable Cancer or Advanced Disease Part 3: Grief and Bereavement Effective Date: February 22, 2017 Scope This guideline addresses the needs of adult patients with incurable cancer or advanced disease (but can be useful for adults dying of any cause), as well as the needs of their caregivers or family, including (...) contacting the Physician Health Program. Refer to Associated Document: Resource Guide for Patients and Caregivers. BCGuidelines.ca: PalliativeCare for the Patient with Incurable Cancer or Advanced Disease 2 Part 3: Grief and Bereavement (2017) Grief } Assessment of Grief • Consider using the Adult Attitudes to Grief Scale 3 (Appendix A: Adult Attitudes to Grief Scale – Patient Handout, Practitioner Score Sheet, and Protocol for Use). The Adult Attitudes to Grief Scale is a brief, self-reported, evidence
PalliativeCare for the Patient with Incurable Cancer or Advanced Disease: Part 1: Approach to Care Guidelines & Protocols Advisory Committee PalliativeCare for the Patient with Incurable Cancer or Advanced Disease Part 1: Approach to Care Effective Date: February 22, 2017 Scope This guideline presents palliativecare assessment and management strategies for primary care practitioners caring for adult patients aged = 19 years with incurable cancer and end stage chronic disease of many types (...) , and their families. NOTE: Care gaps have been identified at important transitions for this group of patients: • upon receiving a diagnosis of incurable cancer; • when discharged from active treatment to the community; • while still ambulatory but needing pain and symptom management; and • at the transition when End-of-Life care may be needed. Diagnostic code: 239 (neoplasm of unspecified nature) Palliativecare planning fee code: G14063 Key Recommendations • Identify patients who would benefit from palliative
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
Impact of intervention aimed at improving the integration of oncology units and local palliativecare services: results of the multicentre prospective sequential MIRTO study Chemotherapy (CT) in patients with advanced cancer (ACP) near the end of life is an increasing practice of oncology units. A closer integration with palliativecare (PC) services could reduce the use of potentially harmful CT. This prospective study is aimed at assessing whether a more integrated care model could reduce CT
What is the value of palliativecare provision in low-resource settings? 28588999 2018 11 13 2059-7908 2 1 2017 BMJ global health BMJ Glob Health What is the value of palliativecare provision in low-resource settings? e000139 10.1136/bmjgh-2016-000139 Anderson R Eleanor RE Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA. Grant Liz L Global Health Academy, University of Edinburgh, FRCPE, Edinburgh, UK. eng Journal Article 2017 02 14 England BMJ (...) Glob Health 101685275 2059-7908 Competing interests: None declared. 2016 07 26 2016 11 03 2017 6 8 6 0 2017 6 8 6 0 2017 6 8 6 1 epublish 28588999 10.1136/bmjgh-2016-000139 bmjgh-2016-000139 PMC5335766 Afr J Prim Health Care Fam Med. 2014 Nov 14;6(1):E1-8 26245417 Lancet. 2013 Sep 21;382(9897):1060-9 23697823 J Pain Palliat Care Pharmacother. 2003;17(3-4):xxix-xxxvi 15022945 Lancet. 2016 May 21;387(10033):2133-44 26578033 Science. 2009 Oct 30;326(5953):682-8 19900925 Indian J Palliat Care. 2016 Jul
Effects of Early Integrated PalliativeCare in Patients With Lung and GI Cancer: A Randomized Clinical Trial Purpose We evaluated the impact of early integrated palliativecare (PC) in patients with newly diagnosed lung and GI cancer. Patients and Methods We randomly assigned patients with newly diagnosed incurable lung or noncolorectal GI cancer to receive either early integrated PC and oncology care (n = 175) or usual care (n = 175) between May 2011 and July 2015. Patients who were assigned (...) to the intervention met with a PC clinician at least once per month until death, whereas those who received usual care consulted a PC clinician upon request. The primary end point was change in quality of life (QOL) from baseline to week 12, per scoring by the Functional Assessment of Cancer Therapy-General scale. Secondary end points included change in QOL from baseline to week 24, change in depression per the Patient Health Questionnaire-9, and differences in end-of-life communication. Results Intervention
What processes decrease the risk of opioid toxicity following interventional procedures for uncontrolled pain in palliativecare or cancer patients? Review Methods Search Strategy: A systematic search was conducted across a wide-ranging set of data- bases: Ovid Medline, including In-Process & Other Non-Indexed Citations, Ovid Embase, Ebsco CINAHL and Cochrane Library. The preliminary search strategy was devel- oped on Ovid Medline using both text words and Medical subject headings from January (...) 2006 to February 2017 restricted to English language humans. The search strategy was modified to capture indexing systems of the other databases. (Search strategies available upon request). To identify additional papers, the following website was searched: palliativecare knowledge network Furthermore electronic tables of content for the last two years were scanned for British Journal of Anaesthesia, Journal of Pain and Symptom Management, Pain and Palliative medicine. Reference lists of systematic
PalliativeCare ACS TQIP PALLIATIVECARE BEST PRACTICES GUIDELINES Table of Contents Introduction 3 Interdisciplinary PalliativeCare Team 5 Essential Components of PalliativeCare 6 Breaking Bad News 9 PalliativeCare Assessment 12 Goals of Care Conversation 19 End-of-Life Care 21 Special Considerations for Geriatric Patients 23 Special Considerations for Pediatric Patients 25 Special Considerations for Spinal Cord Injury 26 Special Considerations for Traumatic Brain Injury 27 Supporting (...) the Health Care Team 28 Clinical Documentation 30 Performance Improvement Initiatives 32 Implementation Guidelines 34 Glossary of Terms Relevant to PalliativeCare 36 Acronyms 37 Appendices 38 2INTRODUCTION Key Messages z Best practice palliativecare is delivered in parallel with life-sustaining trauma care, throughout the continuum from injury through recovery. z The unit of care is the patient and family. z Core trauma palliativecare can and should be provided by trauma center teams even
Complementary and alternative medicine for management of symptoms in hospice and palliativecare: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence
Specialty and non-specialty palliativecare delivery: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address