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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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Development of Prognosis in Palliativecare Study (PiPS) predictor models to improve prognostication in advanced cancer: prospective cohort study. To develop a novel prognostic indicator for use in patients with advanced cancer that is significantly better than clinicians' estimates of survival.Prospective multicentre observational cohort study.18 palliativecare services in the UK (including hospices, hospital support teams, and community teams).1018 patients with locally advanced (...) or metastatic cancer, no longer being treated for cancer, and recently referred to palliativecare services.Performance of a composite model to predict whether patients were likely to survive for "days" (0-13 days), "weeks" (14-55 days), or "months+" (>55 days), compared with actual survival and clinicians' predictions.On multivariate analysis, 11 core variables (pulse rate, general health status, mental test score, performance status, presence of anorexia, presence of any site of metastatic disease
Transitions to palliativecare in acute hospitals in England: qualitative study. To explore how transitions to a palliativecare approach are perceived to be managed in acute hospital settings in England.Qualitative study.Secondary or primary care settings in two contrasting areas of England.58 health professionals involved in the provision of palliativecare in secondary or primary care.Participants identified that a structured transition to a palliativecare approach of the type advocated (...) in UK policy guidance is seldom evident in acute hospital settings. In particular they reported that prognosis is not routinely discussed with inpatients. Achieving consensus among the clinical team about transition to palliativecare was seen as fundamental to the transition being effected; however, this was thought to be insufficiently achieved in practice. Secondary care professionals reported that discussions about adopting a palliativecare approach to patient management were not often held
Summary of General PalliativeCare Guidelines for the Management of Pain at the End of Life for Adults Summary of General PalliativeCare GuidelineS for the manaGement of Pain at the end of life for adultS Opioid for moderate to severe pain ± Non-opioid ± Adjuvant Opioid for mild to moderate pain ± Non-opioid ± Adjuvant Non-opioid ± Adjuvant WHO Pain Relief Ladder Step 3 Step 2 Step 1 Pain For patients with hepatic impairment or renal impairment consult full text version of Pain Guidelines Step (...) cause/s of pain/s • is there any disease modifying treatment which may help pain control? • Start at the level of the World health organisation (Who) analgesic ladder appropriate for the severity of the pain • if pain uncontrolled prescribe medication from the next step of the ladder rather than alternative analgesic from the same step • involve patient and carer in management plan For persisting complex Pain: SEEK SPECIALIST ADVICE e.g. specialist palliativecare
General PalliativeCare Guidelines for the Management of Pain at the End of Life in Adult Patients General PalliativeCare Guidelines for the ManaGeMent of Pain at the end of life in adult Patients February 20111 Contents IntroduCtIon 3 understandIng PaIn 5 PrInCIPles oF PaIn ManageMent 8 assessMent oF PaIn 9 general PrInCIPles oF analgesIC PresCrIbIng 13 PharMaCologICal ManageMent oF PaIn 14 fiGure 1 PharMaColoGiCal ManaGeMent of Pain 14 steP 1 for Mild Pain 15 steP 2 for Mild to Moderate Pain (...) In CognItIve IMP aIrMent 59 PaIn assessMent and ManageMent In 61 learnIng dIsabIlItIes aPPendIx 1 PaIn assessMent Chart 63 aPPendIx 2 hosPItal anxIety & dePressIon sCale 65 aPPendIx 3 nICe ClInICal guIdelInes For 66 neuroP athIC PaIn aPPendIx 4 PatIent InForMatIon leaFlet oPIoIds 68 aPPendIx 5 audIt assessMent tool 73 aPPendIx 6 draFt suMMary Poster 74 aPPendIx 7 sPeCIalIst PallIatIveCare ContaCt 82 InForMatIon aPPendIx 8 MeMbershIP oF PaIn guIdelInes 84 workstrand aPPendIx 9 abbrevIatIons 86 reFerenCes
Does palliativecare improve outcomes for patients with incurable illness? A review of the evidence Does palliativecare improve outcomes for patients with incurable illness? A review of the evidence Does palliativecare improve outcomes for patients with incurable illness? A review of the evidence El-Jawahri A, Greer JA, Temel JS CRD summary The authors concluded that available evidence confirmed palliativecare services were associated with improvements in patients' quality of life, family (...) caregiver outcomes, patient and caregiver satisfaction with care, and the quality of care delivered at the end of life for patients with incurable illnesses. Due to multiple limitations in this review and the evidence, these conclusions may not be reliable. Authors' objectives To review the efﬁcacy of various palliativecare interventions to improve patients’ quality of life, physical and psychological symptoms, satisfaction with care, family caregiver outcomes, health service use, and quality of end
The use of massage therapy for reducing pain, anxiety, and depression in oncological palliativecare patients: a narrative review of the literature The use of massage therapy for reducing pain, anxiety, and depression in oncological palliativecare patients: a narrative review of the literature The use of massage therapy for reducing pain, anxiety, and depression in oncological palliativecare patients: a narrative review of the literature Falkensteiner M, Mantovan F, Muller I, Them C CRD (...) in patients receiving oncological palliativecare. Searching The Cochrane Library, CINAHL, PsycINFO, MEDLINE, EMBASE, AMED and Trip databases were searched for studies published between 2000 and 2010. Reference lists of relevant studies and selected journals were screened for further articles. Only studies published in English, German or Italian were included. Study selection Eligible studies were of massage therapy (full body or partial, including hand massage) given in palliative/oncological care
Droperidol for treatment of nausea and vomiting in palliativecare patients. Nausea and vomiting are common symptoms in patients with terminal illness and can be very unpleasant and distressing. There are several different types of antiemetic treatments which can be used to control these symptoms. Droperidol is an antipsychotic drug and has been used and studied as an antiemetic in the management of post-operative and chemotherapy nausea and vomiting.To evaluate the efficacy and adverse events (...) (both minor and serious) associated with the use of droperidol for the treatment of nausea and vomiting in palliativecare patients.We searched electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL and AMED, using relevant search terms and synonyms. The basic search strategy was ("droperidol" OR "butyrophenone") AND ("nausea" OR "vomiting"), modified for each database. The search was updated on 2 December 2009.Randomised controlled trials (RCTs) of droperidol for the treatment of nausea
Availability and integration of palliativecare at US cancer centers. The current state of palliativecare in cancer centers is not known.To determine the availability and degree of integration of palliativecare services and to compare between National Cancer Institute (NCI) and non-NCI cancer centers in the United States.A survey of 71 NCI-designated cancer centers and a random sample of 71 non-NCI cancer centers of both executives and palliativecare clinical program leaders, where (...) applicable, regarding their palliativecare services between June and October 2009. Survey questions were generated after a comprehensive literature search, review of guidelines from the National Quality Forum, and discussions among 7 physicians with research interest in palliative oncology. Executives were also asked about their attitudes toward palliative care.Availability of palliativecare services in the cancer center, defined as the presence of at least 1 palliativecare physician.A total of 142
Management of locally advanced and metastatic prostate cancer - Palliativecare Guidelines:Prostate cancer/Management/Locally advanced and metastatic/Palliativecare - Cancer Guidelines Wiki Skip Links Personal tools Search Navigation Cancer Council guidelines Methodology Hosted cancer guidelines Adolescents and Young Adult (AYA) guidelines Prevention Policies Social links Page actions > Guidelines:Prostate cancer/Management/Locally advanced and metastatic/Palliativecare > Information (...) PalliativecarePalliativecare has been defined in a number of ways. The World Health Organization (WHO) has defined palliativecare as …an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.' Palliativecare: provides relief from pain
End stage heart failure patients. Palliativecare in general practice RACGP - End stage heart failure patients – palliativecare in general practice Search the RACGP website Latest issue December 2017 Vol 46(12) 881-960 Articles in the December issue discuss various health issues affecting school-aged children, including acne, eczema and growth disorders. Australian Family Physician Chronic heart failure December 2010 / / / / Focus Chronic heart failure End stage heart failure patients (...) Palliativecare in general practice Pages 916-920 David C Currow Patricia M Davidson Peter S Macdonald Phillip J Newton Background Chronic heart failure is common, particularly in older individuals, and comorbidities are frequent. Patients with end stage heart failure can be highly symptomatic and require careful monitoring and treatment adjustment to improve symptoms. Objective/s This article summarises the fundamentals of implementing palliativecare in general practice and provides guidelines
Clinical practice guidelines for quality palliativecare. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding for the National Guideline
Early palliativecare for patients with metastatic non-small-cell lung cancer. Patients with metastatic non-small-cell lung cancer have a substantial symptom burden and may receive aggressive care at the end of life. We examined the effect of introducing palliativecare early after diagnosis on patient-reported outcomes and end-of-life care among ambulatory patients with newly diagnosed disease.We randomly assigned patients with newly diagnosed metastatic non-small-cell lung cancer to receive (...) either early palliativecare integrated with standard oncologic care or standard oncologic care alone. Quality of life and mood were assessed at baseline and at 12 weeks with the use of the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale and the Hospital Anxiety and Depression Scale, respectively. The primary outcome was the change in the quality of life at 12 weeks. Data on end-of-life care were collected from electronic medical records.Of the 151 patients who underwent randomization, 27
Haloperidol for the treatment of nausea and vomiting in palliativecare patients. Nausea and vomiting are common symptoms of patients with terminal, incurable illnesses and can be distressing.The primary objective of the review was to evaluate the efficacy and adverse events associated with the use of haloperidol for the treatment of nausea and vomiting in palliativecare patients.Several electronic databases were searched including CENTRAL, MEDLINE, EMBASE, CINAHL and AMED, using relevant (...) search terms and synonyms. Handsearching complemented electronic searches (using reference lists of included studies, relevant chapters and review articles). There were no language restrictions imposed. Database searching was performed between 2nd and 16th September 2007.Studies considered for inclusion were randomised controlled trials (RCTs) of haloperidol for the treatment of nausea or vomiting, or both, in any setting. The studies had to be conducted with adults receiving palliativecare
Palliativecare for Latino patients and their families: whenever we prayed, she wept. Latinos account for 15% of the US population, a proportion projected to grow to 30% by the year 2050. Although there is tremendous diversity within this community, commonalities of language, beliefs, attitudes, and behaviors unite Latinos, making them more similar than different. Differences by national origin, although important, are attenuated when immigrants come to the United States, dominated (...) by an English-language, Anglo-centric culture. For non-Latino and non-Spanish-speaking clinicians, communication barriers and cultural misunderstandings can impede the care of dying Latino patients and their families. We present the case of a young, pregnant, Spanish-speaking woman from Central America diagnosed with a fatal leukemia. As illustrated by this case, Latino immigrants face a number of external challenges to optimal end-of-life care: (1) geographic distance as well as political and economic
Referring a patient and family to high-quality palliativecare at the close of life: "We met a new personality... with this level of compassion and empathy". Palliativecare services are increasingly available to primary care physicians for both expert consultations and services to seriously ill patients. The United States now has more than 1400 hospital-based palliativecare teams and more than 4700 hospice programs. We use an illustrative case of a palliativecare hospitalization (...) and intervention for a middle-aged man with severe pain from spinal metastases to discuss 4 key questions that a primary care physician faces in caring for the seriously ill patient with difficult symptom management: (1) Should I refer a patient to a hospital-based palliativecare team or to hospice services for difficult symptom management? (2) If the patient is referred to a hospital-based palliativecare team, what should I, as the primary care physician, expect? (3) When should I refer to hospice services
Effects of a palliativecare intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial. There are few randomized controlled trials on the effectiveness of palliativecare interventions to improve the care of patients with advanced cancer.To determine the effect of a nursing-led intervention on quality of life, symptom intensity, mood, and resource use in patients with advanced cancer.Randomized controlled trial conducted from November (...) = 161).Quality of life was measured by the Functional Assessment of Chronic Illness Therapy for PalliativeCare (score range, 0-184). Symptom intensity was measured by the Edmonton Symptom Assessment Scale (score range, 0-900). Mood was measured by the Center for Epidemiological Studies Depression Scale (range, 0-60). These measures were assessed at baseline, 1 month, and every 3 months until death or study completion. Intensity of service was measured as the number of days in the hospital
Massage therapy for cancer palliation and supportive care: a systematic review of randomised clinical trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Is short-term palliativecare cost-effective in multiple sclerosis? A randomized phase II trial Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.