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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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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
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
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
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
Effectiveness of topical administration of opioids in palliativecare: a systematic review The discovery of peripheral opioid receptors has become the scientific basis for topical use of opioids in malignant and nonmalignant ulcers and oropharyngeal mucositis. This systematic review aimed to assess the quality of published literature and to examine whether topical opioids are effective in controlling pain in palliativecare settings. After a systematic literature review, 19 studies (six
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
Effectiveness of topical administration of opioids in palliativecare: a systematic review Effectiveness of topical administration of opioids in palliativecare: a systematic review Effectiveness of topical administration of opioids in palliativecare: a systematic review LeBon B, Zeppetella G, Higginson IJ CRD summary The review provided support for the effectiveness of topical opioids in controlling pain in palliativecare, but did not provide clear recommendations for clinical practice (...) regarding the ideal opioid, dosage, interval of administration, carrier, or identification of wounds that were most suitable for treatment. The limitations of the evidence provided imply that the authors' conclusions should be interpreted with caution. Authors' objectives To evaluate the effectiveness of topical opioids in controlling pain in palliativecare. Searching The databases MEDLINE, EMBASE, CINAHL, CANCERLIT, St Christopher’s Hospice Library database, www.controlled-trials.com, and Evidence
Physical activity as a supportive care intervention in palliative cancer patients: a systematic review Physical activity as a supportive care intervention in palliative cancer patients: a systematic review Physical activity as a supportive care intervention in palliative cancer patients: a systematic review Lowe SS, Watanabe SM, Courneya KS CRD summary The review concluded there was insufficient evidence to evaluate the efficacy of physical activity as a supportive care intervention (...) in palliative cancer patients. This conclusion reflected the limited data available and is likely to be reliable. Authors' objectives To evaluate physical activity as a supportive care intervention in palliative cancer patients. Searching The authors stated that 14 electronic databases, three journals, and two conference proceedings were searched, without reporting any further details (other than there were no language restrictions). Study authors were also contacted to identify further studies. Study
Medically assisted nutrition for palliativecare in adult patients. Many palliativecare patients have a reduced oral intake during their illness. The management of this can include the provision of medically assisted nutrition with the aim of prolonging the length of life of a patient, improving their quality of life, or both.To determine the effect of medically assisted nutrition on the quality and length of life of palliativecare patients.Studies were identified from searching The Cochrane (...) -controlled trials (including one qualitative study) that studied medically assisted nutrition in palliativecare participants, and one Cochrane systematic review (on Motor Neurone disease), but no RCTs or prospective controlled studies.There are insufficient good quality trials to make any recommendations for practice with regards to the use of medically assisted nutrition in palliativecare patients.
A critical literature review exploring the challenges of delivering effective palliativecare to older people with dementia This paper considers the challenges of delivering effective palliativecare to older people with dementia and the possible strategies to overcome barriers to end-of-life care in these patients.In UK alone, approximately 100,000 people with dementia die each year and as the number of older people increases, dementia is set to become even more prevalent. Dementia (...) is a progressive terminal illness for which there is currently no cure. Patients dying with dementia have significant health-care needs and in recent years it has been recognised that palliativecare should be made available to everyone regardless of diagnosis, as this improves comfort and quality of life. Despite this, patients dying with dementia are often still not given access to palliativecare services.A review of English language literature published after 1996 to the present day relating to older
Medically assisted hydration for palliativecare patients. Many palliativecare patients have reduced oral intake during their illness. The management of this can include the provision of medically assisted hydration with the aim of prolonging the length of life of a patient, improving their quality of life, or both.To determine the effect of medically assisted hydration in palliativecare patients on their quality and length of life.Studies were identified from searching CENTRAL, MEDLINE (1966 (...) to 2008), EMBASE (1980 to 2008), CINAHL, CANCERLIT, Caresearch, Dissertation abstracts, SCIENCE CITATION INDEX and the reference lists of all eligible studies, key textbooks, and previous systematic reviews. The date of the latest search was February 2008.All relevant randomised controlled trials (RCTs) or prospective controlled studies of medically assisted hydration in palliativecare patients.Five relevant studies were identified. These included two RCTs (93 participants), and three prospective
Palliativecare for patients with head and neck cancer: "I would like a quick return to a normal lifestyle". Head and neck cancers constitute a diverse group of diseases including malignancies of the oral cavity, oropharynx, larynx, sinuses, and skull base. Treatment of these cancers includes a combination of surgical resection, chemotherapy, and radiation. Due to both the patterns of disease recurrence and the adverse effects of treatments, patients with head and neck cancer often have (...) a complex and prolonged course of illness that is marked by periods of freedom from disease and symptoms interspersed with bouts of serious illness, debility, and numerous physical and psychological symptoms including pain, dysphagia, weight loss, disfigurement, depression, and xerostomia. Thus, management of this disease is best provided by an interdisciplinary team that includes individuals from the disciplines of otolaryngology, palliativecare, radiation oncology, oncology, nutrition, speech
Effectiveness of specialized palliativecare: a systematic review. Specialized palliativecare teams are increasingly providing care for the terminally ill. However, the impact of such teams on quality of life, satisfaction with care, and economic cost has not been examined systematically using detailed criteria for study quality.To systematically review the evidence for effectiveness of specialized palliative care.We performed a keyword search of the following databases from their inception (...) to January 2008: MEDLINE, Ovid Healthstar, CINAHL, EMBASE, and the Cochrane Central Register of Controlled Trials.We included all randomized controlled trials in which specialized palliativecare was the intervention and for which outcomes included quality of life, satisfaction with care, or economic cost.Data on population, intervention, outcome, methods, and methodological quality were extracted by 2 investigators using standardized criteria.Of 396 reports of randomized controlled trials, 22 met our
Evidence-based interventions to improve the palliativecare of pain, dyspnea, and depression at the end of life: a clinical practice guideline from the American College of Physicians. RECOMMENDATION 1: In patients with serious illness at the end of life, clinicians should regularly assess patients for pain, dyspnea, and depression. (Grade: strong recommendation, moderate quality of evidence.) RECOMMENDATION 2: In patients with serious illness at the end of life, clinicians should use therapies (...) of evidence.) RECOMMENDATION 4: In patients with serious illness at the end of life, clinicians should use therapies of proven effectiveness to manage depression. For patients with cancer, this includes tricyclic antidepressants, selective serotonin reuptake inhibitors, or psychosocial intervention. (Grade: strong recommendation, moderate quality of evidence.) RECOMMENDATION 5: Clinicians should ensure that advance care planning, including completion of advance directives, occurs for all patients