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Palliative cancer care - pain: What issues should I consider before prescribing diazepam? Diazepam | Prescribing information | Palliative cancer care - pain | CKS | NICE Search CKS… Menu Diazepam Palliative cancer care - pain: What issues should I consider before prescribing diazepam? Last revised in October 2016 What issues should I consider before prescribing diazepam? The most frequent adverse effects are drowsiness, sedation, muscle weakness, and ataxia. These effects are caused
Palliative cancer care - pain Palliative cancer care - pain | Topics A to Z | CKS | NICE Search CKS… Menu Palliative cancer care - pain Palliative cancer care - pain Last revised in October 2016 Cancer-related pain may be persistent or breakthrough (episodic), and influenced by physical, psychological, social and spiritual factors. Management Prescribing information Background information Palliative cancer care - pain: Summary Cancer-related pain may be persistent or breakthrough (episodic (...) ), and influenced by physical, psychological, social and spiritual factors. Breakthrough pain may be: Unpredictable (spontaneous). Predictable (incident) and related to movement or activity. The type of pain experienced depends on the underlying cause, and may be somatic, visceral or neuropathic pain. It can be caused by direct effects of a tumour, cancer treatment, related to procedures such as dressing changes, or unrelated to the underlying cancer. When assessing pain for a person in palliativecare
of Chronic Symptoms that Substantially Predate the Diagnosis of a Life-Limiting Illness. J Palliat Med. 2015 Jun;18(6):480–5. 5. Cleary AS. Integrating palliativecare into primary care for patients with chronic, life- limiting conditions. Nurse Pract. 2016 Mar 15;41(3):42–48; quiz 49. 6. Gómez-Batiste X, Martínez-Muñoz M, Blay C, Espinosa J, Contel JC, Ledesma A. Identifying needs and improving palliativecare of chronically ill patients: a community- oriented, population-based, public-health approach (...) . Curr Opin Support PalliatCare. 2012 Sep;6(3):371–8. 7. Nelson JE, Hope AA. Integration of palliativecare in chronic critical illness management. Respir Care. 2012 Jun;57(6):1004–12; discussion 1012-1013. 8. Pereira J, Chasen MR. Early palliativecare: taking ownership and creating the conditions. Curr Oncol Tor Ont. 2016 Dec;23(6):367–70. 9. Department of Health and Community Services. Chronic Disease Control | Health and Community Services [Internet]. 2018 [cited 2018 Mar 12]. Available from
Coronavirus - COVID 19: Scenario: Palliativecare Scenario: Palliativecare | Management | Coronavirus - COVID 19 | CKS | NICE Search CKS… Menu Scenario: Palliativecare Coronavirus - COVID 19: Scenario: Palliativecare Last revised in July 2020 Scenario: Palliativecare From age 18 years onwards. How should my management vary when considering the possibility of COVID-19? General advice When managing a person who is in the palliative or terminal phase of their illness with COVID‑19 like (...) for recommendation These recommendations are based on the National Institute for Health and Care Excellence (NICE) COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community [ ]. How should my management of delirium vary when considering the possibility of COVID-19? People in the palliative phase of their illness and who may have contracted COVID-19 are at higher risk of developing anxiety, delirium, and agitation. Assess and treat reversible causes of anxiety or delirium
accessed 24 April 2017). https://www.capc.org/policymakers/overview/ Kelley AS, Morrison RS. Palliativecare for the seriously ill. N Engl J Med. 2015;373:747-755. http://www.nejm.org/doi/full/10.1056/NEJMra1404684 http://www.ncbi.nlm.nih.gov/pubmed/26287850?tool=bestpractice.com To palliate comes from the Latin word 'palliare', meaning 'to cloak', or to ease symptoms without curing the underlying disease. The primary goal of palliativecare is to provide quality of life for the patient and family (...) PalliativecarePalliativecare - Medical information | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Palliativecare Last reviewed: February 2019 Last updated: January 2018 Summary Palliativecare is specialised medical care for people with serious illness that focuses on the best quality of life for both the patient and his or her family. Center to Advance PalliativeCare. Overview for policymakers: palliativecare. http://www.capc.org/ (last
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
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 PalliatCare. 2013 Feb 15;12:7 23414145 Soc Sci Med. 2015 Jan;124:48-56 25461861 Int J Health Policy Manag. 2016 Jun
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