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Integrated Outpatient Palliative Carein 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 Quality Enhancement Research Initiative (QUERI) Evidence-Based Synthesis Program. Evidence Report (...) : Integrated Outpatient Palliative Carein 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, palliative careimproves quality of life by managing patients' physical symptoms, as well as psychosocial and spiritual distress. Palliative careoccurs across a continuum, ideally beginning at the time when a serious illness has been diagnosed and continuing until the end of life
Guidelines on Management of Pain in Cancer and/or Palliative Care | CancerCare 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 Palliative CareGuidelines & Advice Guidelines on Management of Pain in Cancer and/or Palliative CareID: ES 18-4 Sep 2017 Type of Content: Guidelines & Advice, Evidence (...) as a source of information for the Ontario Palliative CareNetwork (OPCN). Patient Population Patients with cancer or other diseases requiring palliative care. 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 Palliative CareNetwork. This evidence summary may also be of interest to physicians, nurses, caregivers, and patients dealing with cancer or palliative caresymptom
Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial. Importance: The use of benzodiazepines to control agitation in delirium in the last days of life is controversial. Objective: 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. Design, Setting, and Participants: Single (...) -center, double-blind, parallel-group, randomized clinical trial conducted at an acute palliative careunit 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. Interventions: Lorazepam (3 mg) intravenously (n = 47) or placebo (n = 43) in addition to haloperidol (2 mg) intravenously upon the onset of an agitation episode. Main Outcomes
Palliative careand 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 palliative care, 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 palliative care. Early integration of palliative carewith 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 palliative carein adults with glioma 28593859 2017 06 08 2017 07 31 1474-5488 18 6 2017 06 The Lancet. Oncology Lancet Oncol. European Association for Neuro-Oncology (EANO) guidelines for palliative carein adults with glioma. e330-e340 S1470-2045(17)30345-5 10.1016/S1470-2045(17)30345-5 Patients with glioma present with complex palliative careneeds 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 palliative careapproach. The multidisciplinary palliative caretask 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 palliative careof adult patients with glioma, with the aim to reduce symptom burden and improve the quality of life of patients
Palliative CareDevelopment in Africa: Lessons From Uganda and Kenya 30241205 2018 12 07 2378-9506 4 2018 Sep Journal of global oncology J Glob Oncol Palliative CareDevelopment in Africa: Lessons From Uganda and Kenya. 1-10 10.1200/JGO.2017.010090 Despite increased access to palliative carein Africa, there remains substantial unmet need. We examined the impact of approaches to promoting the development of palliative carein 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 palliative carein 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 palliative care, in which successful approaches to palliative caredevelopment have been used. Both countries have implemented strategies
Early palliative carefor adults with advanced cancer. BACKGROUND: 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, palliativemeasuresgenerally 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 palliative careis (...) initiated much earlier in the disease trajectory and closer to the diagnosis of incurable cancer. OBJECTIVES: To compare effects of early palliative careinterventions 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. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health
Assessment tools for palliative careAssessment tools for palliative careAssessment tools for palliative careAslakson 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 palliative care. Rockville: Agency for Healthcare Research and Quality (AHRQ). Technical Brief No. 30. 2017 Authors' objectives To (1) provide an overview of palliative careassessment 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 palliative careassessment tool development and evaluation. Authors' conclusions We
Palliative carefor Parkinsonâ€™s disease: suggestions from a council of patient and carepartners 28649616 2018 11 13 2373-8057 3 2017 NPJ Parkinson's disease NPJ Parkinsons Dis Palliative carefor Parkinson's disease: suggestions from a council of patient and carepartners. 16 10.1038/s41531-017-0016-2 In 2015, the Parkinson's Disease Foundation sponsored the first international meeting on Palliative Careand Parkinson's disease and the Patient Centered Outcomes Research Institute funded (...) the first comparative effectiveness trial of palliative carefor 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 palliative carecould be applied to people living with Parkinson's disease and their families. The council endorses palliative careas an approach to the care of Parkinson's disease patients
Drug therapy for symptoms associated with anxiety in adult palliative carepatients. BACKGROUND: 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 palliative carepatients. 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. OBJECTIVES: To assess the effectiveness of drug therapy (...) for treating symptoms of anxiety in adults with a progressive life-limiting illness who are thought to be in their last year of life. SEARCH METHODS: We ran the searches for this update to May 2016. We searched the CENTRAL, MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), PsychLIT (Silver Platter) and PsycINFO (Ovid). We searched seven trials registers and seven pharmaceutical industry trials registers. We handsearched the conference abstracts of the European Association of Palliative Care. SELECTION
Palliativeandend-of-lifecare conversations in COPD: a systematic literature review 28462236 2018 11 13 2312-0541 3 2 2017 Apr ERJ open research ERJ Open Res Palliativeandend-of-lifecare conversations in COPD: a systematic literature review. 00068-2016 10.1183/23120541.00068-2016 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 palliative careplans are grounded in patients' preferences. This systematic review aimed to explore what is known about palliative careconversations 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
Palliative Carefor the Patient with Incurable Cancer or Advanced Disease: Part 3: Grief and Bereavement Guidelines & Protocols Advisory Committee Palliative Carefor 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: Palliative Carefor 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
Palliative Carefor the Patient with Incurable Cancer or Advanced Disease: Part 2: Pain and Symptom Management Guidelines & Protocols Advisory Committee Palliative Carefor 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 palliativepainand symptom management, see also the BC Inter-professional PalliativeSymptomManagement Guidelines produced by the BC Centre for Palliative Care, available at: www.bc-cpc.ca/cpc/symptom-management-guidelines/ The inter-professional guidelines cover the following symptoms: - Hiccoughs - Twitching / myoclonus / seizures - Delirium
Palliative Carefor the Patient with Incurable Cancer or Advanced Disease: Part 1: Approach to Care Guidelines & Protocols Advisory Committee Palliative Carefor the Patient with Incurable Cancer or Advanced Disease Part 1: Approach to Care Effective Date: February 22, 2017 Scope This guideline presents palliative careassessment 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-Lifecare may be needed. Diagnostic code: 239 (neoplasm of unspecified nature) Palliative careplanning fee code: G14063 Key Recommendations • Identify patients who would benefit from
Impact of intervention aimed at improving the integration of oncology units and local palliative careservices: results of the multicentre prospective sequential MIRTO study 28761725 2018 11 13 2059-7029 2 1 2017 ESMO open ESMO Open Impact of intervention aimed at improving the integration of oncology units and local palliative careservices: results of the multicentre prospective sequential MIRTO study. e000116 10.1136/esmoopen-2016-000116 Chemotherapy (CT) in patients with advanced cancer (...) (ACP) near the end of life is an increasing practice of oncology units. A closer integration with palliative care (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 use near the end of life and increase local PC service utilisation. The study enrolled sequentially two cohorts of ACP with an estimated life expectancy of ≤6 months. In the first cohort, the usual oncologist's practice
What is the value of palliative careprovision in low-resource settings? 28588999 2018 11 13 2059-7908 2 1 2017 BMJ global health BMJ Glob Health What is the value of palliative careprovision 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