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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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Palliativecare - general issues Palliativecare - general issues - NICE CKS Share Palliativecare - general issues: Summary Palliativecare is defined as the active holistic care of people with advanced, progressive illness. Professionals providing general palliativecare services should: Be involved as early as possible after diagnosis. Aim to meet the needs of the patient and their family within the limits of their knowledge and competence. Seek specialist advice or refer the patient (...) on locally agreed protocols and guidelines, delivered within the context of a managed system or pathway. Requires a multidisciplinary team because of the potential multidimensional nature of problems in palliativecare. Have I got the right topic? Have I got the right topic? From age 16 years onwards. This CKS topic covers the general management issues related to palliativecare and incorporates guidance from the National Institute for Health and Care Excellence on Improving supportive and palliative
Palliativecare - cough Palliativecare - cough - NICE CKS Share Palliativecare - cough: Summary Cough is a defensive reflex that occurs in response to stimulation of irritant receptors which are found in the airways. It has two functions — to prevent foreign material entering the lower respiratory tract, and to clear secretions from the lungs and airways. Cough in people with cancer is most commonly associated with cancer of the airways, lungs, pleura, and mediastinum, but tumours (...) metastasizing to the thorax can also cause cough. In people with cancer, the most common cause of acute cough is respiratory tract infection. Other possible non-malignant causes include post-nasal drip, asthma, chronic obstructive pulmonary disease, and gastro-oesophageal reflux disease. When assessing someone with cough in palliativecare, the following should be elicited: The impact on the person's quality of life. The severity, time of onset, and duration of the cough. The pattern and character
Palliativecare - constipation Palliativecare - constipation - NICE CKS Share Palliativecare - constipation: Summary Constipation is defecation that is unsatisfactory because of infrequent stools, difficult stool passage, or seemingly incomplete defecation. Stools are often dry and hard, and may be abnormally large or abnormally small. About 80% of people with cancer will require treatment with laxatives at some time. People receiving palliativecare have multiple causes of constipation (...) , such as: Drugs, for example, opioid analgesics, antimuscarinic drugs, antacids. Secondary effects of disease, for example, dehydration, inadequate dietary fibre, inactivity, delirium, spinal cord compression, lack of privacy. Direct effects of malignant tumours, causing bowel obstruction, hypercalcaemia, nerve damage. When assessing a person with constipation in palliativecare: The history should include information about the frequency and character of stools, discomfort, blood or mucus with the stool
Palliativecare - nausea and vomiting Palliativecare - nausea and vomiting - NICE CKS Share Palliativecare - nausea and vomiting: Summary Nausea is an unpleasant sensation of the need to vomit, which is often accompanied by autonomic symptoms (for example pallor, cold sweat, salivation, and tachycardia). Vomiting (emesis) is the forceful ejection of stomach contents through the mouth. There are many causes of nausea and vomiting in the palliativecare setting, including: Drugs (for example (...) of the person’s illness, their prognosis, the severity of their symptoms, and the wishes of the person and their family. Simple measures may help relieve nausea and vomiting in palliativecare. They include: Ensuring access to a large bowl, tissues, and water. Eating snacks consisting of a few mouthfuls rather than large meals. Drinking cool fizzy drinks rather than still or hot drinks. Relaxation techniques. Parenteral hydration, if appropriate. Cognitive behavioural therapy (for anticipatory nausea
Palliativecare - secretions Palliativecare - secretions - NICE CKS Share Palliativecare - secretions: Summary During the terminal phase of a person's illness, airway secretions may accumulate and result in gurgling and rattling noises during inspiration and expiration. It may be difficult to tell whether noisy secretions in the last few hours of life are causing distress to the person, but such noises may be distressing to some families or carers. Listen to the concerns and fears (...) . QOF indicators QOF indicators Table 1 . Indicators related to palliativecare in the Quality and Outcomes Framework of the General Medical Services contract. Indicator Points Payment stages PC001 The contractor establishes and maintains a register of all patients in need of palliativecare/support irrespective of age 3 — PC002 The contractor has regular (at least 3 monthly) multidisciplinary case review meetings where all patients on the palliativecare register are discussed 3 — Data from
Palliativecare - dyspnoea Palliativecare - dyspnoea - NICE CKS Share Palliativecare - dyspnoea: Summary Breathlessness is an objective observable sign, whereas dyspnoea is a subjective described symptoms of difficulty in breathing. Anxiety is often a major component of dyspnoea. Dyspnoea can result from impaired ventilation or increased ventilatory demand, or both factors. There are multiple possible causes of dyspnoea in people with cancer, including: Direct causes — such as primary lung (...) cancer or lung metastases. Indirect effects of cancer — such as pleural effusion, superior vena cava syndrome, anaemia, pulmonary embolism, and surgery. Non-malignant causes — such as pneumonia, chronic obstructive pulmonary disease, heart failure, and anxiety. Assessment of someone with dyspnoea in a palliativecare setting involves asking about: Features of the dyspnoea (for example severity, timing, onset, and precipitating and exacerbating factors). Associated physical symptoms (for example cough
Palliative cancer care - pain Palliative cancer care - pain - NICE CKS Share 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: A validated structured pain assessment tool may be helpful. The impact on quality of life should be discussed. If appropriate, an examination should be performed — looking particularly for specific points of tenderness and signs of neurological deficit which may suggest spinal cord compression. Investigations may
What are best practice service models in rural areas for the delivery of end of life and palliativecare? Objectives To provide specific, innovative examples of best practice service models for end of life and palliativecare services (cancer and non-cancer) in rural areas applicable to the UK. In addition, to: ? Explore potential of new technology (tele-rehabilitation, tele -health, tele-medicine) in enhancing access to and the sustainability of rural services. ? Identify the barriers (...) to success. ? Identify key themes of successful end of life/palliativecare services from the perspective of patients, families and their carers. Review Methods A systematic search was conducted across a wide-ranging set of databases: Ovid Medline, including In-Process & Other Non-Indexed Citations, Ovid Embase, OVID HMIC, Ovid PsycINFO and Ebsco CINAHL. The preliminary search strategy was developed on Ovid Medline using both text words and Medical subject headings from January 2005 to November 2015
Routine Bowel Care for Patients in Long-Term or PalliativeCare: Guidelines Routine Bowel Care for Patients in Long-Term or PalliativeCare: Guidelines | CADTH.ca Find the information you need Routine Bowel Care for Patients in Long-Term or PalliativeCare: Guidelines Routine Bowel Care for Patients in Long-Term or PalliativeCare: Guidelines Published on: December 7, 2015 Project Number: RB0940-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type (...) : Report Question What are the guidelines for routine bowel care of long-term care seniors and palliativecare residents? Key Message Two evidence-based guidelines were identified regarding routine bowel care of long-term care seniors and palliativecare residents. Tags constipation, defecation, diarrhea, duodenal obstruction, fecal impaction, fecal incontinence, geriatrics, long-term care, nursing homes, palliativecare, palliative Files Rapid Response Summary of Abstracts Published : December 7, 2015
PalliativeCare. 26605939 2015 11 27 2018 12 02 1533-4406 373 22 2015 11 26 The New England journal of medicine N. Engl. J. Med. PalliativeCare. 2188 10.1056/NEJMc1511946 Hashemian S Mohammadreza SM Beheshti Shahid S Miller James J eng Letter Comment United States N Engl J Med 0255562 0028-4793 AIM IM N Engl J Med. 2015 Aug 20;373(8):747-55 26287850 Critical Illness therapy Humans PalliativeCare 2015 11 26 6 0 2015 11 26 6 0 2015 12 15 6 0 ppublish 26605939 10.1056/NEJMc1511946 10.1056
PalliativeCare. 26605940 2015 11 27 2018 12 02 1533-4406 373 22 2015 11 26 The New England journal of medicine N. Engl. J. Med. PalliativeCare. 2188-9 10.1056/NEJMc1511946 McGovern Terrance T Catapano Anthony A Shroff Ninad N eng Letter Comment United States N Engl J Med 0255562 0028-4793 AIM IM N Engl J Med. 2015 Aug 20;373(8):747-55 26287850 Critical Illness therapy Humans PalliativeCare 2015 11 26 6 0 2015 11 26 6 0 2015 12 15 6 0 ppublish 26605940 10.1056/NEJMc1511946 10.1056
Antimicrobials at the End of Life: An Opportunity to Improve PalliativeCare and Infection Management 26426830 2015 12 24 2018 11 13 1538-3598 314 19 2015 Nov 17 JAMA JAMA Antimicrobials at the End of Life: An Opportunity to Improve PalliativeCare and Infection Management. 2017-8 10.1001/jama.2015.13080 Juthani-Mehta Manisha M Yale School of Medicine, Section of Infectious Diseases, Department of Internal Medicine, New Haven, Connecticut. Malani Preeti N PN University of Michigan Health System (...) Anti-Bacterial Agents AIM IM Anti-Bacterial Agents administration & dosage adverse effects Bacterial Infections drug therapy Decision Making Humans Risk Assessment Terminal Care methods Terminally Ill 2015 10 2 6 0 2015 10 2 6 0 2015 12 25 6 0 ppublish 26426830 2451305 10.1001/jama.2015.13080 PMC4675049 NIHMS742212 J Pain Symptom Manage. 1998 Feb;15(2):91-101 9494307 Arch Intern Med. 2008 Feb 25;168(4):357-62 18299489 Arch Intern Med. 2010 Jul 12;170(13):1102-7 20625013 Chest. 2010 Sep;138(3):588
Haloperidol for the treatment of nausea and vomiting in palliativecare patients. Nausea and vomiting are common symptoms in patients with terminal, incurable illnesses. Both nausea and vomiting can be distressing. Haloperidol is commonly prescribed to relieve these symptoms. This is an updated version of the original Cochrane review published in Issue 2, 2009, of Haloperidol for the treatment of nausea and vomiting in palliativecare patients.To evaluate the efficacy and adverse events (...) associated with the use of haloperidol for the treatment of nausea and vomiting in palliativecare patients.For this updated review, we performed updated searches of CENTRAL, EMBASE and MEDLINE in November 2013 and in November 2014. We searched controlled trials registers in March 2015 to identify any ongoing or unpublished trials. We imposed no language restrictions. For the original review, we performed database searching in August 2007, including CENTRAL, MEDLINE, EMBASE, CINAHL and AMED, using
Levomepromazine for nausea and vomiting in palliativecare. This is an updated version of the original Cochrane Review published in Issue 4, 2013, on Levomepromazine for nausea and vomiting in palliative care.Nausea and vomiting are common, distressing symptoms for patients receiving palliativecare. There are several drugs which can be used to treat these symptoms, known as antiemetics. Levomepromazine is an antipsychotic drug is commonly used as an antiemetic to alleviate nausea and vomiting (...) in palliativecare settings.To evaluate the efficacy of, and adverse events associated with, levomepromazine for the treatment of nausea and vomiting in palliativecare patients.For this update we searched electronic databases, including those of Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, up to February 2015. We searched clinical trial registers on 7 October 2015 for ongoing trials.Randomised controlled trials of levomepromazine for the treatment of nausea or vomiting
Strategies to promote coping and resilience in oncology and palliativecare nurses caring for adult patients with malignancy: a comprehensive systematic review. Cancer care nursing is perceived as personally and professionally demanding. Developing effective coping skills and resilience has been associated with better health and wellbeing for nurses, work longevity and improved quality of patient care.The objective of this systematic review was to identify personal and organizational strategies (...) that promote coping and resilience in oncology and palliativecare nurses caring for adult patients with malignancy.The search strategy identified published and unpublished studies from 2007 to 2013. Individual search strategies were developed for the 12 databases accessed and search alerts established. The review considered qualitative, quantitative and mixed methods studies that assessed personal or organizational interventions, programs or strategies that promoted coping and resilience. These included
Palliativecare experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol. The objective of this review is to synthesize the best available evidence on palliativecare experiences of adult cancer patients from ethnocultural groups.More specifically, this systematic review seeks to answer the following questions:1. What are the palliativecare experiences of adult cancer patients from diverse ethnocultural groups?2. What meanings do adult patients (...) with cancer from diverse ethnocultural groups assign to their experiences with palliativecare?Globally, over 20.4 million people need palliativecare services annually. The majority of these people (19 million) are adults, with 34% of them being patients diagnosed with cancer. With the current increase in the aging population, especially in developed countries, the number of adults requiring palliativecare is expected to rise. Furthermore, how palliativecare is offered and received continues
PalliativeCare for the Seriously Ill. 26287850 2015 08 25 2018 11 13 1533-4406 373 8 2015 Aug 20 The New England journal of medicine N. Engl. J. Med. PalliativeCare for the Seriously Ill. 747-55 10.1056/NEJMra1404684 Kelley Amy S AS Morrison R Sean RS eng K23 AG040774 AG NIA NIH HHS United States K24 AG022345 AG NIA NIH HHS United States P30 AG028741 AG NIA NIH HHS United States R24 AG044300 AG NIA NIH HHS United States Journal Article Review United States N Engl J Med 0255562 0028-4793 AIM (...) IM N Engl J Med. 2015 Nov 26;373(22):2188-9 26605940 N Engl J Med. 2015 Nov 26;373(22):2188 26605939 Critical Illness psychology therapy Hospice Care Humans Long-Term CarePalliativeCare standards Practice Guidelines as Topic Spirituality United States 2015 8 20 6 0 2015 8 20 6 0 2015 8 26 6 0 ppublish 26287850 10.1056/NEJMra1404684 PMC4671283 NIHMS736777 JAMA. 2004 Jan 7;291(1):88-93 14709580 Natl Vital Stat Rep. 2012 Oct 10;61(6):1-51 24984457 Palliat Med. 2005 Apr;19(3):228-33 15920937 J Pain
Training and supportive programs for palliativecare volunteers in community settings. Palliativecare is specialised health care to support people living with a terminal illness and their families. The involvement of volunteers can extend the range of activities offered by palliativecare services, particularly for those living in the community. Activities undertaken by palliativecare volunteers vary considerably but can be practical, social or emotional in nature. The types of training (...) and support provided to these volunteers are likely to affect the volunteers' effectiveness in their role and influence the quality of care provided to palliativecare clients and their families. Training and support can also have considerable resource implications for palliativecare organisations, which makes it important to know how to provide this training and support as effectively as possible.To assess the effects of training and support strategies for palliativecare volunteers on palliativecare
[Information brief concerning palliativecare day centres] Avis sur les centres de jour en soins palliatifs [Information brief concerning palliativecare day centres] Avis sur les centres de jour en soins palliatifs [Information brief concerning palliativecare day centres] Auclair Y, Hernandez Hurtado E, Fournier M Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made (...) for the HTA database. Citation Auclair Y, Hernandez Hurtado E, Fournier M. Avis sur les centres de jour en soins palliatifs. [Information brief concerning palliativecare day centres] Quebec: Institut national d'excellence en sante et en services sociaux (INESSS). ETMIS 2015; 11(2). 2015 Authors' conclusions Although some evidence suggests that attending a PCDC may be beneficial for patients, the data do not enable determination of: (1) the contribution of PCDCs to management of symptoms or to improvement