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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 for patients with advanced fibrotic lung disease: a randomised controlled phase II and feasibility trial of a community case conference intervention Those affected by advanced fibrotic interstitial lung diseases (ILDs) have considerable unmet symptom and psychological needs. Case conferencing has been proposed to address these issues, but requires evaluation.To obtain preliminary information on the impact of a case conference intervention delivered in the home (Hospital2Home (...) ) on palliativecare concerns of patients and their carers, and to evaluate feasibility and acceptability.Hospital2Home was trialled at a specialist centre using a Phase II fast-track randomised controlled trial with qualitative interviews. The primary outcome for effect was mean change from baseline of PalliativeCare Outcome Scale (POS) (a measure of symptoms and concerns) at 4 weeks. Secondary outcomes included symptom control, quality of life, consent and recruitment rates and percentage of patients
Pharmacological treatments for fatigue associated with palliativecare. This review updates the original review, 'Pharmacological treatments for fatigue associated with palliativecare' and also incorporates the review 'Drug therapy for the management of cancer-related fatigue'.In healthy individuals, fatigue is a protective response to physical or mental stress, often relieved by rest. By contrast, in palliativecare patients' fatigue can be severely debilitating and is often not counteracted (...) in palliativecare, with a focus on patients at an advanced stage of disease, including patients with cancer and other chronic diseases.For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO and EMBASE, and a selection of cancer journals up to 28 April 2014. We searched the references of identified articles and contacted authors to obtain unreported data. To validate the search strategy we selected sentinel references.We considered randomised controlled
Laxatives for the management of constipation in people receiving palliativecare. This article describes the second update of a Cochrane review on the effectiveness of laxatives for the management of constipation in people receiving palliativecare. Previous versions were published in 2006 and 2010 where we also evaluated trials of methylnaltrexone; these trials have been removed as they are included in another review in press. In these earlier versions, we drew no conclusions on individual (...) effectiveness of different laxatives because of the limited number of evaluations. This is despite constipation being common in palliativecare, generating considerable suffering due to the unpleasant physical symptoms and the availability of a wide range of laxatives with known differences in effect in other populations.To determine the effectiveness and differential efficacy of laxatives used to manage constipation in people receiving palliative care.We searched the Cochrane Central Register of Controlled
Dignity-conserving care in palliativecare settings: An integrative review To report an integrative review of evidence relating to dignity-conserving care in palliativecare settings. It will also suggest avenues for future research.Research suggests that dignity is welcomed by those receiving palliative and end of life care. However, as dignity is a subjective term, it is not always explicit how this may be employed by nurses. Given that the preferred place of care for patients with palliative (...) care needs is the home, the issue of dignity may be particularly important for community nurses. Therefore, synthesising evidence of dignity-conserving care for community nurses caring for people with palliativecare needs provides clarity in a complex area of palliativecare research.Integrative literature review.The review involved key bibliographic and review databases CINAHL, MEDLINE, EMBASE, ASSIA and PsycInfo. Medical Subject Headings and free terms were undertaken for articles published from
Management of Constipation in Adult Patients Receiving PalliativeCare Management of Constipation in Adult Patients Receiving PalliativeCare National Clinical Guideline No. 10 November 2015Guideline Development Group The Management of Constipation in Adult Patients Receiving PalliativeCare Guideline was developed by a subgroup of the Health Service Executive (HSE)/Royal College of Physicians of Ireland (RCPI) National Clinical Programme for PalliativeCare, known as the Guideline Development (...) Group (GDG). The Guideline Development Group was supported by senior multidisciplinary service leads assembled by the National Clinical Programme for PalliativeCare who evaluated the quality of the development process and documentation at key time points. This group was called the Guideline Steering Group. The All Ireland Institute of Hospice and PalliativeCare (AIIHPC) awarded an educational bursary to three members of the Guideline Development Group. The AIIHPC had no editorial influence
Palliativecare needs in patients hospitalized with heart failure (PCHF) study: rationale and design. The primary aim of this study is to provide data to inform the design of a randomized controlled clinical trial (RCT) of a palliativecare (PC) intervention in heart failure (HF). We will identify an appropriate study population with a high prevalence of PC needs defined using quantifiable measures. We will also identify which components a specific and targeted PC intervention in HF should (...) and disease-specific quality of life, mood, symptom burden, caregiver burden, and end of life care. Inpatient assessments will be performed and after discharge outpatient assessments will be carried out every 4 months for up to 2.5 years. Participants will be followed up for a minimum of 1 year for hospital admissions, and place and cause of death. Methods for identifying patients with HF with PC needs will be evaluated, and estimates of healthcare utilisation performed.By assessing the prevalence
Droperidol for treatment of nausea and vomiting in palliativecare patients. This is an updated version of the original Cochrane review published in Issue 10, 2010, on droperidol for the 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 that 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 postoperative 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 (1950-), EMBASE (1980-), CINAHL (1981-) and AMED (1985-), using relevant search terms and synonyms. The basic search strategy
Putting the Heart into PalliativeCare Putting the Heart into PalliativeCare - Evidently Cochrane Search and hit Go By October 10, 2014 // In the last of our special series of guest blogs for Hospice Care Week, GP Richard Lehman considers palliativecare for people with heart failure and the need for good care based on the patient’s goals at the end of life, whatever their mode of dying. Stewart S, MacIntyre K, Hole DJ, Capewell S, McMurray JJ More “malignant” than cancer? Five-year survival (...) following a first admission with heart failure. Eur J Heart Fail 2001;3:315-22 Looking through the PalliativeCare section of the Cochrane Library, you will find a great wealth of reviews, from the very general to the very specific. Almost all of them relate to dying from cancer. Most people, however, die from conditions other than cancer; and conversely most people with cancer do not die from it. The average age of patients in acute medical hospital wards is now 80 or over, and the commonest cause
Implementing patient-reported outcome measures in palliativecare clinical practice: a systematic review of facilitators and barriers 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.
Fentanyl transdermal patches in palliativecare: clinical effectiveness, safety, and guidelines Fentanyl transdermal patches in palliativecare: clinical effectiveness, safety, and guidelines Fentanyl transdermal patches in palliativecare: clinical effectiveness, safety, and guidelines CADTH 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 CADTH. Fentanyl transdermal patches in palliativecare: clinical effectiveness, safety, and guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response - Summary of Abstracts. 2014 Authors' conclusions Two evidence-based guidelines regarding the use of fentanyl transdermal patches for pain relief in palliativecare patients were identified. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Administration, Cutaneous; Fentanyls
Impact of community based, specialist palliativecare teams on hospitalisations and emergency department visits late in life and hospital deaths: a pooled analysis. To determine the pooled effect of exposure to one of 11 specialist palliativecare teams providing services in patients' homes.Pooled analysis of a retrospective cohort study.Ontario, Canada.3109 patients who received care from specialist palliativecare teams in 2009-11 (exposed) matched by propensity score to 3109 patients who (...) received usual care (unexposed).The palliativecare teams studied served different geographies and varied in team composition and size but had the same core team members and role: a core group of palliativecare physicians, nurses, and family physicians who provide integrated palliativecare to patients in their homes. The teams' role was to manage symptoms, provide education and care, coordinate services, and be available without interruption regardless of time or day.Patients (a) being in hospital
Fentanyl Transdermal Patches in PalliativeCare: Clinical Effectiveness, Safety, and Guidelines TITLE: Fentanyl Transdermal Patches in PalliativeCare: Clinical Effectiveness, Safety, and Guidelines DATE: 29 May 2014 RESEARCH QUESTIONS 1. What is the clinical effectiveness and safety of fentanyl transdermal patches for pain relief in palliativecare patients? 2. What are the evidence-based guidelines for the use of fentanyl transdermal patches for pain relief in palliativecare patients? KEY (...) MESSAGE Two evidence-based guidelines regarding the use of fentanyl transdermal patches for pain relief in palliativecare patients were identified. METHODS A limited literature search was conducted on key resources including PubMed, The Cochrane Library (2014, Issue 5), University of York Centre for Reviews and Dissemination (CRD) databases, Canadian and major international health technology agencies, as well as a focused Internet search. No methodological filters were applied to limit retrieval
Medically assisted nutrition for adult palliativecare 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. This is an updated version of the original Cochrane review published in Issue 4, 2008.To determine the effect of medically assisted nutrition on the quality and length (...) of life of palliativecare patients.We identified studies from searching Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, CANCERLIT, Caresearch, Dissertation abstracts, SCIENCE CITATION INDEX and the reference lists of all eligible trials, key textbooks and previous systematic reviews. The date of the latest search was 26 March 2014.All relevant randomised controlled trials (RCTs) or prospective controlled trials (if no RCTs were found).We found no RCTs
Benefits and costs of home palliativecare compared with usual care for patients with advanced illness and their family caregivers. Are home palliativecare services associated with benefits to patients with advanced illness and family caregivers, and are they cost-effective?Compared with usual care, home palliativecare is associated with increased odds of dying at home and fewer symptoms for patients with advanced illness. It is not associated with changes in caregiver grief. Cost
Delirium in adult patients receiving palliativecare: a systematic review of the literature. Delirium in palliativecare patients is common and its diagnosis and treatment is a major challenge. Our objective was to perform a literature analysis in two phases on the recent scientific evidence (2007-2012) on the diagnosis and treatment of delirium in adults receiving palliativecare. In phase 1 (descriptive studies and narrative reviews) 133 relevant articles were identified: 73 addressed (...) the issue of delirium secondarily, and 60 articles as the main topic. However, only 4 prospective observational studies in which delirium was central were identified. Of 135 articles analysed in phase 2 (clinical trials or descriptive studies on treatment of delirium in palliativecare patients), only 3 were about prevention or treatment: 2 retrospective studies and one clinical trial on multicomponent prevention in cancer patients. Much of the recent literature is related to reviews on studies
Early palliativecare for patients with advanced cancer: a cluster-randomised controlled trial. Patients with advanced cancer have reduced quality of life, which tends to worsen towards the end of life. We assessed the effect of early palliativecare in patients with advanced cancer on several aspects of quality of life.The study took place at the Princess Margaret Cancer Centre (Toronto, ON, Canada), between Dec 1, 2006, and Feb 28, 2011. 24 medical oncology clinics were cluster randomised (...) (in a 1:1 ratio, using a computer-generated sequence, stratified by clinic size and tumour site [four lung, eight gastrointestinal, four genitourinary, six breast, two gynaecological]), to consultation and follow-up (at least monthly) by a palliativecare team or to standard cancer care. Complete masking of interventions was not possible; however, patients provided written informed consent to participate in their own study group, without being informed of the existence of another group. Eligible
2014LancetControlled trial quality: predicted high