Current opinion in supportive and palliative care
-
Awareness of palliative care, including knowledge and skills regarding symptom alleviation via pharmacological and non-pharmacological interventions, is limited in many settings. Lists have been published of recommended drugs for palliative care that include medications for different disease stages, using different modes of administration. ⋯ Recommendations for the most appropriate drugs which should be available for the care of dying patients in all settings is suggested to have potential to improve quality of care through increasing the confidence of physicians and nurses, being costeffective, decreasing the need for hospital admissions, and most of all - reducing suffering. Education and training at all levels, as well as further policy work through expert recommendations, care pathways, and media attention, are needed.
-
Curr Opin Support Palliat Care · Sep 2012
ReviewIs there a role for parenteral nutrition or hydration at the end of life?
This review aims to update healthcare providers on the role of parenteral nutrition/hydration in terminal patients and highlight recent research. ⋯ Hydration and nutrition are essential for the maintenance of life. In patients at the end of life, artificial hydration and nutrition pose clinical, ethical, and logistical dilemmas. No strong evidence exists supporting the use of parenteral hydration/nutrition for the majority of terminally ill patients; however, a subset of patients may derive some benefit. Uncertainty about determining prognosis, psychosocial factors, and perceptions of perceived benefits results in artificial nutrition/hydration being initiated in terminally ill patients. Discontinuation of artificial support can result in distress for patients, family members, and healthcare providers.
-
Curr Opin Support Palliat Care · Sep 2012
ReviewEnd-of-life care in rural areas: what is different?
This review explores global developments in palliative care provision in rural settings, since 2010. It highlights models of rural palliative care provision including challenges faced in establishing services and draws upon examples from around the world. ⋯ Although culture and geography will change, challenges to providing palliative care in rural settings appear to be almost universal. Lessons learnt from developing palliative care in rural communities can be shared and applied in different areas. Caution is raised in transplanting urban models to rural settings, thus emphasizing learning from other rural settings to provide accessible and appropriate palliative care.
-
Curr Opin Support Palliat Care · Sep 2012
ReviewThe challenge of international consensus: defining an opioid essential prescription package.
To describe a new strategy that aimed to facilitate opioid prescription for better pain management. ⋯ The opioid essential prescription package was an international project designed to ensure that opioids are better tolerated by reducing the adverse effects of opioids, which could lead to more sustained improvements in pain management.