Current opinion in supportive and palliative care
-
Curr Opin Support Palliat Care · Mar 2013
ReviewIdentifying treatment burden as an important concept for end of life care in those with advanced heart failure.
The concept of treatment burden is receiving increasing attention and this review seeks to show that treatment burden is an important issue for end-of-life care in those with advanced heart failure. ⋯ Treatment burden has the potential to be an important barometer of quality of care from the patient perspective in advanced heart failure.
-
Curr Opin Support Palliat Care · Mar 2013
ReviewMalignant wound management in advanced illness: new insights.
This article describes why this review is timely and relevant. To report on the recent research, which advances our understanding and practice of palliative wound care (wound-related pain and symptom management or wound palliation). ⋯ This article describes the implications of the findings for clinical practice or research. The findings of the wound malodour survey indicate that approaches to managing malodour are wide ranging, but ineffective. Collaborate research and development is needed with industry into interventions to combat malodour, which are based on the causal agents. The growing evidence of the effectiveness of electrochemotherapy, as an uncomplicated palliative treatment and method of managing symptoms, offers palliative care clinicians a means of managing the otherwise relentless progression of cutaneous malignancy.
-
Curr Opin Support Palliat Care · Mar 2013
ReviewEvidence-based approach to manage persistent wound-related pain.
Pain is a significant concern in people with chronic wounds. A systematized approach is recommended for the management of wound-associated pain with the objectives to address pain relief, increase function, and restore overall quality of life. ⋯ Pain is a complex biopsychosocial phenomenon that requires multiple pharmacological and nonpharmacological management approach.
-
Curr Opin Support Palliat Care · Mar 2013
ReviewEnd-of-life care in adults with congenital heart disease: now is the time to act.
There are increasing numbers of adults with congenital heart disease (CHD) and these patients remain at long-term risk of complications and premature death. This review focuses on the changing picture of adult CHD with more complex patients surviving, the challenges of balancing life-prolonging intervention, the barriers to discussing the end-of-life (EOL) issues and draws on the experience of other specialities in managing young patients. ⋯ These patients require an early and proactive approach to EOL discussions, and the unique needs of young patients should be recognized. Further research is needed to develop local and national guidelines for the palliative care approach in these patients.
-
Curr Opin Support Palliat Care · Mar 2013
ReviewThe management of wound-related procedural pain (volitional incident pain) in advanced illness.
The prevention and treatment of wound-related procedural pain is one of the greatest areas of unmet need within wound management. Also referred to as 'Volitional Incident Pain', it is the most prevalent subtype of breakthrough pain experienced by patients afflicted with wounds. Novel formulations of existing analgesics are now available to address this challenge. ⋯ Novel formulations of fentanyl citrate, delivered through an array of noninvasive routes, allow for rapid-onset and short-acting effects that better match the onset and duration of wound-related procedural pain.