Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2019
Novel Data Linkages to Characterize Palliative and End-of-Life Care: Challenges and Considerations.
Working groups have called for linkages of existing and diverse databases to improve quality measurement in palliative and end-of-life (EOL) care, but limited data are available on the challenges of using different data sources to measure such care. ⋯ We found substantial variation between EHR and claims for EOL health-care use. Reliance on EHR will miss some health-care use, while claims will not capture the complex clinical details in EHR that can help define the quality of palliative care and EOL health-care utilization.
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J Pain Symptom Manage · Nov 2019
Patient-reported symptoms improve performance of risk prediction models for ED visits among patients with cancer: a population-wide study in Ontario using administrative data.
Prior work shows measurements of symptom severity using the Edmonton Symptom Assessment System (ESAS) which are associated with emergency department (ED) visits in patients with cancer; however, it is not known if symptom severity improves the ability to predict ED visits. ⋯ This study demonstrates the importance of incorporating symptom measurements when developing an ED visit risk calculator for patients with cancer. Improved predictive models for ED visits using measurements of symptom severity may serve as an important clinical tool to prompt timely interventions by the cancer care team before an ED visit is necessary.
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J Pain Symptom Manage · Nov 2019
Co-occurring Gastrointestinal Symptoms Are Associated with Taste Changes in Oncology Patients Receiving Chemotherapy.
Over 80% of patients with cancer report taste changes. Despite the high prevalence of this symptom and its negative effects on health, few studies have assessed its association with other gastrointestinal (GI) symptoms. ⋯ This study provides new evidence on the frequency, severity, and distress of CFT in oncology patients undergoing chemotherapy. These findings suggest that CFT is an important problem that warrants ongoing assessments and nutritional interventions.
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J Pain Symptom Manage · Nov 2019
Challenges and Priorities for Pediatric Palliative Care Research in the United States and Similar Practice Settings: Report from a Pediatric Palliative Care Research Network Workshop.
To dramatically advance the evidence base for pediatric palliative care (PPC) interventions, practices, and programs in the U.S. and similar practice settings, the field needs to better understand the challenges and opportunities for rigorous scholarship. ⋯ These challenges and priorities identify key research areas that can guide individual investigators and research funders to advance the field.
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J Pain Symptom Manage · Nov 2019
Barriers to accessing internationally controlled essential medicines in Uganda: A qualitative study.
Access to internationally controlled essential medicines is a problem worldwide. More than five billion people cannot access opioids for pain and palliative care or do not have access to surgical care or anesthetics, 25 million people living with epilepsy do not have access to their medicines, and 120,000 women die annually owing to postpartum hemorrhage. In Uganda, access to controlled medicines is also problematic, but a lack of data on factors that influence access exists. ⋯ The findings of this research indicate that to improve access to internationally controlled essential medicines in Uganda, health system strengthening is needed on multiple fronts. Active engagement and concerted efforts are needed from all stakeholders to ensure access and prevent abuse.