Journal of pain and symptom management
-
J Pain Symptom Manage · Jun 2022
Evolution of Investigating Informed Assent Discussions about CPR in Seriously Ill Patients.
Outcomes after cardiopulmonary resuscitation (CPR) remain poor. We have spent 10 years investigating an "informed assent" (IA) approach to discussing CPR with chronically ill patients/families. IA is a discussion framework whereby patients extremely unlikely to benefit from CPR are informed that unless they disagree, CPR will not be performed because it will not help achieve their goals, thus removing the burden of decision-making from the patient/family, while they retain an opportunity to disagree. ⋯ IA is a feasible and reasonable approach to CPR discussions in selected patient populations.
-
J Pain Symptom Manage · Jun 2022
HAprog: a new prognostic application to assist oncologists in routine care.
More patients are seeing palliative care (PC) earlier in the disease trajectory. The Barretos Prognostic Nomogram (BPN) was designed to fill the gap of survival prognostication for patients with advanced cancer and months of life expectancy. However, its routine use is limited by the common need for a ruler and calculator. Additionally, the BPN requires blood tests. ⋯ The new models that integrate HAprog are refined prognostic tools with adequate calibration and discrimination properties. It has potential practical impact for the oncologist dealing with outpatients with advanced cancer during the decision-making process.
-
J Pain Symptom Manage · Jun 2022
Behaviours of patients who take their strong opioids as unmeasured 'sips'.
Some patients take their strong opioid painkillers as unmeasured sips. ⋯ This is the first published study exploring the behavior of patients who take their strong analgesia as unmeasured sips. Knowing that patients who sip are likely to be taking an incorrect dose, and the reasons behind sipping may help clinicians to help these patients to manage their pain better.