Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2023
Should Neuroleptics Be Used in Patients With Delirium Seen by Palliative Care?
Delirium commonly occurs in the palliative care setting and impacts many aspects of patient care, such as symptom assessment, patient-clinician communication, and medical decision-making. One controversial topic regarding the management of delirium in the palliative care setting is whether neuroleptics should be used. In this "Controversies in Palliative Care" article, 3 expert clinicians independently answer this question. ⋯ They also agreed that neuroleptics should be considered for patients with hyperactive or mixed delirium when the conservative measures fail to control delirium symptoms and for delirious patients with days of life expectancy and thus limited time to try other measures. Risk of adverse effects such as extrapyramidal symptoms and seizures should be considered as part of the treatment decision. There is also a need to conduct high quality research to examine both neuroleptics and neuroleptic-sparing strategies for the management of delirium.
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This series focuses on addressing the intersection of race and racism in palliative care through roundtable discussions with interdisciplinary clinicians, researchers, educators, and leaders in palliative care. These short discussions are intended to stimulate readers to examine issues of race and racism within the field of hospice and palliative care - in the various forms that it appears - as well as serve as a continual call to action to facilitate and promote equity.
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J Pain Symptom Manage · Jan 2023
Operationalizing Depression Screening in Ambulatory Palliative Care: A Quality Improvement Project.
Depression is common in the palliative care setting and impacts outcomes. Operationalized screening is unusual in palliative care. ⋯ Operationalized depression screening is feasible in ambulatory palliative care workflow, though optimization through having screening be completed prior to clinician visit might improve uptake.
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J Pain Symptom Manage · Jan 2023
A Visual Tool to Help Develop a Statistical Analysis Plan for Randomized Trials in Palliative Care.
Collaboration with a statistician about the design of a statistical analysis plan can be enhanced by illustrating how statisticians conceptualize their task. This conceptualization can be represented by a directed acyclic graph (DAG), which illustrates the statistician's approach and also provides an actionable tool to assist in the development of the plan.