Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2023
Project EPIC (Early Palliative Care In COPD): A Multiphase Evaluation of the EPIC Telehealth Intervention.
Early, concurrent palliative care interventions in chronic obstructive pulmonary disease (COPD) are limited. Project EPIC (Early Palliative Care In COPD) is a multiphase mixed methods study working to fill this gap. ⋯ EPIC was acceptable and feasible in patients with COPD and their family caregivers. Larger feasibility and effectiveness trials are warranted.
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J Pain Symptom Manage · Apr 2023
Standard Naloxone Prescribing for Palliative Care Cancer Patients on Opioid Therapy: A Single-Site Quality Improvement Pilot to Assess Attitudes and Access.
Limited data exist on when to offer naloxone to cancer patients on opioid therapy. ⋯ Opioid safety education and naloxone prescribing can be done quickly and is well-received by clinicians and patients.
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J Pain Symptom Manage · Apr 2023
Racial Disparities in Health Beliefs and Advance Care Planning Among Patients Receiving Maintenance Dialysis.
Among people receiving maintenance dialysis, little is known about racial disparities in the occurrence of prognostic discussions, beliefs about future health, and completion of advance care planning (ACP) documents. ⋯ We found no significant difference in the frequency of prognostic discussions between Black (11.9%) versus White patients (7%) (P=0.15). However, Black patients (19%) had lower odds of believing that their health would worsen over the next 12 months (OR 0.22, CI 0.12, 0.44) and reporting completion of any ACP-related document (OR 0.5, CI 0.32, 0.81) compared to White patients CONCLUSION: Racial differences exist in beliefs about future health and completion of ACP-related documents. Systemic efforts to investigate differences in health beliefs and address racial disparities in the completion of ACP-related documents are needed.
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J Pain Symptom Manage · Apr 2023
Hospital Opioid Usage and Adverse Events in Patients with End-Stage Liver Disease.
Patients with end-stage liver disease (ESLD) commonly experience pain and other symptoms that result in a poor quality of life. Few studies have examined opioid usage, adverse events (AEs), and other outcomes in ESLD patients receiving opioid analgesia. ⋯ Opioid administration was not an independent risk factor for the number of AEs in hospitalized patients with ESLD, whereas anxiety and more liver-related complications increased AE risk. Our findings suggest that opioids have an appropriate and reasonably safe role in alleviation of pain in patients with ESLD.
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J Pain Symptom Manage · Apr 2023
"It's Not Us Versus Them": Building Cross-Disciplinary Relationships in the Perioperative Period.
Palliative care (PC) interventions improve quality outcomes for surgical patients, yet they are underutilized in the perioperative period. Developing cross-disciplinary provider relationships increases PC consults. However, the attributes of collaborative relationships and how they evolve are unclear. ⋯ The study informs future interventions to improve the quality of care for seriously ill patients by better-involving PC in the perioperative period. Future work will extend this approach to incorporate the perspectives of patients on their providers' collaboration and how it impacts patient-related outcomes at the intersection of PC and surgery.