Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2023
Differential Use of Outpatient Palliative Care by Demographic and Clinical Characteristics.
Little is known about equity in utilization of outpatient palliative care (PC). ⋯ We found that Black and Latinx patients were less likely to complete an initial visit and those with a preferred language other than English were less likely to complete a follow-up visit. To promote equity in PC, these differences and their impact on outcomes must be explored.
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J Pain Symptom Manage · Aug 2023
Implementation of Patient Reported Outcomes in Outpatient Palliative Care: From Paper to Computer.
This quality improvement project aimed to transition completion of Edmonton Symptom Assessment System (ESAS) at our supportive care clinic from paper to electronic format. ⋯ Transition to eESAS was a gradual process and was catalyzed by the pandemic.
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J Pain Symptom Manage · Aug 2023
Effect of Training on Physicians' Palliative Care-Related Knowledge and Attitudes in Vietnam.
Palliative care remains largely inaccessible in low- and middle-income countries (LMICs), and efforts to increase access are impeded by lack of training of proven effectiveness for physicians. ⋯ Our basic palliative care course in Vietnam resulted in significant and enduring improvements among physicians in palliative care-related knowledge, attitudes, and self-assessed competence. To respond to the enormous unmet need for palliative care in LMICs, primary care providers and physician-specialists in many fields, among others, should receive palliative care training of proven effectiveness, receive ongoing mentoring or refresher training, and be given the responsibility and opportunity to practice what they learn.
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J Pain Symptom Manage · Aug 2023
The Use of Templates for Documenting Advance Care Planning Conversations: A Descriptive Analysis.
While professional societies and expert panels have recommended quality indicators related to advance care planning (ACP) documentation, including using structured documentation templates, it is unclear how clinicians document these conversations. ⋯ This study provides a preliminary exploration of ACP documentation and found that templates may influence what information is documented after an ACP conversation.
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J Pain Symptom Manage · Aug 2023
Should palliative care teams be involved in medical assisted dying?
Palliative care teams offer holistic care for patients experiencing serious illness and related suffering, nevertheless, there are times when clinicians are asked by patients for help to obtain assisted dying. Patients in a growing number of areas may be eligible to request medically administered or self-administered lethal medications to control the timing of death and palliative care practices, established to neither hasten nor postpone death, may be challenged when caring for patients asking for assisted dying. In this "Controversies in Palliative Care" article, we invite three experts to provide a synopsis of the key studies that inform their thought processes, share practical advice on their clinical approach, and highlight the opportunities for future research. ⋯ Research is needed on many aspects of assisted dying and palliative care including improving evidence-based clinical guidelines, addressing the needs of families, and coping strategies for all involved. An international study comparing assisted dying practices within, and outside palliative care may inform policy helping to clarify whether the integration of palliative care in assisted dying improves end-of-life care. In addition to research, it is recommended that researchers and clinicians collaborate on the development of a clinical textbook on assisted dying and palliative care to support all palliative care team members, offering guidelines and recommendations for practice.