Journal of pain and symptom management
-
J Pain Symptom Manage · Nov 2022
ReviewSubcutaneous drugs and off-label use in hospice and palliative care: a scoping review.
Subcutaneous drug administration is an interesting approach for symptom control in hospice and palliative care. However, most drugs have no marketing authorization for subcutaneous administration and are therefore used off-label. In order to meet the requirements of a safe and effective drug therapy, especially in highly vulnerable patients, it is essential to investigate the scope of evidence of these common practices. ⋯ This work provides an overview of current evidence on subcutaneous and off-label used drugs in hospice and palliative care. Although both are common practices, evidence on tolerability and effectiveness, particularly pharmacokinetic data, is limited and the identified information gaps need to be closed. This work establishes a basis for further research in this area.
-
J Pain Symptom Manage · Nov 2022
Review Meta AnalysisCannabis in palliative care: a systematic review of current evidence.
Palliative care aims to improve the quality of life in patients with incurable illness. Medicinal cannabis (MC) has been used in the palliative care setting to address multiple symptoms in patients. ⋯ While positive treatment effects have been reported for some MC products in the palliative care setting, further high quality evidence is needed to support recommendations for its use in clinical practice.
-
J Pain Symptom Manage · Nov 2022
Pediatric and adult cardiologists' and respirologists' referral practices to palliative care.
Children and adults with advanced cardiac or respiratory disease may benefit from specialized palliative care (SPC), but there has been little SPC research in this area. ⋯ There are important differences between pediatric and adult clinicians' beliefs about and referral practices to SPC. This may reflect unique features of pediatric diseases, provider characteristics, care philosophies, or service availability.
-
J Pain Symptom Manage · Nov 2022
Care Intensity and Palliative Care in Chronically Critically Ill Infants.
Increasingly, chronically critically ill (CCI) infants survive to discharge from Neonatal Intensive Care Units (NICUs). Little is known about their care intensity and the primary and specialty palliative care families receive at and following discharge. ⋯ CCI infants receive intensive medical care including multiple medical technologies, medications, and specialty follow up at discharge and remain complex at one year of life. Most receive primary interprofessional palliative care in the NICU, however these infants and their families may have limited access to specialty palliative care in the short- and long-term.
-
J Pain Symptom Manage · Nov 2022
"I Don't Do Religion": Using Nature Photographs to Engage Patients in Spiritual Reflection.
When caring for healthcare patients, professional chaplains may find an increasing proportion of individuals in the U. S. who do not identify as religious and who may benefit from creative approaches to discussing their spiritual and existential concerns. One approach to engaging patients is using a "third voice," as shared in a personal narrative in which a chaplain uses landscape photographs to engage a patient for discussion of spiritual and existential concerns. The content of the conversation may inform decisions about treatment, quality of life, and person-centered care.