Journal of pain and symptom management
-
J Pain Symptom Manage · Apr 2020
Mapping levels of palliative care development in 198 countries: the situation in 2017.
Palliative care is gaining ground globally and is endorsed in high-level policy commitments, but service provision, supporting policies, education, and funding are incommensurate with rapidly growing needs. ⋯ Palliative care at the highest level of provision is available for only 14% of the global population and is concentrated in European countries. An 87% global increase in serious health-related suffering amenable to palliative care interventions is predicted by 2060. With an increasing need, palliative care is not reaching the levels required by at least half of the global population.
-
Therapeutic Reviews aim to provide essential independent information for health professionals about drugs used in palliative and hospice care. Additional content is available via www.palliativedrugs.com. The series editors welcome feedback on the articles.
-
J Pain Symptom Manage · Apr 2020
Randomized Controlled TrialFeasibility of using communication coaching to teach palliative care clinicians Motivational Interviewing.
Palliative care clinicians often have challenging conversations with patients or family caregivers who express ambivalence about goals or feel reluctant to discuss topics. Motivational Interviewing (MI) has tools to address ambivalence and reluctance. ⋯ This pilot study indicates that coaching palliative care clinicians is feasible and shows promise that coaching can improve palliative care clinician communication.
-
J Pain Symptom Manage · Apr 2020
Improving Advance Care Planning in Outpatients with Decompensated Cirrhosis: A Pilot Study: Advance Care Planning in Patients with Decompensated Cirrhosis.
Despite significant morbidity and mortality among patients with decompensated cirrhosis, reported rates of advance directive (AD) completion and goals of care discussions (GCDs) between patients and providers are very low. We aimed to improve these rates by implementing a hepatologist-led advance care planning (ACP) intervention. ⋯ Addressing provider and system-specific barriers dramatically improved documentation rates of ACP.
-
J Pain Symptom Manage · Apr 2020
Review Meta AnalysisThe effects of opioids on cognition in older adults with cancer and chronic non-cancer pain: A systematic review.
Opioids are prescribed to manage moderate-to-severe pain and can be used with older adults; however, they may lead to several adverse effects, including cognitive impairment. ⋯ Both improvements and impairments to cognition were observed in studies with higher mean opioid doses. In clinical practice, a brief screening tool assessing attention, language, orientation, psychomotor function, and verbal working/delayed episodic memory may be beneficial to detect worsening cognition in older adults with chronic pain using opioids.