Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2013
Randomized Controlled TrialDelivery strategies to optimize resource utilization and performance status for patients with advanced life-limiting illness: results from the "palliative care trial" [ISRCTN 81117481].
Evidence-based approaches are needed to improve the delivery of specialized palliative care. ⋯ A single case conference added to current specialized community-based palliative care reduced hospitalizations and better maintained performance status. Comparatively, patient/caregiver education was less effective; GP education was not effective.
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J Pain Symptom Manage · Feb 2013
Randomized Controlled TrialArmodafinil for sarcoidosis-associated fatigue: a double-blind, placebo-controlled, crossover trial.
Fatigue has been identified in more than one-half of patients with sarcoidosis. Although fatigue is not synonymous with impaired quality of life, most studies of sarcoidosis identify fatigue as a major cause of impaired quality of life. ⋯ Armodafinil treatment led to a significant reduction in fatigue in sarcoidosis patients. This effect was seen even in patients who did not have excessive daytime somnolence.
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J Pain Symptom Manage · Feb 2013
Randomized Controlled TrialDevelopment of fatigue in cancer survivors: a prospective follow-up study from diagnosis into the year after treatment.
There is a lack of longitudinal studies investigating fatigue from before cancer treatment to long after successful cancer treatment. ⋯ Twenty-two percent of the survivors had severe persistent fatigue in the year after cancer treatment. Fatigue and cognitive behavioral factors predicted persistent fatigue in the year after cancer treatment. Diagnosis or cancer treatment did not predict persistent fatigue. The implication is that cognitive behavioral therapy for postcancer fatigue, aimed at the fatigue-perpetuating factors, could be offered from two months after successful cancer treatment.
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J Pain Symptom Manage · Jan 2013
Randomized Controlled TrialRandomized, double-blind, placebo-controlled trial of oral docusate in the management of constipation in hospice patients.
The stool softener docusate is widely used in the management of constipation in hospice patients. There is little experimental evidence to support this practice, and no randomized trials have been conducted in the hospice setting. ⋯ There was no significant benefit of docusate plus sennosides compared with placebo plus sennosides in managing constipation in hospice patients. Docusate use should be considered on an individual basis.
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J Pain Symptom Manage · Jan 2013
Randomized Controlled TrialRandomized double-blind trial of sublingual atropine vs. placebo for the management of death rattle.
Noisy breathing because of respiratory tract secretions (RTS), often referred to as "death rattle," occurs in up to half of all dying patients. Despite a lack of evidence showing benefit compared with placebo, antimuscarinic medications have been used in an attempt to decrease noise associated with RTS and to decrease family distress. ⋯ Sublingual atropine given as a single dose was not more effective than placebo in reducing the noise associated with death rattle.