Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2024
ReviewThe Impact of Advance Care Planning on Healthcare Professionals' Well-being: A Systematic Review.
Advance care planning (ACP) improves care for patients with chronic illnesses and reduces family stress. However, the impact of ACP interventions on healthcare professionals' well-being remains unknown. ⋯ This review is the first to explore the impact of ACP interventions on healthcare professionals' well-being. ACP interventions appear to have a positive impact, but high-quality studies are scarce. Further research is needed, particularly using more rigorous and systematic methods to implement interventions and report results.
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J Pain Symptom Manage · Feb 2024
Case ReportsRoutine Monitoring of QTc Interval as a Barrier for Efficient Use of Methadone in Palliative Care.
Methadone is a commonly prescribed opioid amongst cancer patients. It has unique pharmacological properties which can benefit in treating complex pain syndromes and neuropathic pain. However, strict guidelines have been created in a generalized manner for chronic pain and long-term survival patients. These guidelines, such as QT interval monitoring can lead to limitations for methadone use in patients with comfort-associated goals. We present two cases of patients with metastatic cancer who were treated for pain with methadone and had to undergo opioid rotation due to abnormal QT intervals. ⋯ In the palliative care setting, monitoring QTc per chronic pain guidelines may lead to uncontrolled pain and a significant impact on quality of life.
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J Pain Symptom Manage · Feb 2024
Transdermal rotigotine at end-of-life for Parkinson's disease: association with measures of distress.
End-of-life (EOL) care for Parkinson's disease (PD) can be challenging when oral medications are no longer tolerated. ⋯ Rotigotine dose and admission LEDD were both associated with proxy measures of distress in the last 72 hours of life. This suggests cautious use of rotigotine at EOL. LEDD may help identify patients at risk of distress. Rates of inappropriate prescribing and symptom prevalence were high, indicating a need for further staff education to optimize the care of PWP.