Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2021
Multicenter Study Observational StudyHow successful is parenteral oxycodone for relieving terminal cancer dyspnea compared with morphine? A multicenter prospective observational study.
Parenteral morphine is widely used for dyspnea of imminently dying cancer patients (terminal dyspnea). However, the efficacy of other opioids such as oxycodone remains largely unknown. ⋯ Parenteral oxycodone may be equally effective and safe as morphine in the treatment of terminal dyspnea in cancer patients. Future randomized controlled trials should confirm the efficacy and safety of opioids other than morphine for terminal dyspnea.
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J Pain Symptom Manage · May 2021
Multicenter StudyMulticenter Evaluation of 434 Hospital Deaths from COVID-19. How can we improve End-of-Life Care during a Pandemic?
The pandemic has substantially increased the workload of hospital palliative care providers, requiring them to be responsive and innovative despite limited information on the specific end of life care needs of patients with COVID-19. Multi-site data detailing clinical characteristics of patient deaths from large populations, managed by specialist and generalist palliative care providers are lacking. ⋯ This large multicenter study comprehensively describes COVID-19 deaths throughout the hospital setting. Clinicians are alert to and diagnose dying appropriately in most patients. Outcomes could be improved by advance care planning to establish preferences, including whether hospital admission is desirable, and alongside this, support the prompt use of anticipatory subcutaneous medications and syringe drivers if needed. Finally, rapid discharges and direct hospice admissions could better utilize hospice beds and improve care.
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J Pain Symptom Manage · Mar 2021
Multicenter StudyHow we can improve the quality of care for patients requesting medical assistance in dying: a qualitative study of health care providers.
Since Canada decriminalized medical assistance in dying (MAID) in 2015, clinicians and organizations have developed policies and protocols to implement assisted dying in clinical practice. Five years on, there is little consensus as to what constitutes high-quality care in MAID. ⋯ Canadian health care providers described unique challenges in caring for patients who request MAID, along with practices to improve the quality of care.
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J Pain Symptom Manage · Feb 2021
Randomized Controlled Trial Multicenter StudyA Question Prompt List for advanced cancer patients promoting advance care planning: a French randomised trial.
Advance care planning is essential to enable informed medical decisions to be made and to reduce aggressiveness in end-of-life (EOL) care. ⋯ Questions on PC and EOL issues in outpatient PC consultations were more frequent, and patient satisfaction was better when a QPL was made available before the consultation.
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J Pain Symptom Manage · Jan 2021
Randomized Controlled Trial Multicenter StudyThe effect of disclosing life expectancy information on patients' prognostic understanding: secondary outcomes from a multicenter randomized trial of a palliative chemotherapy educational intervention.
Many advanced patients with cancer have unrealistic prognostic expectations. ⋯ Offering LE information within a PC educational intervention had no effect on patients' prognostic expectations.