Palliative medicine
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Palliative medicine · Jan 2017
Development of a measure (ICECAP-Close Person Measure) through qualitative methods to capture the benefits of end-of-life care to those close to the dying for use in economic evaluation.
End-of-life care affects both the patient and those close to them. Typically, those close to the patient are not considered within economic evaluation, which may lead to the omission of important benefits resulting from end-of-life care. ⋯ This measure is designed to capture the benefits of end-of-life care to close-persons for use in economic evaluation. Further research should value the measure and develop methods for incorporating outcomes for close-persons into economic evaluation.
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Palliative medicine · Jan 2017
Turning waste medicines to cost savings: A pilot study on the feasibility of medication recycling as a solution to drug wastage.
Unused medicines represent a major source of wastage in healthcare systems around the world. Previous studies have suggested the potential cost savings from recycling the waste medicines. However, issues of product safety and integrity often deter healthcare institutions from recycling donated medications. ⋯ Most donated medications were reusable. The current protocol can be further streamlined to focus on the more reusable donor sources and drug classes and validated in other settings. Overall, we opine that it is feasible to practise medication recycling on a larger scale to reduce medication wastage.
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Palliative medicine · Jan 2017
Differences in out-of-pocket costs of healthcare in the last year of life of older people in 13 European countries.
Research on the costs of healthcare provision has so far focused on insurer costs rather than out-of-pocket costs. Out-of-pocket costs may be important to patients making medical decisions. ⋯ Variation in out-of-pocket costs for healthcare in the last year of life between European countries indicates that countries face different challenges in making healthcare in the last year of life affordable for all.
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Palliative medicine · Jan 2017
Tidying rooms and tending hearts: An explorative, mixed-methods study of hospital cleaning staff's experiences with seriously ill and dying patients.
Palliative care is based on multi-professional team work. In this study, we investigated how cleaning staff communicate and interact with seriously ill and dying patients as well as how cleaning staff cope with the situation of death and dying. ⋯ Cleaning staff perceive that they have an important role in the clinic-not only cleaning but also supporting patients. Likewise, patients appreciate being able to speak openly with cleaning staff. Still, it appears that cleaning staff may benefit from additional training in communication about sensitive issues such as illness and death.
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Palliative medicine · Jan 2017
Palliative lumboperitoneal shunt for leptomeningeal metastasis-related hydrocephalus: A case series.
Leptomeningeal metastasis-related hydrocephalus causes distress to patients with end-stage cancer through headache and other symptoms by elevating intracranial pressure, thus reducing quality of life. Ventriculoperitoneal shunt has been used as a treatment option in palliative care. We review four cases of patients who underwent lumboperitoneal shunt for leptomeningeal metastasis-related hydrocephalus. ⋯ Lumboperitoneal shunt appears to improve quality of life if the patient is suffering from symptoms of leptomeningeal metastasis-related hydrocephalus. Compared to ventriculoperitoneal shunt, lumboperitoneal shunt is less invasive and simpler, providing a suitable option for frail patients with end-stage cancer. Adjustable pressure shunt valves can cope with varying symptoms and ventricle sizes.