Palliative medicine
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Palliative medicine · Mar 2017
Multicenter StudyAdding items that assess changes in activities of daily living does not improve the predictive accuracy of the Palliative Prognostic Index.
Changes in activities of daily living in cancer patients may predict their survival. The Palliative Prognostic Index is a useful tool to evaluate cancer patients, and adding an item about activities of daily living changes might improve its predictive value. ⋯ Adding items about activities of daily living changes to the Palliative Prognostic Index did not improve prognostic value in advanced cancer patients.
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Palliative medicine · Mar 2017
ReviewUnderstanding patterns and factors associated with place of death in patients with end-stage kidney disease: A retrospective cohort study.
Meeting place-of-death preferences is an important measure of the quality of end-of-life care. Systematic review shows that 42% of end-stage kidney disease patients prefer home death. Little research has been undertaken on place of death. ⋯ Most patients with end-stage kidney disease die in hospital, but patients managed without dialysis are significantly more likely to die outside of hospital. Planning ahead is key to be able to meet preference for place of death.
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Palliative medicine · Mar 2017
Comparative StudyPalliative care delivery across health sectors: A population-level observational study.
Little population-level information exists about the delivery of palliative care across multiple health sectors, important in providing a complete picture of current care and gaps in care. ⋯ We describe methods to capture palliative care using administrative data. Despite an estimate of overall reach (51.9%) that is higher than previous estimates, we have shown that palliative care is infrequently delivered particularly in community settings and to non-cancer patients and occurs close to death.
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Palliative medicine · Mar 2017
Implementing a patient-centred outcome measure in daily routine in a specialist palliative care inpatient hospital unit: An observational study.
Gathering clinical evidence data on patients' palliative care needs is paramount to identify changes in outcomes over time and maintaining on-going quality improvement. Implementation of patient-centred outcome measures has been widely recommended. The routine use of these instruments in daily practice is challenging and not widespread. ⋯ Implementing a patient-centred outcome measure in a hospital palliative care service is feasible and improves quality of care. Controlling high pain at T0 improved (>80%) by T1. Results became more consistent and symptom control was improved overall. Patients are evaluated based on holistic domains by an interdisciplinary team and we have added a much needed measure to help guide improvement of the quality of care provided.