Palliative medicine
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Palliative medicine · Jul 2018
Laycarers can confidently prepare and administer subcutaneous injections for palliative care patients at home: A randomized controlled trial.
Palliative care patients consistently nominate home as their preferred care environment. This is challenging without support from laycarers, especially if patients require subcutaneously administered symptom relief. Laycarers typically lack confidence with this task and request professional guidance. ⋯ Upskilled laycarers can confidently administer subcutaneous injections for loved ones, regardless of who prepares injections. This finding can improve patient outcomes and potentially decrease unwanted admissions to inpatient facilities.
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Palliative medicine · Jul 2018
In silico (computed) modelling of doses and dosing regimens associated with morphine levels above international legal driving limits.
Morphine can cause central nervous system side effects which impair driving skills. The legal blood morphine concentration limit for driving is 20 µg/L in France/Poland/Netherlands and 80 µg/L in England/Wales. There is no guidance as to the morphine dose leading to this concentration. ⋯ This novel study provides predictions of the in silico (computed) dose-concentration relationship for international application. Individualised morphine prescribing decisions by clinicians must be informed by clinical judgement considering the individual patient's level of impairment and insight irrespective of the blood morphine concentration as people who have impaired driving will be breaking the law. Taking into account expected morphine concentrations enables improved individualised decision making.
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Palliative medicine · Jul 2018
Differences between early and late involvement of palliative home care in oncology care: A focus group study with palliative home care teams.
To date, no randomised controlled trials on the integration of specialised palliative home care into oncology care have been identified. Information on whether existing models of integrated care are applicable to the home care system and how working procedures and skills of the palliative care teams might require adaptation is missing. ⋯ Being involved earlier leads to different tasks and working procedures and to the need for transmural collaboration. Future research might focus on the development of an intervention model for the early integration of palliative home care into oncology care. To develop this model, components of existing models might need to be adapted or extended.
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10th World Research Congress of the European Association for Palliative Care (EAPC). Palliative Medicine, May 2018 32:1_suppl 3-330, doi: 10.1177/0269216318769196.