Palliative medicine
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Palliative medicine · Sep 2018
Randomized Controlled TrialClinician-reported changes in octreotide prescribing for malignant bowel obstruction as a result of an adequately powered phase III study: A transnational, online survey.
Translating research evidence into clinical practice often has a long lag time. ⋯ Clinician-reported change in practice in the survey is seen in the majority of respondents. This suggests that there is a cohort of 'early adopters' within palliative care practice as new evidence becomes available.
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Palliative medicine · Sep 2018
Duration and determinants of hospice-based specialist palliative care: A national retrospective cohort study.
Understanding service provision for patients with advanced disease is a research priority, with a need to identify barriers that limit widespread integration of palliative care. ⋯ Despite increasing rhetoric around early referral, patients with advanced disease are receiving referrals to hospice specialist palliative care very late in their illness trajectory. Age and diagnosis persist as determinants of duration of hospice specialist palliative care before death.
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Palliative medicine · Sep 2018
Patient empowerment, what does it mean for adults in the advanced stages of a life-limiting illness: A systematic review using critical interpretive synthesis.
Patient empowerment, defined as 'a process through which people gain greater control over decisions and actions affecting their health' (World Health Organization) is a key theme within global health and social care strategies. The benefits of incorporating empowerment strategies in care are well documented, but little is known about their application or impact for patients with advanced, life-limiting illness(s). ⋯ There are features of empowerment, for patients with advanced life-limiting illness distinct to those of other patient groups. Greater efforts should be made to progress the empowerment of patients nearing the end of their lives. We propose that the identified themes may provide a useful starting point to guide the assessment of existing or planned services and inform future research.
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Palliative medicine · Sep 2018
Reducing costs at the end of life through provider incentives for hospice care: A retrospective cohort study.
Costs of medical care have been found to be highest at the end of life. ⋯ By expanding hospice care benefits through a provider reimbursement policy, significant costs at the end of life were saved.
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Palliative medicine · Sep 2018
Medication management for community palliative care patients and the role of a specialist palliative care pharmacist: A qualitative exploration of consumer and health care professional perspectives.
Pharmacists have a key role to play in optimisation of medication regimens and promotion of medication safety. The role of specialist pharmacists as part of the multidisciplinary palliative care team, especially in the primary care setting, is not widely recognised. ⋯ While community-based palliative care is an essential aspect of meeting the health care demands of an ageing society, the current model has several gaps and limitations. An appropriately qualified and skilled pharmacist within the palliative care team may help to address some of the gaps in relation to medication access and appropriateness.