Palliative medicine
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Palliative medicine · Apr 2021
Clinical TrialDexmedetomidine for hyperactive delirium at the end of life: An open-label single arm pilot study with dose escalation in adult patients admitted to an inpatient palliative care unit.
Terminal delirium, specifically the hyperactive delirium subtype at the end of life, is common in palliative care patients. Standard care often involves sedation to alleviate distress. The alpha2-adrenoreceptor agonist dexmedetomidine may have promise in terminal delirium, due to its properties of decreasing delirium and permitting rousable sedation. ⋯ Dexmedetomidine shows potential for the management of terminal delirium with improved interactivity. Further research is needed to determine efficacy compared to current standard care.
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Palliative medicine · Apr 2021
An evaluation of the experiences of young people in Patient and Public Involvement for palliative care research.
The active involvement of patients and the public in the design and conduct of research (Patient and Public Involvement) is important to add relevance and context. There are particular considerations for involving children and young people in research in potentially sensitive and emotional subject areas such as palliative care. ⋯ Young people want to be involved in palliative care research, and recognise its importance. A continuous relationship with the researcher throughout the study, with clear demonstration of the impact that their input has on the research plans, are important.
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Palliative medicine · Apr 2021
ReviewFatigue in advanced disease associated with palliative care: A systematic review of non-pharmacological treatments.
Fatigue is a common complaint reported by patients with advanced disease, impacting their daily activities and quality of life. The pathophysiology is incompletely understood, and evidence-based treatment approaches are needed. ⋯ Physical exercise should be considered as a measure to reduce fatigue in patients with advanced cancer, but data on other advanced diseases is lacking. Due to the differences between studies, no clear recommendations can be made with respect to the best type of physical therapy. Restoration exercise and psycho-educational therapy are promising treatment options, although further research is needed.
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Palliative medicine · Apr 2021
The monetary valuation of informal care to cancer decedents at end-of-life: Evidence from a national census survey.
Carers' end-of-life caregiving greatly benefits society but little is known about the monetary value of this care. ⋯ The monetary valuation we produce for carers' work is substantial, for example the weekly UK Carers' Allowance only amounts to 7% of our estimated value of £948.86 per week. Our research provides further information on subgroup variation, and a valid carer time instrument and method to inform economic evaluation and policy.
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Palliative medicine · Apr 2021
A systematic review of quality improvement initiatives for continuous sedation until death.
Extensive debate surrounds the practice of continuous sedation until death within end-of-life care. ⋯ The reviewed initiatives may contribute to improvement of continuous sedation until death, though their evidence base is rather limited. More insight is needed into their feasibility, preconditions for effective implementation and impact in actual practice.