Palliative medicine
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Palliative medicine · Sep 2019
How many older adults receive drugs of questionable clinical benefit near the end of life? A cohort study.
The high burden of disease-oriented drugs among older adults with limited life expectancy raises important questions about the potential futility of care. ⋯ A substantial share of older persons with life-limiting diseases receive drugs of questionable clinical benefit during their last months of life. Adequate training, guidance and resources are needed to rationalize and deprescribe drug treatments for older adults near the end of life.
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Palliative medicine · Sep 2019
The incidence and prevalence of delirium across palliative care settings: A systematic review.
Delirium is a common and distressing neurocognitive condition that frequently affects patients in palliative care settings and is often underdiagnosed. ⋯ Delirium is prevalent across all palliative care settings, with one-third of patients delirious at the time of admission to inpatient palliative care. Study heterogeneity limits meta-analyses and highlights the future need for rigorous studies.
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Palliative medicine · Sep 2019
Family members' experiences of assisted dying: A systematic literature review with thematic synthesis.
Families' experiences of assisted dying are under-investigated and families are rarely considered in clinical guidelines concerning assisted dying. ⋯ Our data confirm that families across all jurisdictions are involved in assisted suicide decision and enactment. Family needs are under-researched, and clinical guidelines should incorporate recommendations about how to consider family needs and how to provide them with evidence-based tailored interventions.
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Palliative medicine · Sep 2019
A brief, patient- and proxy-reported outcome measure in advanced illness: Validity, reliability and responsiveness of the Integrated Palliative care Outcome Scale (IPOS).
Few measures capture the complex symptoms and concerns of those receiving palliative care. ⋯ The Integrated Palliative care Outcome Scale is a valid and reliable outcome measure, both in patient self-report and staff proxy-report versions. It can assess and monitor symptoms and concerns in advanced illness, determine the impact of healthcare interventions, and demonstrate quality of care. This represents a major step forward internationally for palliative care outcome measurement.
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Palliative medicine · Sep 2019
Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence.
Effective communication between healthcare professionals and relatives of patients approaching the end-of-life is vital to ensure patients have a 'good death'. To improve communication, it is important to first identify how this is currently being accomplished. ⋯ Findings suggest training could provide healthcare professionals with these strategies to improve communication. Interventions such as question prompt lists could help relatives overcome barriers to involvement in decision-making. Further research is needed to understand communication with relatives in different settings and with different healthcare professionals.