Palliative medicine
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Palliative medicine · Jul 2019
Alteration of drug-metabolizing enzyme activity in palliative care patients: Microdosed assessment of cytochrome P450 3A.
Cytochrome P450 3A is the most relevant drug-metabolizing enzyme in humans as it is involved in the elimination of 50% of marketed drugs. Nothing is known about the activity of cytochrome P450 3A in palliative care patients who have complicated symptoms often associated with a terminal illness. ⋯ Dosing of cytochrome P450 3A substrate drugs (e.g. macrolide antibiotics, benzodiazepines, calcium channel blockers) needs to be adjusted in palliative care patients; otherwise, escalation of debilitating symptoms due to drug interactions might occur.
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Palliative medicine · Jul 2019
Appropriate frameworks for economic evaluation of end of life care: A qualitative investigation with stakeholders.
The use of quality-adjusted life years rests on the assertion that the objective of the health care system is to improve health. ⋯ Managing symptoms and reducing anxiety were considered to be core objectives of end of life care and fit with the wider health service objective of improving/maximising health. A single objective across the entire health system ensures consistency in the way that resource allocation is informed across that entire system. However, the purpose of care at the end of life is more complex, encompassing diverse and patient-centred objectives which we have interpreted as enabling the patient to experience a good death.
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Palliative medicine · Jun 2019
Meta AnalysisAirflow relieves chronic breathlessness in people with advanced disease: An exploratory systematic review and meta-analyses.
Chronic breathlessness is a neglected symptom of advanced diseases. ⋯ Airflow appears to offer meaningful relief of chronic breathlessness and should be considered as an adjunct treatment in the management of breathlessness.