Palliative medicine
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Palliative medicine · Dec 2015
ReviewTreatment of holistic suffering in cancer: A systematic literature review.
Holistic suffering is a debilitating problem for cancer patients. Although many treatments have been suggested for its alleviation, they have not been compared for effectiveness. ⋯ This systematic review found that spiritual well-being, meaning, hope and benefit finding can be positively impacted by a variety of treatment modalities.
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Palliative medicine · Dec 2015
ReviewThe economic evidence for advance care planning: Systematic review of evidence.
Advance care planning is a process of discussion and review concerning future care in the event of losing capacity. Aimed at improving the appropriateness and quality of care, it is also often considered a means of making better use of healthcare resources at the end of life. ⋯ There is need for clearer articulation of the likely mechanisms by which advance care planning can lead to reduced care costs or improved cost-effectiveness, particularly for people who retain capacity. There is also a need to consider wider costs, including the costs of advance care planning facilitation or interventions and the costs of substitute health, social and informal care. Economic outcomes need to be considered in the context of quality benefits.
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Palliative medicine · Dec 2015
Clinical TrialTesting pilocarpine drops for dry mouth in advanced cancer using n-of-1 trials: A feasibility study.
Dry mouth is a common and troublesome symptom in palliative care. Pilocarpine is a cholinergic agent that promotes salivation. ⋯ The formulation of pilocarpine drops proved unacceptable to most participants. More work is required to determine an appropriate formulation, dose and method of delivery and then a retest of pilocarpine drops for this symptom.
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Palliative medicine · Oct 2015
Comparison of preferences for end-of-life care among patients with advanced cancer and their caregivers: A discrete choice experiment.
Patients with advanced cancer often have to make difficult decisions, such as how much to spend on moderately life-extending treatments. This and other end-of-life decisions are also influenced by their informal caregivers. Understanding the relative value that patients and their caregivers place on various aspects of end-of-life care can help clinicians tailor treatments to best meet the preferences of their patients. ⋯ Results highlight the importance of pain management, supporting home deaths, and addressing other end-of-life concerns, in addition to efforts to extend life. Differences in willingness to pay of patients and caregivers suggest the need for eliciting patient preferences during treatment decision making as opposed to relying on caregiver input.
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Palliative medicine · Oct 2015
Observational StudyAcute symptomatic complications among patients with advanced cancer admitted to acute palliative care units: A prospective observational study.
Limited information is available on the symptomatic complications that occur in the last days of life. ⋯ Symptomatic complications were common in cancer patients admitted to acute palliative care units, often do not resolve completely, and were associated with a poor prognosis despite active medical management.