Palliative medicine
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Palliative medicine · Sep 2007
Multicenter StudyWhat determines referral of UK patients with haematological malignancies to palliative care services? An exploratory study using hospital records.
We investigated the frequency and characteristics of patients with haematological malignancies (HMs) who were, or were not, referred for specialist palliative care (SPC). Data were abstracted from hospital records of 108 patients who died - 27 with leukaemia, 11 with myelodysplastic syndromes, 48 with lymphoma and 22 with myeloma. Ninety-three patients (86.1%) were >60 years of age at diagnosis, with 33 (30.6%) being >or=80 years and 31 (28.7%) having existing comorbidities. ⋯ In 14 patients, HM diagnosis was confirmed after death. Identification of these 14 patients is likely to be a unique feature of our study, as patients were selected from a regional, population-based register with centralized diagnostic services, enabling the identification of all patients with HM. The interface between curative and palliative treatment in HM is more complex than the National Institute for Clinical Excellence recommendations suggest.
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Palliative medicine · Sep 2007
Comparative StudyTaking care of terminally-ill patients at home - the economic perspective revisited.
End-of-life care can be delivered in a variety of settings, whereby the majority of terminally-ill cancer patients prefer to die at home. The aim of our study is to evaluate health services utilisation during the last year of life, and to compare terminally ill patients who have received home-specialised palliative care services (HSPCS) with patients who died receiving home non-specialised palliative care services. The study included 120 and 515 patients, respectively, who died between 1999-2000. ⋯ The median cost per patient was as low as one-fifth in the last month. Men and the older age group of 65 and above, cost significantly less compared with women and younger patients, respectively, regardless of provider setting. The main differences in health services utilisation were in hospitalisations and oncology treatments (P < 0.01 and P < 0.05, respectively).
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Palliative medicine · Jul 2007
Multicenter StudyThe impact of palliative care on cancer deaths in Hong Kong: a retrospective study of 494 cancer deaths.
To study the utilization of public health care by advanced cancer patients in their last 6 months of life and their end-of-life process within the last 2 weeks of life. ⋯ Our results suggest that palliative care service has played a role in improving end-of-life cancer care in Hong Kong.
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Palliative medicine · Jul 2007
ReviewChallenges to participation in paediatric palliative care research: a review of the literature.
It has been identified that there is a need for increased palliative care research within the paediatric setting. The assessment of parental views is necessary for this population. However, the conduct of research and recruitment of participants is often challenging. ⋯ This comprehensive review of the literature aims to address the ethical and recruitment issues of involving parents of children that are receiving palliative or end-of-life care. Key elements, that may maximize completion of research and a more representative sample, are also discussed. These elements include obtaining the opinions on study design and interview script from experienced families and maximizing the partnership between health care professionals and the research team.
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Palliative medicine · Jul 2007
Modelling services to meet the palliative care needs of chronic heart failure patients and their families: current practice in the UK.
To describe current provision of specialist palliative care for chronic heart failure (CHF) patients, and explore challenges, referral criteria and recommendations to inform service development. ⋯ Information regarding existing services' challenges, recommendations and referral systems is essential when designing a new service, maximising feasibility and acceptability. This study design is of particular value when descriptions and evaluations of service models are lacking in the literature. The survey gives much-needed depth and detail to the types of services currently providing palliative care to CHF patients across the UK.