The American journal of hospice & palliative care
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The palliative care population is generally vulnerable to experiencing medication-induced adverse effects and drug-drug interactions. Neuromodulation may offer particular advantages over systemic medications in this population. ⋯ More recently, deep brain stimulation/motor cortex stimulation has anecdotally been utilized for certain intractable pain states. Although brain electrical stimulation has not been adequately trialed or in some cases even tried at all for management of a variety of symptoms, it is conceivable that in the future it may be a potential therapeutic option in efforts to palliate various severe refractory symptoms (eg, intractable pain, nausea, dyspnea, delirium).
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Established hospital palliative care consult services (PCCS) have been associated with reduced costs and length of stay, decreased symptom burden, and increased satisfaction with care. Using a retrospective case-control design, we analyzed administrative data of patients seen by PCCS while hospitalized at the Rochester, Minnesota Mayo Clinic hospitals from 2003 to 2008. ⋯ Costs for patients seen and discharged alive were US $35,449 (95% confidence interval [CI] US $34,157-US $36,686) compared to US $37,447 (95% CI US $36,734-US $38,126), without PCCS consultation. Costs for PCCS patients that died during hospitalization were US $54,940 (95% CI US $51,483-US $58,576) and non-PCCS patients were US $79,660 (95% CI US $76,614-US $83,398).
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Am J Hosp Palliat Care · Mar 2014
Commonly prescribed medications in a population of hospice patients.
Although much attention has been placed on appropriate symptom management at the end of life, little is known about the medications actually prescribed to people in hospice care. The purpose of this study was to determine the most commonly prescribed medications in a population of hospice patients. ⋯ Opioid and nonopioid analgesics, anxiolytics, anticholinergics, and antipsychotics were the most commonly prescribed pharmacologic classes. This description of prescribing practices could be useful in creating more informed care plans, educating health care personnel, and anticipating the changing medication needs of patients as they enter hospice care.
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Am J Hosp Palliat Care · Mar 2014
End-of-life care in a general respiratory ward in the United Kingdom.
Patients with advanced chronic lung disease such as chronic obstructive pulmonary disease (COPD) often have an unpredictable clinical course and a high symptom burden. Their prognosis is similar to that of patients with lung cancer. ⋯ Palliative care involvement and discussion of patients' end of life care wishes is poor in COPD. Timely and effective discussions regarding disease prognosis and patient wishes, including early consideration for initiating anticipatory care planning needs to be instituted.
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Am J Hosp Palliat Care · Mar 2014
A population-based survey on perceptions of opioid treatment and palliative care units: OPTIM study.
This study aimed to clarify the general public's perceptions of opioids and palliative care units (PCUs) and explore factors related to such perceptions. A cross-sectional, anonymous questionnaire was administered to 8000 people. ⋯ The higher positive perceptions were associated with a higher sense of security regarding regional cancer care (P < .001). Providing the general public with adequate knowledge about palliative care may improve perceptions of palliative care and the sense of security.