Journal of palliative medicine
-
Multicenter Study
Pharmacovigilance in hospice/palliative care: rapid report of net clinical effect of metoclopramide.
Understanding the performance of prescribed medications in day-to-day practice is important to minimize harm, maximize clinical benefits, and, eventually, better target the people who are most likely to benefit, especially in hospice/palliative care where there may be limited time to optimize prescribing. Metoclopramide, a benzamide prokinetic antiemetic, is widely used for a number of indications including nausea, vomiting, hiccups, and reflux. It has recently had a new "black box" warning issued by the Food and Drug Administration in relation to tardive dyskinesia to limit use to 12 weeks. ⋯ Overall, one in three people gained net clinical benefit at one week. Limiting effects include side-effects that need to be sought actively in clinical care.
-
The purpose of this study was to explore the attitudes of cancer patients, their family, and community members in Albania, a post-communist country in Southeast Europe, regarding breaking bad news. ⋯ This survey identified important characteristics of cancer patients, their relatives, and a community-based sample in Albania that could predict the willingness to disclose a fatal diagnosis. Establishment of a formal training of health professionals regarding breaking bad news should be considered in order to ensure a proper approach of communicating diagnosis to cancer patients in transitional Albania.
-
Randomized Controlled Trial
The role of thalidomide and placebo for the treatment of cancer-related anorexia-cachexia symptoms: results of a double-blind placebo-controlled randomized study.
To determine the effects of thalidomide and placebo on anorexia-cachexia and its related symptoms, body composition, resting metabolic rate, and serum cytokines and their receptors in patients with advanced cancer. ⋯ Based on the poor accrual rate and attrition observed in this study, it is important that future research on thalidomide as a treatment for cancer-related anorexia-cachexia symptoms (ACS) in patients with advanced cancer use less stringent entry criteria and less exhaustive outcome measures.
-
Forgiveness has begun to receive empirical attention in end-of-life contexts, but primarily among patients. This study examined forgiveness issues and communication priorities among family members of hospice patients. ⋯ Although not as commonly endorsed as expressions of love and gratitude, forgiveness-related communications are seen as extremely important by many family members of hospice patients. If family members see forgiveness (granting or seeking) as important but have not completed the process, these unresolved issues are associated with depressive symptoms. This study suggests that unresolved offenses and forgiveness issues warrant assessment and clinical attention within families receiving hospice care.