Journal of palliative medicine
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Observational Study
Red Blood Cell Transfusions in Patients with Advanced Cancer Receiving Home Palliative Care.
Background: Red blood cell (RBC) transfusion is the standard treatment for anemia in advanced cancer. Nevertheless, guidelines for managing this condition are still not exhaustive. Objective: To investigate frequency, timing, and clinical characteristics associated with RBC transfusions in patients with advanced cancer assisted by at-home oncological care service and to evaluate the association between parameters at the entry and the possibility of receiving RBC transfusions during homecare. ⋯ Duration of the assistance was correlated with the period from last transfusion to death (p < 0.001). Conclusion: Hematological and genitourinary cancer and being in simultaneous care at the entry were associated with transfusion. Although the appropriateness of this treatment remains to be defined in this population, transfused patients frequently received "late in life" transfusions.
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Therapeutic clinical relationships and skilled communication are foundational elements of high-quality hospice and palliative care. Both require that we draw on the most valuable, yet limited, resource in our practice: clinician time. ⋯ Equally, many skilled interventions, including serious illness communication, can occur during time-efficient encounters, which still preserve compassion and authentic presence. This report invites clinicians to reevaluate the meaning and use of time in modern palliative care practice and offers six strategies to enhance time-efficiency in daily clinical care.
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Introduction: Methadone is used to treat intractable cancer pain when other opioid analgesics are ineffective. Methadone tablets may be difficult to administer in cases of gastrointestinal passage obstruction. However, changing the route of methadone tablet administration is possible. ⋯ Conclusion: Using a simple suspension method to administer methadone is a safe pain management method when accompanied by careful monitoring. To date, no study has examined the tube administration safety of methadone tablets. Thus, this case report is of important clinical significance.