Journal of palliative medicine
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Context: Parkinson's disease (PD) is the second most common neurodegenerative disorder worldwide. Oral medications for control of motor symptoms are the mainstay of treatment. However, as the disease progresses, patients with PD may develop dysphagia that prohibits them from safely taking oral medications. ⋯ There are very few articles addressing the issue of treatment of patients with advanced PD who are unable to take oral medications. Although rotigotine patch and apormorphine injections are most frequently recommended, there are no clinical trials in this patient population to support those recommendations. Conclusion: This study highlights a need for further research examining the efficacy and dosing of nonoral medications in advanced PD with dysphagia.
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Purpose: To describe a novel metric to aid clinical decision making between shorter versus longer palliative radiotherapy (PRT) regimens using objective patient factors. Materials and Methods: Patients receiving PRT at a single institution between 2014 and 2018 were reviewed. The time between PRT start and finish was calculated and divided by overall survival (in days from start of PRT) to generate the percent of remaining life (PRL). ⋯ Single fraction is associated with low PRL. When considering multifraction PRT regimens, the PACS identifies patients who may benefit from shorter courses of PRT and alternatively, low-risk patients for whom a more protracted course is reasonable. Prospective external validation is warranted.
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Background and Objectives: Historically marginalized religious and cultural groups are at risk for lower quality of care than majority groups. No study to date specifically queries Muslim experiences with the American health care system (AHCS). We performed a thematic analysis of Muslim parents' interactions with the AHCS and how their background informs their approach to care. ⋯ Several themes emerged highlighting open communication with care teams, willingness to share religious affiliations, and the importance of leaning into faith and accepting God's will. Conclusions: A thematic analysis of Muslim parents' interactions with the AHCS describes value in honest communication, mixed concerns about how providers will react to their religious affiliation, and emphasizes the importance of leaning heavily into faith and accepting God's plan. Future studies evaluating needs of Muslim patients, especially those with different diagnoses, language barriers, and a larger sample size will further delineate needs to minimize inequalities in care.
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In 2018, the Avera Sacred Heart Hospital and two partners were awarded a planning grant to improve palliative health care services in South Dakota (SD), United States, by assessing palliative care in rural SD communities. Through this effort, a newly formed South Dakota Palliative Care Network (SDPCN) convened statewide partners to develop a palliative care strategy for improving quality palliative care access for individuals with serious illness. Guided by a multidisciplinary governing board, the SDPCN completed needs assessments to (1) better understand the perception of palliative care in SD; (2) assess the palliative care landscape in the state; and (3) explore possible solutions to address the uneven access to palliative care. ⋯ The SDPCN has engaged partners, captured data, and mapped a blueprint for sustaining accessible quality palliative care. Three years since its inception, the SDPCN secured additional funding to sustain the Network and to provide education on palliative care to providers and community members as a first strategic step toward improving overall palliative care in rural communities. The SDPCN currently serves rural SD patients by increasing knowledge of palliative care among health professionals (current and future), fostering Network member engagement, and maintaining an active governing board.
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Observational Study
Trends in Palliative Care Telephone Consultation Support for Health Care Professionals: A Dutch Nationwide Registry between 2004 and 2019.
Background: Regional palliative care consultation (PCC) teams aim to support health care professionals by telephone in providing quality palliative care (PC) in the Netherlands. Objectives: The study aims to assess trends in the number and characteristics of PC telephone consultations in the Netherlands between 2004 and 2019. Design: A retrospective observational study reviewed data from the Dutch national register for PC consultations by telephone (PRADO). ⋯ Conclusion: Dutch PC telephone consultations have changed over time. More PC telephone consultations were held for hospitalized patients and noncancer diseases over the past years. These trends are in line with the shift toward more integrated PC in which different services collaborate.