Journal of palliative medicine
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Randomized Controlled Trial
Clinician roles in early integrated palliative care for patients with advanced cancer: a qualitative study.
Early palliative care provides better quality of life, increased prognostic awareness, and even improved survival for patients with advanced cancer but how the integrated care model achieves these outcomes has not been completely explained. ⋯ These data lay the foundation for developing training programs for clinicians in early integrated palliative care.
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Methadone is a useful analgesic for neuropathic and nociceptive pain. However, there is little information about the use of methadone in the final days of life when a patient cannot swallow, discouraging its use by many palliative care physicians. ⋯ The cases reviewed suggest that methadone is well tolerated and effective when switched to the buccal route in patients at the end of life on a palliative care unit.
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Observational Study
Convenient measurement of systolic pressure: the reliability and validity of manual radial pulse pressure measurement.
It is important to assess a patient's medical condition noninvasively, particularly in hospice care settings. ⋯ Manually measuring the radial pulse pressure is reliable and can be used to indicate a systolic blood pressure of 90 mm Hg or more.
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Surveys demonstrate < 20% of radiation oncologists in the United States offer single-fraction palliative radiotherapy (RT) even though it is an acceptable standard of care. A study was conducted to investigate whether this held true for those practicing within the Veterans Healthcare Administration (VHA). ⋯ A majority of radiation oncologists within the VHA offer single-fraction therapy to their patients. These data ensure access to palliative RT is not limited within this health care system by a preference for prolonged treatment courses that may discourage patients and clinicians from seeking this care.