Journal of palliative medicine
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Hemodialysis (HD) patients experience significant symptom burden that is often undertreated. ⋯ Renal HCPs are often unaware of the magnitude of symptom burden in their HD patients. This study found that there is lack of ownership for assessing and treating these symptoms. Providers also feel certain symptoms are "untreatable." Research is needed to develop effective treatment strategies for HD populations.
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Observational Study
Characteristics of subjects who died of chronic obstructive pulmonary disease in Andalusia in 2010 and 2011.
The place of death is an important consideration in the end-of-life care of patients with chronic obstructive pulmonary disease (COPD). ⋯ Age, sex, marital status, and rural areas of residence determine where COPD patients will end their life in Andalusia. Knowledge about place of death and its determinants will facilitate the planning of health care palliative services.
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There is good evidence for the efficacy of inpatient palliative care in improving clinical care, patient and provider satisfaction, quality of life, and health care utilization. However, the evidence for the efficacy of nonhospice outpatient palliative care is less well known and has not been comprehensively reviewed. ⋯ The available evidence supports the ongoing expansion of innovative outpatient palliative care service models throughout the care continuum to all patients with serious illness.
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Little is known about the determining factors related to the administration of continuous palliative sedation. Knowledge of these determinants may assist physicians in identifying patients who are at high risk of developing refractory symptoms, enable physicians to inform patients, and optimize close monitoring. ⋯ Given the variation in study designs and the limitations of the included studies, the outcomes should be interpreted carefully. Further research is needed, particularly regarding factors that can be influenced and that may alter the course of a patient's symptoms and the patient's eventual need for palliative sedation.