BMJ supportive & palliative care
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BMJ Support Palliat Care · Sep 2015
The extent and cost of potentially avoidable admissions in hospital inpatients with palliative care needs: a cross-sectional study.
More than 90% of people spend time in hospital in the last year of life and, in many developed countries, hospitals are the setting in which most people will die. Previous research indicates that a proportion of these hospital admissions could have been avoided. The objective of this study was to establish the extent and cost of potentially avoidable hospital admissions among patients with palliative care needs. ⋯ A significant proportion of patients with palliative care needs experience a potentially avoidable admission. Although these admissions are relatively short compared to those whose admissions are unavoidable, any hospital admission impacts on the experiences of patients and families and may contribute to unnecessary hospital expenditure.
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BMJ Support Palliat Care · Sep 2015
Preferred place of death for patients referred to a specialist palliative care service.
Understanding patients' preferences for place of death and supporting patients to achieve their wishes has become a priority. This study aims to: (1) examine preferences of patients referred to a specialist palliative care service; (2) determine whether preferences of those who have been admitted as hospice inpatients differ from those who have not; (3) identify reasons why preferred place of death (PPD) is sometimes not recorded; and (iv) investigate whether nominating a PPD relates to actual place of death. ⋯ Most patients in a specialist palliative care setting are willing to express a PPD. Preferences differ for patients who had never been admitted as hospice inpatients from those who have had at least one inpatient stay. Routine and ongoing assessment of PPD are recommended to support patients' wishes at the end of life.
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BMJ Support Palliat Care · Sep 2015
Multicenter StudyPharmacovigilance in hospice/palliative care: net effect of gabapentin for neuropathic pain.
Hospice/palliative care patients may differ from better studied populations, and data from other populations cannot necessarily be extrapolated into hospice/palliative care clinical practice. Pharmacovigilance studies provide opportunities to understand the harms and benefits of medications in routine practice. Gabapentin, a γ-amino butyric acid analogue antiepileptic drug, is commonly prescribed for neuropathic pain in hospice/palliative care. Most of the evidence however relates to non-malignant, chronic pain syndromes (diabetic neuropathy, postherpetic neuralgia, central pain syndromes, fibromyalgia). The aim of this study was to quantify the immediate and short-term clinical benefits and harms of gabapentin in routine hospice/palliative care practice. ⋯ Overall, 42% of people experienced benefit at a level that resulted in continued use at 21 days.
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BMJ Support Palliat Care · Sep 2015
Volunteer activity in specialist paediatric palliative care: a national survey.
To assess the involvement of volunteers with direct patient/family contact in UK palliative care services for children and young people. ⋯ This is the most detailed national survey of volunteer activity in palliative care services for children and young people to date. It highlights the range and depth of volunteers' contribution to specialist paediatric palliative care services and will help to provide a basis for future research, which could inform expansion of volunteers' roles.