BMJ supportive & palliative care
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It is now accepted that teaching in palliative medicine should be integrated throughout the medical undergraduate curriculum. Recommendations suggest the inclusion of knowledge areas such as symptom control, as well as more attitudinal aspects such as teamwork and understanding patient and carer perspectives on illness. These subjects should be taught on a stepwise basis, introducing concepts at an early stage and then be built on throughout training. ⋯ These were led by the patient/carer/professionals' experiences and further explored with facilitated questions by the students. The sessions have been evaluated well by all involved, including patients, carers, multi-disciplinary team members and palliative medicine doctors. The learning objectives (to understand patient perspectives, multi-disciplinary working and holistic care) were achieved, along with discussion of professionalism.
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BMJ Support Palliat Care · Mar 2014
Palliative care in people with idiopathic Parkinson's disease who die in hospital.
The UK National Institute for Health and Clinical Excellence guidelines state that palliative care options for people with Parkinson's disease (PD) should be discussed. ⋯ For those dying in hospital, there are few previously documented end-of-life care discussions with patients or their relatives. The use of end-of-life pathways and access to specialist palliative care is variable. Following the Neuberger report, the Liverpool Care Pathway is to be replaced with individual end-of-life care plans. It is important to engage patients, and their relatives, in decision making regarding preferences at the end of life.
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BMJ Support Palliat Care · Dec 2013
Circles of care: should community development redefine the practice of palliative care?
Specialist palliative care, within hospices in particular, has historically led and set the standard for caring for patients at end of life. The focus of this care has been mostly for patients with cancer. More recently, health and social care services have been developing equality of care for all patients approaching end of life. ⋯ Within this article, we propose a model of care which identifies a person with an illness at the centre of a network which includes inner and outer networks, communities and service delivery organisations. All of these are underpinned by policy development, supporting the overall structure. Adoption of this model would allow individuals, communities, service delivery organisations and policy makers to work together to provide end of life care that enhances value and meaning for people at end of life, both patients and communities alike.
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BMJ Support Palliat Care · Dec 2013
Randomized Controlled TrialIs home-based palliative care cost-effective? An economic evaluation of the Palliative Care Extended Packages at Home (PEACH) pilot.
The aim of this study was to evaluate the cost-effectiveness of a home-based palliative care model relative to usual care in expediting discharge or enabling patients to remain at home. ⋯ The results of this small pilot study point to the potential of PEACH as a cost-effective end-of-life care model relative to usual care. Findings support the feasibility of conducting a definitive, fully powered study with longer follow-up and comprehensive economic evaluation.