BMJ supportive & palliative care
-
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.
-
BMJ Support Palliat Care · Dec 2013
Discontinuity of care at end of life: a qualitative exploration of OOH end of life care.
This study aimed to understand the experiences of palliative care patients when accessing or making decisions about out of hours (OOH) services. It also aimed to illuminate barriers and enablers to accessing appropriate and timely care following the introduction of the 2004 New General Medical Services Contract. ⋯ Interpersonal or relationship continuity and management continuity are vital to the process of optimising the patient experience of OOH palliative care. While recent service innovations are tackling some of the issues highlighted, this research reinforces the value patients with palliative care needs places on continuity and the need to improve this aspect of care management.
-
BMJ Support Palliat Care · Dec 2013
Comparative StudyEffect of a home-based end-of-life nursing service on hospital use at the end of life and place of death: a study using administrative data and matched controls.
To assess the effect of routinely delivered home-based end-of-life care on hospital use at the end of life and place of death. ⋯ Home-based end-of-life care offers the potential to reduce demand for acute hospital care and increase the number of people able to die at home.
-
BMJ Support Palliat Care · Dec 2013
Use of a structured palliative care summary in patients with established cancer is associated with reduced hospital admissions by out-of-hours general practitioners in Grampian.
Palliative care summaries are used by general practices to provide structured anticipatory care information to those providing care during the out-of-hours period. We hypothesised that the availability of a palliative care summary for individuals with established cancer would influence emergency hospital admission during the out-of-hours period. ⋯ Availability of a structured palliative care plan can aid decision making in the out-of-hours period and prevent unplanned hospital admissions.
-
BMJ Support Palliat Care · Dec 2013
Observational StudyCommunity pharmacists: a forgotten resource for palliative care.
Timely access to medicines within the community is important for palliative patients where their preferred place of care is the home environment. The objective of this observational study is to establish baseline data to quantify the issue of poor access to medicines for symptom control in the last few days of life. The list of 13 medicines was generated from medicine use within a metropolitan palliative care unit. ⋯ Just over 1 in 5 pharmacies reported learning about the palliative status of a patient through another health practitioner. Community pharmacies remain an underused resource to support timely access to medicines for community-based palliative patients. Palliative care services and government agencies can develop new strategies for better access to medicines that will benefit community patients and their carers.