Articles: palliative-care.
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J Pain Symptom Manage · Nov 2024
Impact of a criteria-based inpatient Palliative Oncology consultation model on end-of-life outcomes.
Early, integrated palliative care (PC) improves outcomes in advanced cancer; however, inpatient PC referrals still exceed outpatient referrals nationwide. Recognizing need for enhanced integration, our cancer center implemented a criteria-based PC consultation model in inpatient oncology. ⋯ Embedded, criteria-based PC consultation in inpatient oncology was associated with earlier PC involvement, longer hospice LOS, and reduced EOL care intensity.
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Numerous studies have demonstrated that hospice palliative care interventions for cancer patients can reduce health care utilzation. In Taiwan, 20-25% of patients who require mechanical ventilation are using prolonged mechanical ventilation (PMV); however, only a limited number of studies have addressed the effectiveness of hospice palliative care for these patients. This study investigated the impact of hospice palliative care utilization on medical utilization among subjects using PMV. ⋯ Subjects undergoing PMV while receiving hospice palliative care experienced significant reductions in total hospitalization costs, ICU admissions, cardiopulmonary resuscitation, and medical expenses within 14 d before death.
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Palliative medicine · Nov 2024
ReviewA scoping review of global patterns in reporting race, ethnicity, nationality, or religion in palliative care randomized controlled trials: Recommendations for transparency.
Though randomized controlled trials of non-pharmacological palliative care interventions have shown positive outcomes, findings are often generalized with limited consideration for the impact of the influence of race, ethnicity, nationality, or religion on said outcomes. ⋯ Improving greater transparency in study reporting of social and historical context about population demographics, including specific demographic data collected, may better identify unmet palliative needs, facilitate cross-cultural interpretation, and improve adaptation and implementation of non-pharmacological palliative care interventions.
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Most patients with serious illness prefer to die at home; however, for those requiring ongoing ventilatory support, this preference is often not honored due to the difficulties of arranging a palliative extubation at home. Here we present two cases of successful home palliative extubations, coordinated by a multidisciplinary team including critical care, palliative care, care management, hospice, and emergency medical services (EMS) clinicians. By exploring the operational and regulatory challenges accompanying these cases, we provide a road map for offering mechanically ventilated patients the choice of a death at home and provide truly holistic and patient-centered care.