Articles: palliative-care.
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J Pain Symptom Manage · Nov 2024
Pain in palliative cancer patients - Analysis of the German National Palliative Care Registry.
Palliative care aims to improve the quality of life in patients with progressive diseases such as cancer. Effective cancer pain management is a major challenge of palliative treatment. Empirical data on the prevalence of cancer pain, the efficiency of pain treatment and influencing factors are scarce. ⋯ Data from the German Palliative Care Registry confirmed that although increasingly better addressed over the years, insufficiently controlled cancer pain remains a challenge for palliative care units. Patient-specific (e.g. psychological comorbidity) and cancer-related (e.g. bone or cartilage cancer) risk factors for poor pain treatment underline the need for individualized multimodal pain management including psychological support.
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J Pain Symptom Manage · Nov 2024
The distress and benefits of the Bereaved Family Survey: A mortality follow-back survey.
The Bereaved Family Survey is an important method for evaluating the quality of palliative care. ⋯ Bereaved family members experience both distress and benefits. There is need to devise ways to reduce distress and increase its benefits to continue assessing the quality of palliative care.
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J Pain Symptom Manage · Nov 2024
ReviewLimitations with California Medicaid Data for Palliative and End of Life Care Quality Measures.
In 2014 the California legislature passed Senate Bill 1004 (SB 1004) that was designed to expand access to specialty palliative care for individuals served by California's Medicaid (known as Medi-Cal) Managed Care Plans (MCPs). The California Department of Health Care Services (DHCS) operationalized the legislation by developing minimum requirements for palliative care programs that all MCPs must meet or exceed.7 Quality and utilization data specific to California's Medicaid population are needed for stakeholders to identify care deficiencies and disparities, describe the end of life experience and utilization patterns of MCP members, compare these patterns to Medicare beneficiaries or other populations, and set appropriate targets to help monitor progress. ⋯ Beyond the practical challenges of allowing time for data access and approvals, both projects revealed several limitations to using administrative data to assess quality of palliative and end of life care for a Medicaid population. We describe these challenges that undermined our confidence in analysis results and propose solutions to measuring the quality of palliative and end of life care for Medicaid patients and suggested next steps.
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J Pain Symptom Manage · Nov 2024
Review Case ReportsMedical management of refractory haematuria in palliative patients.
The management of haematuria, in patients with a palliative diagnosis, refractory to standard measures presents a significant challenge for multidisciplinary teams. Our experiences with two cases led us to review the literature and highlighted the limited evidence base. ⋯ We aim to help support clinicians manage other palliative patients with this challenging symptom in future. Relevant references for this review were identified through searches of PubMed using the terms "haematuria," "hematuria," "palliative," "antifibrinolytic," "tranexamic acid," "etamsylate" "glucocorticoid," "oestrogen," "estrogen," "estradiol," "somatostatin," "thalidomide," hyperbaric oxygen" and "intravesical hyaluronic acid." Other references were suggested by the authors.
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J Pain Symptom Manage · Nov 2024
Start of the COVID-19 pandemic and palliative care unit utilization: a retrospective cohort study.
People with noncancer diagnoses have poorer access to palliative care units (PCUs) or hospices compared to those with cancer diagnoses. The COVID-19 pandemic disrupted how specialist palliative care services were delivered and utilized. ⋯ Despite historically poor PCU/hospice access, the COVID-19 pandemic created circumstances that may have enabled unprecedented utilization in individuals with noncancer diagnoses in our cohort.