Articles: palliative-care.
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Background: Symptom burden assessment with the Edmonton Symptom Assessment System (ESAS) has been widely studied among patients in outpatient palliative care (OPC), but fewer reports in home-based palliative care (HBPC), and none has assessed the prognostic value of ESAS scores in HBPC. Methods: This retrospective cohort study compares symptom burden and its prognostic value in adult patients receiving OPC and HBPC services between January 1, 2019, and June 30, 2021. ⋯ ESAS was prognostic of survival in both settings (Hazard ratio 1.18-1.64, p < 0.01). Conclusion: Symptom burden is an independent prognosticator of survival in HBPC and OPC in this community-based setting.
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To assess the utilization of palliative care (PC) and its associated factors among adult cancer patients in Hawassa University Comprehensive Specialized Hospital (HUCSH) oncology center, Hawassa, Ethiopia, 2021. ⋯ The current study revealed two thirds of patients had better utilization of PC services. Older patients with low educational status and income and those living in rural areas had worse access to PC services. It is recommended to improve information provision about PC especially for older patients and patients with low education and to improve accessibility for patients in suburban and rural areas.
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Background: Patients with life-limiting cancers are commonly prescribed opioids to manage pain, dyspnea, and cough. Proper prescription opioid disposal is essential to prevent poisonings and deaths. Objective: We examined opioid disposal practices of patients referred to a Canadian outpatient palliative care clinic (OPCC). ⋯ Conversely, reports of an increased amount of opioid use in the past six months were negatively associated with routine disposal of opioids (OR: 0.38, 95% CI: 0.16-0.88). Conclusion: The high prevalence of people with life-limiting illnesses who do not routinely dispose their opioids requires increased attention. Interventions, such as education, are needed to reduce medication waste and opioid-related harms.
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Journal of critical care · Jun 2023
Stakeholder engagement as a strategy to enhance palliative care involvement in intensive care units: A theory of change approach.
Adult patients admitted to intensive care units in the terminal phase experience high symptom burden, increased costs, and diminished quality of dying. There is limited literature on palliative care engagement in ICU, especially in lower-middle-income countries. This study explores a strategy to enhance palliative care engagement in ICU through a stakeholder participatory approach. ⋯ Theory of change framework facilitated the identification of proposed mechanisms and interventions underpinning palliative care integration in ICUs.
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J Pain Symptom Manage · Jun 2023
The Team-based Serious Illness Care Program, a qualitative evaluation of implementation and teaming.
Earlier and more frequent serious illness conversations with patients allow clinical teams to better align care with patients' goals and values. Nonphysician clinicians often have unique perspectives and understanding of patients' wishes and are thus well-positioned to support conversations with seriously ill patients. The Team-based Serious Illness Care Program (SICP) at Stanford aimed to involve all care team members to support and conduct serious illness conversations with patients and their caregivers and families. ⋯ Team-based serious illness communication is viable and valuable, with a range of successful workflow and leadership approaches.