Articles: palliative-care.
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Palliative medicine · Jul 2022
Health care professionals' perceptions of factors influencing the process of identifying patients for serious illness conversations: A qualitative study.
The Serious Illness Care Programme enables patients to receive care that is in accordance with their priorities. However, despite clarity about palliative care needs, many barriers to and difficulties in identifying patients for serious illness conversations remain. ⋯ The process of identifying patients for serious illness conversations is complex and may not be captured only by generic tools such as the surprise question. It is crucial to address existential and ethical obstacles that can hinder the identification of patients for serious illness conversations.
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Background: Older adults with cancer use the emergency department (ED) for acute concerns. Objectives: Characterize the palliative care needs and clinical outcomes of advanced cancer patients in the ED. Design: A planned secondary data analysis of the Comprehensive Oncologic Emergencies Research Network (CONCERN) data. ⋯ Results: Of the total (674/1075, 62.3%) patients had advanced cancer and most were White (78.6%) and female (50.3%); median age was 64 (interquartile range 54-71) years. A small proportion of them were receiving palliative (6.5% [95% confidence interval; CI 3.0-7.6]; p = 0.005) and hospice (1.3% [95% CI 1.0-3.2]; p = 0.52) care and had a higher 30-day mortality rate (8.3%, [95% CI 6.2-10.4]). Conclusions: Patients with advanced cancer continue to present to the ED despite recommendations for early delivery of palliative care.
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The lancet oncology · Jul 2022
Impact of integrated palliative care in acute and aggressive medical care for patients with advanced haematological malignancies: a retrospective matched case-control study.
Aggressive medical care can increase suffering and the health-care burden on patients with advanced haematological malignancies. Our palliative care team has been pioneering an integrated palliative care (IPC) programme for patients with advanced haematological malignancies in Hong Kong since 2018. The aim of the study was to evaluate the effect of IPC on the administration of chemotherapy or other treatments within the 14 days before death; multiple (more than one) emergency department visits within the 90 days before death; multiple (more than one) unplanned hospitalisations within the 90 days before death; and intensive care unit admission within the 90 days before death. ⋯ None.