The journal of supportive oncology
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Referral criteria were developed to rationalize transfer-of-care requests and referrals to a hospital-based palliative care program (PCP) in Saudi Arabia. This study aimed to explore the impact of an approved referral criteria policy on the pattern of referrals to a PCP. Two periods, 19 months each, were identified: one before the implementation of the referral criteria (precriteria), and the other started 6 months later (post-criteria). ⋯ The median survival of referred patients decreased from 2.27 months during the precriteria period to 1.73 months during the postcriteria period (P = 0.0051). The findings suggest that the implementation of the referral criteria policy was associated with a more rational pattern of transfer-of-care referrals to the PCP. However, more educational efforts and organizational actions are needed to prevent delayed referrals of cancer patients to palliative care teams.
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Review Case Reports
Interventional therapies for the management of cancer pain.
Timely interventional cancer pain therapies complement conventional pain management by reducing the need for high-dose opioid therapy and its associated toxicity. All patients with upper abdominal visceral pain should be considered for celiac plexus neurolysis soon after diagnosis. ⋯ Specific interventions for vertebral metastases and other sites of metastatic bone pain, including vertebroplasty, kyphoplasty, and image-guided tumor ablation, should be understood and considered. A collaborative model of care, including pain medicine specialists with expertise in interventional therapies, should be standard in all oncologic practices in order to optimize outcomes for patients with cancer throughout the course of their treatment.