Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2014
Belgian general practitioners' perspectives on the use of palliative sedation in end-of-life home care: a qualitative study.
Palliative sedation (PS) is a far-reaching palliative measure with a life-shortening potential. Guidelines provide only for a restricted use of PS and as a last resort. ⋯ PS home practice deviates from the PS guidelines' recommendations. In addition to the GPs' shortage of knowledge, the guidelines' recommendations do not always meet the particular needs of EoL home care. If one consideration of EoL home care is to respect a patient's wish to die at home, then the pre-emptive use of PS to avoid a futile transfer to the hospital in the case of an undesirable turn of events deserves more attention in the PS debate.
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J Pain Symptom Manage · Jun 2014
Multicenter Study Clinical TrialA report on the long-term use of fentanyl pectin nasal spray in patients with recurrent breakthrough pain.
As patients with cancer are living longer, there is a need to ensure that treatments used for palliative care are well tolerated and effective during long-term use. ⋯ FPNS appeared to provide sustained benefit and was well tolerated during long-term treatment of BTPc.
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J Pain Symptom Manage · Jun 2014
Comparative StudyCharacteristics and outcomes of patients admitted to the acute palliative care unit from the emergency center.
Most patients admitted to acute palliative care units (APCUs) are transferred from inpatient oncology units. We hypothesized that patients admitted to APCUs from emergency centers (ECs) have symptom burdens and outcomes that differ from those of transferred inpatients. ⋯ The EC patients have a higher acute symptom burden and are more likely to be discharged alive than transferred inpatients. The APCU was successful at managing symptoms and facilitating the discharge of both inpatients and EC patients to the community although the patients had severe symptoms on admission.
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J Pain Symptom Manage · Jun 2014
Randomized Controlled Trial Multicenter StudyA randomized trial of weekly symptom telemonitoring in advanced lung cancer.
Lung cancer patients experience multiple, simultaneous symptoms related to their disease and treatment that impair functioning and health-related quality of life (HRQL). Computer technology can reduce barriers to nonsystematic, infrequent symptom assessment and potentially contribute to improved patient care. ⋯ Feasibility of using a technology-based system for systematic symptom monitoring in advanced lung cancer patients was demonstrated. Future research should focus on identifying patients most likely to benefit and other patient, provider, and health system factors likely to contribute to the system's success.