Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2018
ReviewA Systematic Review in Support of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, Fourth Edition.
Palliative care continues to be a rapidly growing field aimed at improving quality of life for patients and their caregivers. ⋯ A substantial body of evidence exists to support clinical practice guidelines for quality palliative care, but the quality of evidence is limited.
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J Pain Symptom Manage · Dec 2018
ReviewA Systematic Review in Support of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, Fourth Edition.
Palliative care continues to be a rapidly growing field aimed at improving quality of life for patients and their caregivers. ⋯ A substantial body of evidence exists to support clinical practice guidelines for quality palliative care, but the quality of evidence is limited.
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J Pain Symptom Manage · Dec 2018
ReviewManaging Medicines for Patients Dying at Home: A Review of Family Caregivers' Experiences.
Increased life expectancy, technical advances in treatment and symptom control, and the extension of palliative care in community settings not only lengthen life but also make it possible for many patients to be cared for, and to die, at home. Moreover, death increasingly occurs in late old age and after a prolonged period of comorbidity and/or frailty. This has far-reaching consequences for the way that professional services are resourced and organized and for the informal carers who are often responsible for providing the greater part of patient care, including management of complex medication regimes. ⋯ As increasing demands are placed on FCGs, there remains limited acknowledgment or understanding of the challenges they face, how they cope, or could be best supported. Alongside training, FCGs need access to 24 hours of support and medication reviews to rationalize unnecessary medications. Furthermore, the ethical challenges arising from administering medicines at the end of life also need to be acknowledged and discussed.
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J Pain Symptom Manage · Dec 2018
ReviewManaging Medicines for Patients Dying at Home: A Review of Family Caregivers' Experiences.
Increased life expectancy, technical advances in treatment and symptom control, and the extension of palliative care in community settings not only lengthen life but also make it possible for many patients to be cared for, and to die, at home. Moreover, death increasingly occurs in late old age and after a prolonged period of comorbidity and/or frailty. This has far-reaching consequences for the way that professional services are resourced and organized and for the informal carers who are often responsible for providing the greater part of patient care, including management of complex medication regimes. ⋯ As increasing demands are placed on FCGs, there remains limited acknowledgment or understanding of the challenges they face, how they cope, or could be best supported. Alongside training, FCGs need access to 24 hours of support and medication reviews to rationalize unnecessary medications. Furthermore, the ethical challenges arising from administering medicines at the end of life also need to be acknowledged and discussed.
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J Pain Symptom Manage · Dec 2018
ReviewEffects of Shared Decision Making on Distress and Health Care Utilization Among Patients With Lung Cancer: A Systematic Review.
Lung cancer is associated with significant distress, poor quality of life, and a median prognosis of less than one year. Benefits of shared decision making (SDM) have been described for multiple diseases, either by the use of decisions aids or as part of supportive care interventions. ⋯ Although not supported by all studies, our findings suggest that facilitating SDM in the context of lung cancer may lead to improved emotional outcomes and less aggressive therapies. Future studies, explicitly studying the effects of SDM by using decision aids, are needed to better elucidate potential benefits.