Journal of pain and symptom management
-
J Pain Symptom Manage · Oct 2019
Randomized Controlled TrialCOMPASS: A Pilot Trial of an Early Palliative Care Intervention for Patients with End Stage Liver Disease.
Palliative care interventions have shown promise in improving quality of life and reducing health-care utilization among patients with chronic organ failure. ⋯ Logistical obstacles hindered completion of the trial as originally designed. Nevertheless, a preemptive palliative care intervention resulted in increased time to first readmission and more days alive outside the hospital in the first six months after study entry.
-
J Pain Symptom Manage · Oct 2019
ReviewPalliative care transitions from acute care to community-based care - a systematic review.
Although the literature on transitions from hospital to the community is extensive, little is known about this experience within the context of palliative care (PC). ⋯ Heterogeneity of study designs, outcomes, findings, and poor methodological quality renders it challenging to draw conclusions regarding PC's impact on the transition from hospital to home. Further research should use standardized outcomes with randomized controlled trial and/or propensity matched cohort designs.
-
J Pain Symptom Manage · Oct 2019
Development of a Pediatric Palliative Care Curriculum and Dissemination Model: Education in Palliative and End-of-Life Care (EPEC) Pediatrics.
Most children living and dying with serious illnesses experience high burden of distressing symptoms. Many seriously ill children and their families do not have access to subspecialist pediatric palliative care (PPC) services nor to clinicians trained in primary PPC. Lack of PPC education appears to be a significant barrier to PPC implementation. ⋯ EPEC-Pediatrics has developed into the most comprehensive PPC curriculum worldwide. It is highly adaptable for local settings, became self-sustaining and six conferences are offered around the world in 2019.
-
J Pain Symptom Manage · Oct 2019
Comparative StudyA Comparison of Rural and Urban Hospice Family Caregivers' Cancer Pain Knowledge and Experience.
Family caregivers play a vital role in managing the pain of hospice patients with cancer; however, caregivers' knowledge of pain management principles and experiences as pain managers vary widely. Differences in cultural values and access to resources suggest that rural and urban hospice family caregivers may differ with regard to their pain knowledge and experience, but this has not been empirically investigated. ⋯ Rural hospice family caregivers report greater pain knowledge deficits than urban hospice family caregivers, although the two groups report comparable pain management experiences. Additional research is needed to better explain observed differences.
-
J Pain Symptom Manage · Oct 2019
The Current Practice of Opioid for Cancer Dyspnea: The Result from the Nationwide Survey of Japanese Palliative Care Physicians.
Morphine is recommended as the first-line pharmacological therapy for cancer dyspnea. However, the detailed practice of morphine has not been evaluated and consensus about other opioids for cancer dyspnea has not been established. ⋯ Among Japanese palliative care physicians, using oxycodone for cancer dyspnea was relatively popular practice, whereas fentanyl was not. Oxycodone was the most preferred opioid for cancer dyspnea in the setting of renal insufficiency among Japanese palliative care physicians. We should conduct studies to confirm the safety and effectiveness of these opioid practices for cancer dyspnea.