Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2019
Outcomes of Palliative Care Consultations for Hospitalized Patients with Liver Disease.
Although palliative care (PC) has been shown to improve symptoms and end-of-life (EOL) care for patients with cancer, data are lacking on the patterns of use and outcomes of PC consultations for hospitalized patients with liver disease. ⋯ Hospitalized patients with liver disease were more likely to have a PC referral to address goals of care compared with those with cancer and were more likely to die in the hospital. Despite late PC consultations, patients with liver disease experienced improvement in symptoms and clarification of their goals of care, similar to those with cancer.
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J Pain Symptom Manage · Nov 2019
Barriers to accessing internationally controlled essential medicines in Uganda: A qualitative study.
Access to internationally controlled essential medicines is a problem worldwide. More than five billion people cannot access opioids for pain and palliative care or do not have access to surgical care or anesthetics, 25 million people living with epilepsy do not have access to their medicines, and 120,000 women die annually owing to postpartum hemorrhage. In Uganda, access to controlled medicines is also problematic, but a lack of data on factors that influence access exists. ⋯ The findings of this research indicate that to improve access to internationally controlled essential medicines in Uganda, health system strengthening is needed on multiple fronts. Active engagement and concerted efforts are needed from all stakeholders to ensure access and prevent abuse.
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Palliative care (PC) for seriously ill surgical patients, including aligning treatments with patients' goals and managing symptoms, is associated with improved patient-oriented outcomes and decreased health care utilization. However, efforts to integrate PC alongside restorative surgical care are limited by the lack of a consensus definition for serious illness in the perioperative context. ⋯ We identified a consensus definition for serious illness in surgery. Opportunities remain in measuring the prevalence, identifying health trajectories, and developing screening criteria to integrate PC with restorative surgical care.
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J Pain Symptom Manage · Nov 2019
Dying with unrelieved pain - prescription of opioids is not enough.
Fear of pain resonates with most people, in particular, in relation to dying. Despite this, there are still people dying with unrelieved pain. ⋯ Despite almost complete prescription of opioids PRN for patients with pain, patients die with unrelieved pain. Health care providers, hospitals in particular, need to focus more on pain in dying patients. An EoL conversation is one achievable intervention.
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J Pain Symptom Manage · Nov 2019
Agreement of nursing home staff with palliative care principles: a PACE cross-sectional study among nurses and care assistants in five European countries.
To provide high-quality palliative care to nursing home residents, staff need to understand the basic principles of palliative care. ⋯ The level of agreement of nursing home staff with basic principles of palliative care was only moderate and differed between countries. Efforts to improve the understanding of basic palliative care are needed.