Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2019
ReviewControl and context are central for people with advanced illness experiencing breathlessness: A systematic review and thematic-synthesis.
Breathlessness is common and distressing in advanced illness. It is a challenge to assess, with few effective treatment options. To evaluate new treatments, appropriate outcome measures that reflect the concerns of people experiencing breathlessness are needed. ⋯ People with advanced illness living with breathlessness have concerns in multiple domains, supporting a concept of "total breathlessness." This adapted model can help to guide comprehensive clinical assessment and inform future outcome measurement in clinical practice and research.
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J Pain Symptom Manage · Jan 2019
Latent Class Analysis of Specialized Palliative Care Needs in Adult Intensive Care Units from a Single Academic Medical Center.
In the intensive care unit (ICU), 14% of patients meet criteria for specialized palliative care, but whether subgroups of patients differ in their palliative care needs is unknown. ⋯ Based on the initial reason for consultation, we identified four classes of palliative care needs among critically ill patients, and GCAD patients were least likely to be high utilizers. These findings may help inform allocation of palliative care resources for this population.
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J Pain Symptom Manage · Jan 2019
Managing chronic pain in cancer survivors prescribed long-term opioid therapy: a national survey of ambulatory palliative care providers.
Chronic pain, or pain lasting more than three months, is common among cancer survivors, who are often prescribed long-term opioid therapy (LTOT). ⋯ Palliative care providers are comfortable with many aspects of managing chronic pain in cancer survivors on LTOT, although challenges persist, including the lack of systems-based approaches and training in addiction treatment.
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J Pain Symptom Manage · Jan 2019
Changes in the Care Setting of First Consults to Palliative and Supportive Care over a 7-Year Period.
Optimal benefits from palliative care (PC) are achieved when first consults (PC1) occur early, in the outpatient setting. Late PC1, like those in the intensive care unit (ICU), limit these benefits. ⋯ PC1 total annual number has increased, and the proportion of PC1 at ICU, a very late clinical setting, is decreasing. Further efforts are needed to integrate PC in hematologic cancer care.