Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2020
Observational StudyOFF-LABEL AND UNLICENSED DRUGS IN PEDIATRIC PALLIATIVE CARE: A PROSPECTIVE OBSERVATIONAL STUDY.
Off-label and unlicensed use of drugs is a widespread practice in pediatric care because of the lack of specific efficacy and safety data and the absence of formulations adapted to the needs of these individuals. Pediatric patients with a life-limiting illness frequently receive drugs under these conditions, although no studies have established the prevalence of this practice. ⋯ More than half of the prescriptions in this PPCU were off label or unlicensed. Treatment indication was one of the main reasons for off-label use. Administration of compounded preparations was common in patients with a life-limiting illness.
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J Pain Symptom Manage · Nov 2020
Provider perceptions of a humanizing intervention for healthcare workers - a survey study of PPE Portraits.
Reports from patients and health care workers dealing with coronavirus disease 2019 (COVID-19) underscore experiences of isolation and fear. Some of this experience results from the distancing effect of masks, gloves, and gowns known as personal protective equipment (PPE). One approach to bridging the divide created by PPE is the use of PPE portraits, postcard-sized pictures affixed to PPE. ⋯ Providers report that PPE portraits may represent a positive patient-centered idea that helps reassure patients, is well received by interdisciplinary staff, and may enhance patient and team interactions. Potential adaptations to address concerns include photo pins and donor/patient and family experience department support for costs.
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J Pain Symptom Manage · Nov 2020
Cancer Patients' Perceived Difficulties Filling Opioid Prescriptions After Receiving Outpatient Supportive Care.
Limited access to opioids for patients with cancer has been reported as a potential unintended consequence of recent regulations restricting opioid use and prescribing practices. To our knowledge, there are a limited number of peer-reviewed studies that evaluate the perceived difficulties of the patients with cancer when filling their opioid prescription. To understand these difficulties, we surveyed patients receiving opioids in our outpatient supportive care center (SCC). ⋯ This study provides evidence that patients with cancer visiting our SCC perceived difficulties obtaining their opioid prescriptions. The results suggest that negative interactions with the pharmacy and/or pharmacist contribute to their perceived difficulty. Additional research is needed to further characterize the contributors of the difficulties patients with cancer face in filling their opioid prescriptions.
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J Pain Symptom Manage · Nov 2020
Pediatric Chronic Critical Illness: Training teams to address the communication challenges of patients with repeated and prolonged hospitalizations.
Children with chronic critical illness (CCI) have repeated and prolonged hospitalizations. Discrete communication challenges characterize their inpatient care. ⋯ Interdisciplinary communication training regarding long stay patients is feasible and valued by novice and seasoned clinicians. The novel integration of intrateam communication skills alongside team-family skills reflects the reality that the care of children with CCI challenges clinicians to communicate well with each other and families. Teaching interdisciplinary teams to share communication skills has the potential to overcome reported limitations of existing inpatient discussions, which can be dominated by one or two physicians and lack contributions from diverse team members.
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J Pain Symptom Manage · Nov 2020
Palliative care for idiopathic pulmonary fibrosis patients: Pulmonary physicians' view.
Although idiopathic pulmonary fibrosis (IPF) has worse outcomes compared with most malignancies, patients with IPF receive poor access to optimal palliative care. ⋯ Pulmonologists experienced greater difficulty in providing palliative care to patients with IPF than to those with lung cancer. Clinical studies on the optimal palliative care for patients with IPF are urgently required.