Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2022
Multicenter StudySymptom control and survival for people severely ill with COVID: a multicentre cohort study (CovPall-Symptom).
Evidence of symptom control outcomes in severe COVID is scant. ⋯ Symptoms of COVID quickly improved during palliative care. Breathlessness, agitation and multimorbidity could be used as triggers for timelier referral, and symptom guidance for wider specialities should build on treatments identified in this study.
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J Pain Symptom Manage · Oct 2022
Multicenter Study Observational StudyAre Prognostic Scores Better than Clinician Judgment? A Prospective Study using Three Models.
Several prognostic models such as the Palliative Performance Scale (PPS), Palliative Prognostic Index (PPI), Palliative Prognostic Score (PaP) have been developed to complement clinician's prediction of survival (CPS). However, few studies with large scales have been conducted to show which prognostic tool had better performance than CPS in patients with weeks of survival. ⋯ The PPS, PPI, PaP, and CPS had relatively good performance in patients admitted to PCUs with weeks of survival. CPS and PaP had significantly better performance than the PPS and PPI. CPS may be sufficient for experienced clinicians while PPS may help to improve prognostic confidence for inexperienced clinicians.
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J Pain Symptom Manage · Oct 2022
Randomized Controlled Trial Multicenter StudySeriously ill patients' prioritized goals and their clinicians' perceptions of those goals.
Seriously ill patients whose prioritized healthcare goals are understood by their clinicians are likely better positioned to receive goal-concordant care. ⋯ A majority of seriously ill outpatients are cared for by clinicians who accurately perceive their patients' prioritized healthcare goals. However, a substantial portion are not and may be at higher risk for goal-discordant care. Interventions that facilitate goals-of-care discussions may help align care with goals, as recent discussions were associated with accurate perceptions of patients' prioritized goals.