Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2025
Implementing the WHO Indicators for assessing palliative care development in three countries: a Do-It-Yourself approach.
Palliative care is an essential health service, with over 56.8 million people needing it yearly, particularly in low- and middle-income countries. The World Health Assembly has recognized palliative care as an ethical responsibility and called for comprehensive primary health care. The World Health Organization has published a technical report titled "Assessing the Development of Palliative Care Worldwide," as a crucial first step in addressing palliative care. The report includes 14 indicators to help decision-makers identify service provision gaps and inform health priorities, piloted by WHO's ATLANTES in Benin, Morocco, and Uruguay as part of a global assessment. ⋯ The WHO approach has proven effective in identifying health system deficiencies and disseminating information about palliative care evaluation processes. The report provides a 'Do-it-yourself' approach, encouraging self-management without expert guidance.
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J Pain Symptom Manage · Jan 2025
Improving hospital palliative care between COVID-19 waves: A retrospective cohort study.
A specialist palliative care service in an acute hospital characterized care patterns during the first wave of the COVID-19 pandemic. There were delayed referrals for minoritized ethnic groups. COVID-19 treatments (dexamethasone, anticoagulation, remdesivir) alongside service changes were introduced in the second wave. ⋯ Our findings have the potential to inform strategies that improve palliative care response and equity beyond COVID-19, and in future pandemics or crises.
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J Pain Symptom Manage · Jan 2025
Advance Care Planning Bundle: Using Technical and Adaptive Solutions to Promote Goal Concordant Care.
Advance Care Planning (ACP) is critical to achieve goal-aligned care for patients. However, optimal implementation requires complex coordination and alignment across a healthcare system. ⋯ Implementation of technical and adaptive tools as a bundle for Advance Care Planning shows promise to improve and sustain goal-aligned care. Quality Improvement in ACP is a complex, iterative process involving both structural change and behavioral adaptation.
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J Pain Symptom Manage · Jan 2025
Case ReportsCOMPLIMENTARY ROLE OF COMPREHENSIVE PALLIATIVE CARE TREATMENT TO INTRATHECAL THERAPY: CASE REPORT.
Intrathecal therapy with implanted devices is often reported in some recommendations.for the management of difficult cancer pain However, data is often biased by optimistic view and poor assessment. We report a case of patient in which a comprehensive and complex palliative care treatment was effective in managing a patient who was implanted a subcutaneous port for intrathecal analgesia This patient had many characteristics of a difficult pain, really defined as refractory due to various negative prognostic pain factors, such as neuropathic pain and psychological distress.. ⋯ Terms such as intractable or refractory pain, have been ambiguously used in literature to select patients as candidates for implated pumps. A meaningful evaluation and a comprehensive treatment should be mandatory when using intrathecal anlgesia in patients with very difficult pain conditions.