Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2025
ReviewPalliative Care in Hematology: A Systematic Review of the Components, Effectiveness, and Implementation.
While the evidence supporting the benefits of integration of palliative care into cancer care for patients and informal caregivers is growing, it poses challenges for hematological cancer patients due to rapidly changing disease trajectories, uncertain prognosis, and diverse care needs. ⋯ While palliative care interventions are found to improve patient outcomes, future research is needed on the effectiveness of secondary palliative care interventions, integrating primary palliative care, and more reliable and frequent implementation measurements. More focus on informal caregivers and resource allocation based on patient needs is warranted.
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J Pain Symptom Manage · Jan 2025
Should an acute palliative care unit be mandatory for cancer centers and tertiary care hospitals?
Acute palliative care units have been developing in the last years and their clinical activity and characteristics have been described, despite large differences in different countries. One controversial topic is whether such units should be mandatory as standard in comprehensive cancer centers or even in tertiary hospitals. ⋯ Interestingly, all three experts arrived at similar conclusions. They underscored the importance of an acute palliative care unit, which provides a different pattern of activities in comparison with typical inpatient hospices, generally caring for patients who have a limited expected survival.
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J Pain Symptom Manage · Jan 2025
Developing a Scale for Home-Visit Nurses to Start End-of-life Discussions with Cancer Patients.
Home-visit nurses find it challenging to determine the appropriate time to initiate end-of-life discussions with cancer patients. ⋯ The reliability and validity of the T-EOLD is acceptable, as it is an appropriate scale that home-visit nurses can use to determine the time to initiate end-of-life discussions with cancer patients. However, further study is required to examine T-EOLD's clinical utility, both nationally and internationally.
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J Pain Symptom Manage · Jan 2025
Use of Essential Medicines for Pain Relief and Palliative Care: a global consensus process.
The WHO Model List of Essential Medicines includes 24 medications under the section Medicines for Pain and Palliative Care (EML). The Lancet Commission on Pain and Palliative Care developed the Lancet Essential Package (LEP), including 35 medications designed to alleviate serious health-related suffering worldwide. ⋯ We were able to partly achieve our goal, with limited evidence and a wide range of clinical practice described by the experts. This highlights an important gap in critical information which affects mostly the provision of palliative care at the primary care. Both limited availability and lack of training on the adequate use of essential medications may affect how clinicians manage symptoms, possibly relying on personal experience or trial and error, rather than evidence-based information.