Palliative medicine
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Palliative medicine · Jun 2020
Ethical and research governance approval across Europe: Experiences from three European palliative care studies.
Research requires high-quality ethical and governance scrutiny and approval. However, when research is conducted across different countries, this can cause challenges due to the differing ethico-legal framework requirements of ethical boards. There is no specific guidance for research which does not involve non-medicinal products. ⋯ Researchers need to take the differences in research approval procedures into account when planning studies. Future research is needed to establish European-wide recommendations for policy and practice that dovetail ethical procedures and enhance transnational research collaborations.
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Palliative medicine · Jun 2020
Patient-reported symptoms and problems at admission to specialized palliative care improved survival prediction in 30,969 cancer patients: A nationwide register-based study.
Large, nationally representative studies of the association between quality of life and survival time in cancer patients in specialized palliative care are missing. ⋯ Most symptoms/problems were significantly associated with survival and mainly physical function improved predictions of death. Interestingly, the predictive value of physical function was the same as all clinical variables combined (in hospice) or even higher (in palliative care teams).
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Palliative medicine · Jun 2020
Case ReportsRepeated subcutaneous esketamine administration for depressive symptoms and pain relief in a terminally ill cancer patient: A case report.
Depressive disorders are common among cancer patients. Ketamine can quickly relieve depression, and its subcutaneous administration appears to be as effective as and probably safer than its standard intravenous administration. Herein, we report a case verifying the antidepressant effect of a subcutaneous esketamine formulation. ⋯ Placebo-controlled studies with similar cases are needed to establish efficacy and safety.
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Palliative medicine · Jun 2020
Opioid underuse in terminal care of long-term care facility residents with pain and/or dyspnoea: A cross-sectional PACE-survey in six European countries.
Opioids relieve symptoms in terminal care. We studied opioid underuse in long-term care facilities, defined as residents without opioid prescription despite pain and/or dyspnoea, 3 days prior to death. ⋯ Opioid underuse differs between countries. Pain and dyspnoea should be formally assessed at the end-of-life and taken into account in physicians orders.