Palliative medicine
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Palliative medicine · Jan 2018
Meta AnalysisOpioids combined with antidepressants or antiepileptic drugs for cancer pain: Systematic review and meta-analysis.
Combining antidepressant or antiepileptic drugs with opioids has resulted in increased pain relief when used for neuropathic pain in non-cancer conditions. However, evidence to support their effectiveness in cancer pain is lacking. ⋯ Combining opioid analgesia with gabapentinoids did not significantly improve pain relief in patients with tumour-related cancer pain compared with opioid monotherapy. Due to the heterogeneity of patient samples, benefit in patients with definite neuropathic cancer pain cannot be excluded. Clinicians should balance the small likelihood of benefit in patients with tumour-related cancer pain against the increased risk of adverse effects of combination therapy.
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Palliative medicine · Dec 2017
Review Meta AnalysisThe effects of life review interventions on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer: A systematic review and meta-analysis of randomized controlled trials.
Life review interventions have been used to alleviate psycho-spiritual distress in people near the end of life. However, their effectiveness remains inconclusive. ⋯ Therapeutic life review is potentially beneficial for people near the end of life. However, the results should be interpreted with caution due to the limited number of randomized controlled trials and associated methodological weaknesses. Further rigorously designed randomized controlled trials are warranted.
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Palliative medicine · Dec 2017
Review Meta AnalysisRural end-of-life care from the experiences and perspectives of patients and family caregivers: A systematic literature review.
End-of-life care must be relevant to the dying person and their family caregiver regardless of where they live. Rural areas are distinct and need special consideration. Gaining end-of-life care experiences and perspectives of rural patients and their family caregivers is needed to ensure optimal rural care. ⋯ Articulation of the rural voice is increasing; however, there still remain limited published rural studies reporting on patient and family caregivers' experiences and perspectives on rural end-of-life care. Further research is encouraged, especially through national and international collaborative work.
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Palliative medicine · Oct 2017
Review Meta AnalysisWhat do we know about different models of providing palliative care? Findings from a systematic review of reviews.
A wide range of organisational models of palliative care exist. However, decision makers need more information about which models are likely to be most effective in different settings and for different patient groups. ⋯ Irrespective of setting or patient characteristics, models of palliative care appear to show benefits and some models of palliative care may reduce total healthcare costs. However, much more detailed and systematic reporting of components and agreement about outcome measures is essential in order to understand the key components and successfully replicate effective organisational models.
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Palliative medicine · Jul 2017
Review Meta AnalysisDying in the hospital setting: A meta-synthesis identifying the elements of end-of-life care that patients and their families describe as being important.
Despite most expected deaths occurring in hospital, optimal end-of-life care is not available for all in this setting. ⋯ Consumer narratives help to provide a clearer direction as to what is important for hospital end-of-life care. Systems are needed to enable optimal end-of-life care, in accordance with consumer priorities, and embedded into routine hospital care.