Journal of palliative medicine
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Case Reports
Oral transmucosal fentanyl citrate for dyspnea in terminally ill patients: an observational case series.
To evaluate the efficacy and safety of oral transmucosal fentanyl citrate (OTFC) in terminally ill patients experiencing dyspnea. ⋯ OTFC appears to be safe and effective for dyspnea in terminally ill patients. The study population is limited to four cases, however, the initial findings are promising and merit further research.
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Instructional advance directives (ADs) are traditionally written to apply in terminal illness. As such, they do not readily capture patient preferences for care in acute and chronic illness. ⋯ Traditional instructional ADs fail to capture important patient preferences. Future research should further validate these preferences and explore whether including these specific options in ADs can improve their efficacy.
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Comparative Study
Symptom clusters in patients with cancer with metastatic bone pain.
The primary objective was to explore how patients' worst pain clustered together with functional interference items. Secondary objectives were to determine whether symptom clusters change with palliative radiotherapy (RT) and to compare the difference between responders and nonresponders to radiation. ⋯ Symptom clustering has proved to be therapeutically important because treatment of one symptom may affect others within the same cluster. The significant correlations between worst pain and the functional interference items reaffirm the importance of pain reduction as a treatment goal for palliative radiotherapy. By treating a patient's symptom of worst pain, it would subsequently ease their response burden on their daily functional activities by decreasing symptom severity, increasing function, and improving overall quality of life.