Journal of palliative medicine
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There is increasing interest in moving palliative care (PC) upstream to the emergency department (ED). However, barriers to PC provision in ED exist and are not yet clearly delineated. ⋯ We identify two main ED physician-perceived barriers to PC provision: lack of access to medical records and lack of 24/7 availability of PC team. ED physicians may not use the same criteria to initiate PC consultation as used in traditional inpatient PC trigger models. Outlining ED-specific triggers may help streamline the palliative consultation process.
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The prevention and relief of suffering in palliative care are critical to the well-being and quality of life of patients and families facing life-threatening diseases. Many tools to assess different issues in health care are available, but few are specifically designed to evaluate suffering, which is essential for its prevention, early management, and treatment. ⋯ By taking into consideration all features of the assessment instruments under review, the evaluation of suffering can be made easier. A wide and ever expanding range of approaches is now available, which facilitates the selection of the suffering-assessment instrument that is best suited to the needs of the specific patient. One of the challenges ahead will be to further analyze the psychometric properties of some existing instruments.
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Comparative Study
Clinical characteristics of cancer patients referred early to supportive and palliative care.
Palliative care is evolving from end-of-life care to care provided earlier in the disease trajectory. We compared clinical characteristics between patients referred late in the course of their disease (late referrals, LRs) with patients referred earlier (early referrals, ERs). ⋯ ERs had different patient characteristics than LRs, and although ERs experience distress similar to that of LRs, their needs and outcomes differ.
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There is a growing need for palliative care services located outside of hospitals. ⋯ While requiring replication with rigorous methods, preliminary results suggest a home-based PM practice may reduce hospital utilization for ACI patients.
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To compare the treatment effect reducing cancer-related multiple breakthrough pain (BTP) between immediate release morphine sulfate (IRMS) and flurbiprofen axetil. ⋯ Flurbiprofen axetil can relieve BTP quickly and effectively.