Journal of palliative medicine
-
"Chemical coping" is a commonly used term in the pain and palliative care literature, but is heterogeneously defined. We conducted a Delphi survey among palliative care and pain specialists internationally to identify a consensus definition for "chemical coping with opioids" and warning signs for chemical coping. ⋯ Our expert panel reached a consensus definition for chemical coping and related warning signs, which may help clinicians and researchers to identify patients at risk of opioid misuse.
-
The majority of hospital deaths in the United States occur after ICU admission. The characteristics associated with the place of death within the hospital are not known for patients with cancer. ⋯ Understanding existing patterns of care at the end of life will help guide decisions about resource allocation and palliative care programs. Patients who seek care at dedicated cancer centers may elect more aggressive care; thus the generalizability of this study is limited. Although dying in a hospital may be unavoidable for patients who have uncontrolled symptoms that cannot be managed at home, palliative care consultations with patients and their families in advance regarding end-of-life preferences may prevent unwanted admission to the ICU.