Journal of palliative medicine
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Timely identification of patients in need of palliative care is especially challenging in a geriatric population because of prognostic uncertainty. The Supportive and Palliative Care Indicators Tool (SPICT™) aims at facilitating this identification, yet has not been validated in a geriatric population. ⋯ SPICT seems to be valuable for identifying geriatric patients in need of palliative care as it demonstrates significant association with one-year mortality and with clinical survival predictions of experienced geriatricians, as reflected by TLDs given.
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Cancer patients have a high rate of emergency department (ED) visits and inpatient hospitalizations (IHs) that may be reduced by use of outpatient palliative care services. ⋯ Further work is needed to define the best model for outpatient palliative care.
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Comparative Study
Life-Limiting Conditions at a University Pediatric Tertiary Care Center: A Cross-Sectional Study.
The increasing number of children with life-threatening and life-limiting conditions requires an individualized approach and additional supportive care in hospitals. However, these patients' characteristics and their prevalence in a pediatric tertiary hospital setting have not been systematically analyzed. ⋯ A substantial proportion of pediatric inpatients suffered from life-threatening or LLDs, as well as rare diseases, indicating a high burden of symptoms and a high need for additional care. The results suggest a substantial need to implement pediatric palliative care structures in tertiary care centers for patients in critical and terminal conditions.
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Access to Palliative Care Consultation and Advance Care Planning for Adults with High-Risk Leukemia.
Although strong evidence supports early palliative care (PC) and consistent advance care planning (ACP) for patients with poor-prognosis Stage IV solid tumors, best practice standards have not been established for hematologic malignancies. Our primary objective was to describe current access to specialty PC consultation and ACP for inpatients with high-risk leukemia. Secondary objectives were to describe components of ACP and PC practices. ⋯ In this descriptive study of inpatients with high-risk leukemia, we found that despite a poor prognosis and high symptom burden, the frequency of PC consultation and ACP documentation was low. Findings suggest missed opportunities to provide PC to a high-risk subset of hematologic malignancies, and may help to target future interventions.
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Comparative Study Observational Study
Palliative Care Needs in an Acute Internal Medicine Ward in Mexico.
Palliative care is an evolving but underdeveloped practice in Mexico. ⋯ The number of patients requiring palliative care in internal medicine wards may be excessive to the current palliative care structures available.