Journal of palliative medicine
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Randomized Controlled Trial Comparative Study
Intravenous versus subcutaneous morphine titration in patients with persisting exacerbation of cancer pain.
Patients with cancer pain with initially adequate analgesia under oral sustained-release opioid medication may suffer from persisting pain exacerbations. Sometimes even fast help is needed and then optimally performed by intravenous application (IVA) of immediate-release (IR) opioids. This IVA, however, may only be performed by physicians in Germany. ⋯ Intravenous and subcutaneous-morphine titration are adequate to antagonize persisting pain exacerbations in cancer pain patients quickly and to adapt the continuous opioid analgesic medication.
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Randomized Controlled Trial Clinical Trial
A quality improvement intervention to increase palliative care in nursing homes.
Death is common in nursing homes, but access to palliative care is limited. ⋯ A quality improvement intervention was effective in increasing hospice enrollment, pain assessment, nonpharmacologic pain treatment, and advance care planning discussions.
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Randomized Controlled Trial Comparative Study Clinical Trial
Supportive-affective group experience for persons with life-threatening illness: reducing spiritual, psychological, and death-related distress in dying patients.
Attention to psycho-socio-spiritual needs is considered critical by patients with life-threatening illnesses and their caregivers. Palliative care interventions that address these needs--particularly spirituality--are lacking. ⋯ The use of the LTI-SAGE model for enhancing the end-of-life illness experience is promising.
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Randomized Controlled Trial Clinical Trial
Integrating case management and palliative care.
Most seriously ill Americans live at home under the care of their primary physician and with the support of family caregivers. To reduce costs while simultaneously improving the quality of patient care, insurers have increasingly turned to the concept of case management. While case management is targeted to individuals with life-threatening illnesses, palliative care assessment and interventions are typically not included in the management protocols. ⋯ Preliminary programmatic results indicate that combining palliative care with the case management approach is a logical, feasible, and effective strategy to improve the care of seriously ill patients living in the community. Franklin Health has offered the program to their entire client base because they feel that the integration of palliative care into their case management program improved the standard of patient care. Blue Cross Blue Shield of South Carolina has also chosen to sustain this enhanced model of care management for seriously ill patients.