Articles: palliative-care.
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Clin Colorectal Cancer · Dec 2018
Randomized Controlled Trial Multicenter StudyCost-effectiveness Analysis of Regorafenib and TAS-102 in Refractory Metastatic Colorectal Cancer in the United States.
Regorafenib and TAS-102 are standard treatment options in refractory metastatic colorectal cancer based on improvement in overall survival by 6 and 8 weeks, respectively, when compared with best supportive care alone (BSC). Given the small incremental clinical benefit, we evaluated their cost-effectiveness from a United States payer's perspective. ⋯ Neither TAS-102 nor regorafenib are cost-effective at standard willingness-to-pay thresholds (ie, $150,000 per QALY) relative to BSC. There is no clear evidence that either treatment has better relative value.
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J Pain Symptom Manage · Dec 2018
Randomized Controlled Trial Multicenter Study Comparative StudyHyoscine Butylbromide for the Management of Death Rattle: Sooner Rather Than Later.
Death rattle (DR) is a dramatic sign in the dying patient. Existing studies with anticholinergic agents are controversial, as this class of drugs has been commonly administered without considering the rationale of the mechanism of action. A meaningful use of these drugs may provide a better outcome. ⋯ The prophylactic use of HB is an efficient method to prevent DR, whereas the late administration produces a limited response, confirming data from traditional studies performed with anticholinergics. This could be considered a new paradigm to manage a difficult and dramatic sign, such as DR.
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J Pain Symptom Manage · Oct 2018
Randomized Controlled TrialFan Therapy Is Effective in Relieving Dyspnea in Patients With Terminally Ill Cancer: A Parallel-Arm, Randomized Controlled Trial.
Dyspnea is a common distressing symptom among patients with advanced cancer. ⋯ Fan-to-face is effective in alleviating dyspnea in patients with terminally ill cancer.
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Randomized Controlled Trial
Concordance between Goals of Care and Treatment Decisions for Persons with Dementia.
Nursing home (NH) residents with dementia experience high rates of intensive treatment near the end of life. Limited research examines whether treatment is concordant with goals of care (GOC). ⋯ Most families chose comfort as the primary GOC. Further research is needed to translate this preference into comfort-focused treatment plans for late-stage dementia. Clinicaltrials.gov : NCT01565642 (3/26/12).
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Palliative medicine · Sep 2018
Randomized Controlled TrialClinician-reported changes in octreotide prescribing for malignant bowel obstruction as a result of an adequately powered phase III study: A transnational, online survey.
Translating research evidence into clinical practice often has a long lag time. ⋯ Clinician-reported change in practice in the survey is seen in the majority of respondents. This suggests that there is a cohort of 'early adopters' within palliative care practice as new evidence becomes available.