Articles: palliative-care.
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Am J Hosp Palliat Care · Jan 2000
Developing a physicians' palliative care pain hotline in Maryland.
Physicians have had relatively little formal training in pain management and palliative care. For this reason, a telephone consultation service was offered, the physicians' palliative care pain hotline, that would allow physicians to call a toll-free number and, within 15 minutes, speak to a board-certified physician in hospice and palliative medicine. ⋯ This article describes the process involved in creating such a pain hotline and reports on some data collected on its use in the first 10 months. This report should help others who have an interest in establishing a similar program.
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Clinical Trial
[Research from the Palliative Care Department in Poznań on treatment of neoplasm pain with Durogesic (transdermal fentanyl)].
Transdermal Fentanyl (TF, Durogesic) is a strong opioid analgesic which is used in the treatment of cancer pain. In this article we described basic properties and dosing guidelines for TF and our own experience with use of Durogesic in the treatment of cancer pain. In this open study TF was administered in 16 pts aged of 30-88 (mean 62 +/- 17) years with advanced cancer who suffered from strong cancer pain and who had previously been treated with morphine (11 pts), buprenorphine (1 pt), tramadol (2 pts) and non-opioid analgesics (2 pts). ⋯ The treatment was well tolerated and the most frequent adverse reactions were constipation in 10 pts (63%) and drowsiness in 4 pts (25%). During the therapy with TF we didn't encounter serious side-effects which would cause cessation of the treatment. Results of our study confirmed that TF was an effective analgesic most commonly used in pts with stable nociceptive pain especially when opioid analgesics could not be administered orally.
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Comparative Study
Home versus hospice inpatient care: discharge characteristics of palliative care patients in an acute care hospital.
This prospective survey was initiated to identify factors that helped and hindered home discharge for 100 consecutive patients who did not require further specialist palliative or acute care. Information was collected on demographics, functional ability (using the Palliative Performance Scale [PPS] and Karnofsky Performance Scale [KPS]), cognitive function at discharge as measured by the Mini-Mental State Examination (MMSE), home support circumstances, and patient and family preference for discharge. 59 patients were discharged home and 41 were transferred to a hospice. Younger patients with younger caregivers were discharged home more often. ⋯ More physical support at home could have facilitated a home discharge for 13 patients. Functionally dependent and cognitively impaired patients were generally unable to return home. To support patients and their families in an environment of their choice, access to increased physical support in the home must be addressed.