Articles: palliative-care.
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Pharmacotherapy is essential in palliative medicine. Besides potential benefits, pharmacotherapy also poses potential risks that need to be minimized for patient safety. Pharmacists can play an important role in identifying, solving, and avoiding drug-related problems (DRPs). ⋯ Clinically relevant DRPs are common in palliative medicine. The systematic assessment can support therapy decisions. This can result in optimized drug therapy, subsequently having a positive effect on symptom control and quality of life.
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Palliative medicine · Dec 2021
The 'work' of managing medications when someone is seriously ill and dying at home: A longitudinal qualitative case study of patient and family perspectives'.
Managing medications can impose difficulties for patients and families which may intensify towards the end of life. Family caregivers are often assumed to be willing and able to support patients with medications, yet little is known about the challenges they experience or how they cope with these. ⋯ It is essential to consider the limits of what it is reasonable to ask patients and families to do, especially when fatigued, distressed and under pressure. Focus should be on improving support via greater professional understanding of the work needed to manage medications at home.
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Background: The morbidity and mortality of interstitial lung disease (ILD) is high, despite novel therapeutics. Recognizing unmet needs for symptom management, advance care planning (ACP), and support for people with ILD and their families, we developed a palliative care-ILD collaborative care pilot program to improve access to palliative care. Methods: In the quantitative arm of this mixed-methods study, we evaluated which patients were cared for through the palliative care co-management program and the impact of the program on rates of ACP and opioid prescribing. ⋯ Clinicians reported how palliative care co-management improved patient care and clinician experience, but barriers to referral remain including misperceptions about palliative care on the part of providers and patients. Conclusions: Palliative care co-management for patients with moderately severe ILD holds promise, and our experience can inform groups at other centers who are interested in developing such care models. Ongoing challenges include systematically reaching all patients who are likely to benefit.
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Background: Palliative care (PC) programs worldwide are involved in caring for patients with coronavirus disease 2019 (COVID-19) with other professionals. Objectives: To determine health professionals' perceptions of the contributions of PC in COVID-19 care, and describe its effect on professionals' psychological distress. Design: Cross-sectional study. ⋯ Twenty-five (39%) participants agreed that PC eased distress by communicating with patients, families, and other professionals, providing guidance in difficult conversations and offering companionship. Among respondents, 84% would likely work with PC in the future. Conclusions: During the COVID-19 pandemic, health professionals perceived PC as helpful in caring for patients and families, and in easing their own psychological distress.
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The integration of palliative care into intensive care units (ICUs) is advocated to mitigate physical and psychological burdens for patients and their families, and to improve end-of-life care. The most efficacious palliative care interventions, the optimal model of their delivery and the most appropriate outcome measures in ICU are not clear. ⋯ Beneficial effects on the most common outcomes were associated with strategies to enhance palliative care involvement, either with an integrative or a consultative approach. Few studies reported functional outcomes for ICU patients. Almost all studies were from North America, limiting the generalisability to other healthcare systems.