Articles: palliative-care.
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Clin Oncol (R Coll Radiol) · Sep 2008
Multicenter StudyPalliative radiotherapy for women with breast cancer.
Palliative radiotherapy (PRT) plays an important role in women with metastatic breast cancer. However, not all cancer patients with an indication for PRT receive it. The aim of this study was to measure the use of PRT for women who have died of breast cancer in the Canadian province of Alberta, and to identify factors that might affect this use. ⋯ There are many factors that influence the receipt of PRT in Alberta that are unrelated to patient need. The education of physicians and patients, as well as the establishment of more radiotherapy facilities, will help to improve the use of PRT.
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Palliative medicine · Sep 2008
Multicenter StudyDevelopment and validation of a prognostic scale for use in patients with advanced cancer.
The aim of this study was to develop a new prognostic indicator to help predict survival in advanced cancer patients more accurately. Data on 329 patients obtained from a multi-centre study in London were analysed. A multifactorial Cox regression model was applied and validated using bootstrapping techniques. ⋯ Four variables were found to be associated with worse survival: primary lung cancer, secondary liver cancer, raised C-Reactive protein and poor performance status (ECOG 4). Survival curves showed that patients designated as 'high' risk by the resulting index had significantly shorter survival than those designated as 'low' risk. A high score on the newly derived prognostic index is associated with poorer survival, but its clinical utility is limited by the relatively low predictive probability of the score.
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Am J Alzheimers Dis Other Demen · Aug 2008
Multicenter StudyMeaning and practice of palliative care for nursing home residents with dementia at end of life.
To describe the meaning and practice of palliative care (PC) for nursing home (NH) residents with dementia at end of life (EOL). ⋯ The role of PC for NH residents with dementia at EOL is complex and poorly understood. As they are in a residential setting, decisions need to be made about how residents live, as well as how they die, thus balancing quality of living/comfort with disease management.
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Multicenter Study Clinical Trial
Integrating palliative medicine into the care of persons with advanced dementia: identifying appropriate medication use.
To evaluate the feasibility of developing consensus recommendations for appropriate prescribing for patients with advanced dementia using a new conceptual framework and to determine the frequency of inappropriate medication use based on these recommendations in a small sample of patients with advanced dementia. ⋯ Based on these preliminary findings, consensus criteria for prescribing in advanced dementia are needed to decrease polypharmacy and reduce the use of medications that are of minimal benefit or high risk.
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Critical care medicine · Apr 2008
Randomized Controlled Trial Multicenter StudyUsing the medical record to evaluate the quality of end-of-life care in the intensive care unit.
We investigated whether proposed "quality markers" within the medical record are associated with family assessment of the quality of dying and death in the intensive care unit (ICU). ⋯ We identified chart-based variables associated with higher QODD scores. These QODD scores could serve as targets for measuring and improving the quality of end-of-life care in the ICU.