Tahani Alwidyan, Noleen K McCorry, Chris Black, Rachel Coulter, June Forbes, Carole Parsons
BACKGROUND: Although prescribing and deprescribing practices in older people have been the subject of much research generally, there are limited data in older people at the end of life. This highlights the need for research to determine prescribing and deprescribing patterns, as a first step to facilitate guideline development for medicines optimisation in this vulnerable population. AIMS: To examine prescribing and deprescribing patterns in older people at the end of life and to determine the prevalence of potentially inappropriate medication use...
November 30, 2023: Palliative Medicine
Slavica Kochovska, Diana Ferreira, Sungwon Chang, Tim Luckett, Jessica Roydhouse, Magnus Ekström, David C Currow
BACKGROUND: Chronic breathlessness adversely impacts people with chronic obstructive pulmonary disease and their caregivers (family and friends), who may, in turn, experience significant burden due to their caregiving role. Sustained-release morphine may reduce chronic breathlessness in some patients, which may have an impact on caregivers' perceived burden. AIM: To explore the impact on caregiver burden of active treatment of people with chronic breathlessness (modified Medical Research Council (mMRC) ⩾ 3) and chronic obstructive pulmonary disease (COPD) with regular, low-dose, sustained-release morphine within a multi-site, double-blind, randomised, placebo-controlled trial...
November 17, 2023: Palliative Medicine
Emmanuelle Poncin, Emilie Bovet, Emmanuel Tamches, Boris Cantin, Josiane Pralong, Betty Althaus, Gian Domenico Borasio, Mathieu Bernard
BACKGROUND: Empirical studies suggest that gratitude positively influence the quality of life of palliative patients and relatives. However, the literature is marked by a lack of conceptual clarity about what gratitude is and whether it can bring about individual and social benefits. AIM: This paper explores how palliative care patients and relatives understand gratitude, how discursive representations of gratitude may affect their positions, perceptions and relations, and how to conceptualise gratitude in the palliative context...
November 9, 2023: Palliative Medicine
Aleksandra Korzeniewska-Eksterowicz, Olga Brzezinska, Urszula Dryja, Dominka Matczak, Andriy Sopilnyak, Eugenia Szuszkiewicz, Łukasz Przysło, Krzystof Szmyd, Katarzyna Jabłońska, Piotr Krych, Agnieszka Wojtków-Zielińska, Edyta Wąsińska, Maciej Niedźwiecki
BACKGROUND: Studies have shown the risk factors for COVID-19 severity in children, including comorbidities, but information on the infection course in children with life-limiting conditions is sparse. AIM: To describe the effect of COVID-19 on pediatric patients receiving palliative care due to life-limiting conditions. DESIGN: We conducted retrospective cohort study. The WHO Clinical Progression Scale was used to measure COVID-19 severity...
November 8, 2023: Palliative Medicine
Claudia Virdun, Elise Button, Jane L Phillips, Patsy Yates, Tim Luckett
BACKGROUND: Globally there are high numbers of patients with palliative care needs receiving care in hospitals. Patient reported experience measures (PREMs) provide useful data to guide improvement work. How to implement PREMs within palliative care populations is unclear. AIM: To explore the perspectives of inpatients with palliative care needs, their family members, and the clinical team regarding the use of a generic PREM as compared with a PREM designed for people with palliative care needs and related implementation factors...
November 3, 2023: Palliative Medicine
Janet M de Groot, Dwain C Fehon, Lynn Calman, Danielle S Miller, Andrea Feldstain
No abstract text is available yet for this article.
October 30, 2023: Palliative Medicine
Vanessa Abrahamson, Patricia Wilson, Stephen Barclay, Charlotte Brigden, Heather Gage, Kay Greene, Ferhana Hashem, Rasa Mikelyte, Melanie Rees-Roberts, Graham Silsbury, Mary Goodwin, Brooke Swash, Bee Wee, Peter Williams, Claire Butler
BACKGROUND: Hospice-at-home aims to enable patients approaching end-of-life to die at home and support their carers. A wide range of different service models exists but synthesised evidence on how best to support family carers to provide sustainable end-of-life care at home is limited. AIM: To explore what works best to promote family carers' experiences of hospice-at-home. DESIGN: Realist evaluation with mixed methods. This paper focuses on qualitative interviews with carers (to gain their perspective and as proxy for patients) and service providers from 12 case study sites in England...
October 21, 2023: Palliative Medicine
Lucy Coombes, Daney Harðardóttir, Debbie Braybrook, Hannah May Scott, Katherine Bristowe, Clare Ellis-Smith, Lorna K Fraser, Julia Downing, Myra Bluebond-Langner, Fliss Em Murtagh, Richard Harding
BACKGROUND: There is no validated outcome measure for use in children's palliative care outside sub-Saharan Africa. Stakeholders must be involved in the development of such measures to ensure face and content validity. AIM: To gain expert stakeholder consensus on items for inclusion in a paediatric palliative care outcome measure to establish face and content validity. DESIGN: This study was conducted in two phases following Rothrock and COSMIN guidance on patient-reported outcome measure development...
October 18, 2023: Palliative Medicine
Rachel McCauley, Karen Ryan, Regina McQuillan, Geraldine Foley
BACKGROUND: Patients in receipt of palliative care services are often viewed primarily as recipients of support from their family caregiver. There is a dearth of evidence in palliative care on what comprises mutual support between patients and their family caregivers in palliative care. AIM: To identify processes of mutual support between patients and family caregivers in palliative care. DESIGN: Qualitative study comprising semi-structured interviews...
October 13, 2023: Palliative Medicine
Lloyd Morgan, Stephen Barclay, Kristian Pollock, Efthalia Massou, Ben Bowers
BACKGROUND: The prescribing of injectable end-of-life anticipatory medications ahead of possible need is recommended best practice. The financial costs of these medications have been little studied. AIM: To identify the costs of anticipatory medications prescribed, used and not used for patients approaching the end-of-life at home and in residential care. DESIGN: Retrospective observational study using general practitioner and community nursing clinical records...
October 10, 2023: Palliative Medicine
Lesley Dunleavy, Nancy Preston, Catherine Walshe
BACKGROUND: Trial participant recruitment is an interactional process between health care professionals, patients and carers. Little is known about how clinicians carry out this role in palliative care trials and the reasons why they do or do not recruit participants. AIMS: To explore how clinicians recruit to palliative care trials, why they choose to implement particular recruitment strategies, and the factors that influence their choices. DESIGN: A qualitative multiple case study of three UK palliative care trials...
September 27, 2023: Palliative Medicine
Catherine Walshe, Céu Mateus, Sandra Varey, Steven Dodd, Zoe Cockshott, Luís Filipe, Sarah G Brearley
BACKGROUND: Healthcare usage patterns change for people with life limiting illness as death approaches, with increasing use of out-of-hours services. How best to provide care out of hours is unclear. AIM: To evaluate the effectiveness and effect of enhancements to 7-day specialist palliative care services, and to explore a range of perspectives on these enhanced services. DESIGN: An exploratory longitudinal mixed-methods convergent design...
September 21, 2023: Palliative Medicine
Megumi Kishino, Jonathan Koffman, Hiroaki Nagatomi, Misuzu Yuasa, Clare Ellis-Smith
BACKGROUND: Family members can support advance care planning conversations. However, how family involvement in advance care planning operates to achieve goal-concordant care remains unclear. AIM: To explore how family involvement impacts the process of advance care planning for advanced cancer patients and their family members to achieve goal-concordant care in Japan. DESIGN: Qualitative study incorporating semi-structured in-depth interviews with thematic analysis informed by Family Systems Theory...
September 18, 2023: Palliative Medicine
Meilu Liu, Wei Xiao, Longyi Du, Yan Yu, Xugui Chen, Bing Mao, Juanjuan Fu
BACKGROUND: Opioids are recommended to treat advanced refractory dyspnoea despite optimal therapy by the American Thoracic Society clinical practice guidelines, while newly published randomised controlled trials of opioids in chronic obstructive pulmonary disease yield conflicting results. AIM: This study aimed to evaluate the effectiveness and safety of opioids for patients with chronic obstructive pulmonary disease. DESIGN: Systematic review and meta-analysis (PROSPERO CRD42021272556)...
September 14, 2023: Palliative Medicine
Mary Thelen, Sarah G Brearley, Catherine Walshe
BACKGROUND: Individuals with palliative care needs face increased risk of discontinuity of care as they navigate between healthcare settings, locations and practitioners which can result in poor outcomes. Little is known about interactions that occur between specialist and generalist palliative care teams as patients are transition from hospital to community-based care after hospitalisation. AIM: To understand what happens between inpatient specialist palliative care teams and the generalist teams who provide post-discharge palliative care for shared patients...
September 10, 2023: Palliative Medicine
Denise Côté-Arsenault
No abstract text is available yet for this article.
October 2023: Palliative Medicine
Emily Kavanagh, Grace Rowley, Lauri Simkiss, Elizabeth Woods, Craig Gouldthorpe, Kate Howorth, Max Charles, Rachel Kiltie, Hannah Billett, Francesca Mastaglio, Felicity Dewhurst
BACKGROUND: Although home non-invasive ventilation for patients with chronic obstructive pulmonary disease and persisting hypercapnia prolongs time to hospital readmission and prognosis, they retain a poor long-term prognosis. Requiring non-invasive ventilation in this population should trigger advance care planning, yet only 50% of patients are engaged in such discussions. AIM: This study aimed to explore the barriers and facilitators to advance care planning for patients with chronic obstructive pulmonary disease on home non-invasive ventilation and generate recommendations for improving practice...
October 2023: Palliative Medicine
Felicity Dewhurst, Louise Tomkow, Marie Poole, Emma McLellan, Tafadzwa Patience Kunonga, Efioanwan Damisa, Melanie Stowell, Chris Todd, Barbara Hanratty
BACKGROUND: People of African and Caribbean descent experienced disproportionately high mortality from COVID-19 and have poor access to palliative care. AIM: To explore palliative care experiences of people of African and Caribbean descent during and immediately prior to the pandemic. DESIGN: Qualitative interview study with thematic analysis. Refinement of themes/recommendations in consultation with an expert patient and public advisory group...
October 2023: Palliative Medicine
Fiona Runacres, Susan Mathers, Sarah Cm Lee, Rowan Hearn, Sonia Gregory, Natasha Bear, Samar Aoun
BACKGROUND: Motor neurone disease is a rare but debilitating illness with incomplete evidence regarding patients' symptom burden. Palliative care and generalist clinicians are often in-experienced in caring for these patients and assessing their needs. AIM: To identify the symptom prevalence and severity experienced by patients with motor neurone disease. Secondary objectives were to examine differences in symptom burden and clusters according to phenotype, functional status, palliative care provision and those in their last months of life...
October 2023: Palliative Medicine
Eva Ejlersen Wæhrens, Deidre D Morgan, Karen la Cour, Kathleen Doyle Lyons, Mario Lozano Lozano, Marysia Mr Prado De Carlo, Gabriela Rezende, Marc Sampedro Pilegaard
BACKGROUND: While evidence shows that occupational therapists can play a key role in the care of people with palliative care needs, more knowledge about effective occupational therapy interventions for this group is needed. AIM: To identify, organise and prioritise intervention components considered to be effective within occupational therapy for people with palliative care needs from the perspective of occupational therapy clinicians, managers and researchers. DESIGN: Group Concept Mapping utilising a mixed methods participatory approach...
October 2023: Palliative Medicine
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