Acceptability of low molecular weight heparin thromboprophylaxis for inpatients receiving palliative care: qualitative study.

Abstract:

OBJECTIVE:To find out what inpatients with advanced cancer who are receiving palliative care think about the effect of thromoprophylaxis on overall quality of life. DESIGN:Qualitative study using audiotaping of semistructured interviews. SETTING:Regional cancer centre in Wales. PARTICIPANTS:28 inpatients with advanced metastatic cancer receiving palliative care and low molecular weight heparin. MAIN OUTCOME MEASURES:Recurring themes on the effect of thromboprophylaxis on overall quality of life. RESULTS:Major emerging themes showed that patients knew about the risks of venous thromboembolism and the purpose of treatment with heparin. Media coverage had raised awareness about venous thromboembolism, and many had previous experience of thromboprophylaxis. All found low molecular weight heparin an acceptable intervention, and many said that it improved their quality of life by giving them a feeling of safety and reassurance. Antiembolic stockings were considered uncomfortable and had a negative impact on quality of life. Patients were concerned that because they had advanced disease they might not be eligible for thromboprophylaxis. CONCLUSION:Low molecular weight heparin is acceptable to inpatients with advanced cancer receiving palliative care and has a positive impact on overall quality of life. Antiembolic stockings are an unacceptable intervention in this patient group. Guidelines on thromboprophylaxis are urgently needed for palliative care inpatient units and hospices.

journal_name

BMJ

authors

Noble SI,Nelson A,Turner C,Finlay IG

doi

10.1136/bmj.38733.616065.802

keywords:

subject

Has Abstract

pub_date

2006-03-11 00:00:00

pages

577-80

issue

7541

eissn

0959-8138

issn

1756-1833

pii

bmj.38733.616065.802

journal_volume

332

pub_type

杂志文章
  • Absorption of non-haem iron from food during normal pregnancy.

    abstract:OBJECTIVE:To determine whether the increased iron demands of pregnancy could be met by increased absorption from dietary sources. DESIGN AND SETTING:Longitudinal prospective study in the research unit of a maternity hospital. SUBJECTS:12 normal pregnant women. INTERVENTIONS:At 12, 24, and 36 weeks' gestation (within...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.309.6947.79

    authors: Barrett JF,Whittaker PG,Williams JG,Lind T

    更新日期:1994-07-09 00:00:00

  • Amblyopia treatment outcomes after screening before or at age 3 years: follow up from randomised trial.

    abstract:OBJECTIVE:To assess the effectiveness of early treatment for amblyopia in children. DESIGN:Follow up of outcomes of treatment for amblyopia in a randomised controlled trial comparing intensive orthoptic screening at 8, 12, 18, 25, 31, and 37 months (intensive group) with orthoptic screening at 37 months only (control ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.324.7353.1549

    authors: Williams C,Northstone K,Harrad RA,Sparrow JM,Harvey I,ALSPAC Study Team.

    更新日期:2002-06-29 00:00:00

  • Where have all the pennies gone? The work of Manchester Medical Audit Advisory Group.

    abstract::Medical audit has its critics, who point to the large sums of NHS cash that seem to be disappearing down a medical plughole. These criticisms are recognised by medical audit advisory groups but there are many reasons why the work of these groups has not yet resulted in many publications in journals or bumped up health...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.309.6947.98

    authors: Johnson R

    更新日期:1994-07-09 00:00:00

  • Influence of environmental factors on mental health within prisons: focus group study.

    abstract:OBJECTIVE:To increase understanding of how the prison environment influences the mental health of prisoners and prison staff. DESIGN:Qualitative study with focus groups. SETTING:A local prison in southern England. PARTICIPANTS:Prisoners and prison staff. RESULTS:Prisoners reported that long periods of isolation wit...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.327.7413.480

    authors: Nurse J,Woodcock P,Ormsby J

    更新日期:2003-08-30 00:00:00

  • Multicentre criterion based audit of the management of induced abortion in Scotland.

    abstract:OBJECTIVES:To assess and improve the quality of care provided to women undergoing induced abortion. DESIGN:Two rounds of prospective, criterion based case note review audit. SETTING:Ten NHS gynaecology units throughout Scotland. SUBJECTS:2004 patient episodes of abortion care identified consecutively during two roun...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.309.6946.15

    authors: Penney GC,Glasier A,Templeton A

    更新日期:1994-07-02 00:00:00

  • Prediction model to estimate presence of coronary artery disease: retrospective pooled analysis of existing cohorts.

    abstract:OBJECTIVES:To develop prediction models that better estimate the pretest probability of coronary artery disease in low prevalence populations. DESIGN:Retrospective pooled analysis of individual patient data. SETTING:18 hospitals in Europe and the United States. PARTICIPANTS:Patients with stable chest pain without ev...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.e3485

    authors: Genders TS,Steyerberg EW,Hunink MG,Nieman K,Galema TW,Mollet NR,de Feyter PJ,Krestin GP,Alkadhi H,Leschka S,Desbiolles L,Meijs MF,Cramer MJ,Knuuti J,Kajander S,Bogaert J,Goetschalckx K,Cademartiri F,Maffei E,Martini

    更新日期:2012-06-12 00:00:00

  • Open access follow up for inflammatory bowel disease: pragmatic randomised trial and cost effectiveness study.

    abstract:OBJECTIVE:To evaluate whether follow up of patients with inflammatory bowel disease is better through open access than by routine booked appointments. DESIGN:Pragmatic randomised controlled trial. SETTING:Two district general hospitals in Swansea and Neath, Wales. PARTICIPANTS:180 adults (78 with Crohn's disease, 77...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.320.7234.544

    authors: Williams JG,Cheung WY,Russell IT,Cohen DR,Longo M,Lervy B

    更新日期:2000-02-26 00:00:00

  • Management of acute diarrhoea in diabetic patients using oral rehydration solutions containing glucose, rice, or glycine.

    abstract:OBJECTIVE:To assess the risk of hyperglycaemia with two standard oral rehydration solutions that contain carbohydrate compared with a carbohydrate free solution during rehydration of diabetic patients with acute diarrhoea. DESIGN:Prospective randomised allocation to one of three oral rehydration solutions (World Healt...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.308.6929.624

    authors: Haider R,Azad Khan AK,Roy SK,Dewan N,Alam AN,Mahalanabis D

    更新日期:1994-03-05 00:00:00

  • The rise of counselling and the return of alienism.

    abstract::Current services for those with mental disorders show two trends. Psychiatric services are becoming concentrated on the care of those with "severe mental illness," largely (but unjustifiably) synonymous with chronic psychosis. The retreat of psychiatry from the care of those with non-psychotic mental disorders has hel...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7050.158

    authors: Wessely S

    更新日期:1996-07-20 00:00:00

  • Frequency of discrepancies in retracted clinical trial reports versus unretracted reports: blinded case-control study.

    abstract:OBJECTIVES:To compare the frequency of discrepancies in retracted reports of clinical trials with those in adjacent unretracted reports in the same journal. DESIGN:Blinded case-control study. SETTING:Journals in PubMed. POPULATION:50 manuscripts, classified on PubMed as retracted clinical trials, paired with 50 adja...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.h4708

    authors: Cole GD,Nowbar AN,Mielewczik M,Shun-Shin MJ,Francis DP

    更新日期:2015-09-20 00:00:00

  • Control of defecation in patients with spinal injuries by stimulation of sacral anterior nerve roots.

    abstract:OBJECTIVE:To observe the effects of stimulation of the sacral anterior roots on anorectal and low colonic pressures and to programme implanted stimulators to produce defecation. DESIGN:Prospective study of 12 consecutive patients. SETTING:Spinal injuries unit and university gastrointestinal physiology department. PA...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6738.1494

    authors: MacDonagh RP,Sun WM,Smallwood R,Forster D,Read NW

    更新日期:1990-06-09 00:00:00

  • Coronary heart disease prevention: insights from modelling incremental cost effectiveness.

    abstract:OBJECTIVE:To determine which treatments for preventing coronary heart disease should be offered to which patients by assessing their incremental cost effectiveness. DESIGN:Modelling study. DATA SOURCES:Cost estimates (for NHS) and estimates of effectiveness obtained for aspirin, antihypertensive drugs, statins and cl...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.327.7426.1264

    authors: Marshall T

    更新日期:2003-11-29 00:00:00

  • Multiple component patient safety intervention in English hospitals: controlled evaluation of second phase.

    abstract:OBJECTIVE:To independently evaluate the impact of the second phase of the Health Foundation's Safer Patients Initiative (SPI2) on a range of patient safety measures. Design A controlled before and after design. Five substudies: survey of staff attitudes; review of case notes from high risk (respiratory) patients in med...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.d199

    authors: Benning A,Dixon-Woods M,Nwulu U,Ghaleb M,Dawson J,Barber N,Franklin BD,Girling A,Hemming K,Carmalt M,Rudge G,Naicker T,Kotecha A,Derrington MC,Lilford R

    更新日期:2011-02-03 00:00:00

  • Hepatorenal syndrome: pathophysiology, diagnosis, and management.

    abstract::Hepatorenal syndrome (HRS), the extreme manifestation of renal impairment in patients with cirrhosis, is characterized by reduction in renal blood flow and glomerular filtration rate. Hepatorenal syndrome is diagnosed when kidney function is reduced but evidence of intrinsic kidney disease, such as hematuria, proteinu...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.m2687

    authors: Simonetto DA,Gines P,Kamath PS

    更新日期:2020-09-14 00:00:00

  • Antibiotic prescribing without documented indication in ambulatory care clinics: national cross sectional study.

    abstract:OBJECTIVES:To identify the frequency with which antibiotics are prescribed in the absence of a documented indication in the ambulatory care setting, to quantify the potential effect on assessments of appropriateness of antibiotics, and to understand patient, provider, and visit level characteristics associated with ant...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.l6461

    authors: Ray MJ,Tallman GB,Bearden DT,Elman MR,McGregor JC

    更新日期:2019-12-11 00:00:00

  • Prophylaxis and follow-up after possible exposure to HIV, hepatitis B virus, and hepatitis C virus outside hospital: evaluation of policy 2000-3.

    abstract:PROBLEM:Prophylactic treatment and follow-up after exposure to HIV, hepatitis B, and hepatitis C outside hospital needs to be improved. BACKGROUND AND SETTING:Until January 2000, people in Amsterdam could report exposure outside hospital to either a hospital or the municipal health service. If they reported to the mun...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.330.7495.825

    authors: Sonder GJ,Regez RM,Brinkman K,Prins JM,Mulder JW,Spaargaren J,Coutinho RA,van den Hoek A

    更新日期:2005-04-09 00:00:00

  • Progression of HIV disease in a haemophilic cohort followed for 11 years and the effect of treatment.

    abstract:OBJECTIVE:To describe the progression of HIV disease in a haemophilic cohort and to show the influence of treatment. DESIGN:11 year longitudinal clinical and laboratory study. SETTING:A haemophilia centre. PATIENTS:111 patients infected with HIV during October 1979 to July 1985. MAIN OUTCOME MEASURES:Symptoms of HI...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章

    doi:10.1136/bmj.303.6810.1093

    authors: Lee CA,Phillips AN,Elford J,Janossy G,Griffiths P,Kernoff P

    更新日期:1991-11-02 00:00:00

  • Coffee consumption and death from coronary heart disease in middle aged Norwegian men and women.

    abstract:OBJECTIVE:To study the association between number of cups of coffee consumed per day and coronary death when taking other major coronary risk factors into account. DESIGN:Men and women attending screening and followed up for a mean of 6.4 years. SETTING:Cardiovascular survey performed by ambulatory teams from the Nat...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6724.566

    authors: Tverdal A,Stensvold I,Solvoll K,Foss OP,Lund-Larsen P,Bjartveit K

    更新日期:1990-03-03 00:00:00

  • Heat and risk of myocardial infarction: hourly level case-crossover analysis of MINAP database.

    abstract:OBJECTIVE:To quantify the association between exposure to higher temperatures and the risk of myocardial infarction at an hourly temporal resolution. DESIGN:Case-crossover study. SETTING:England and Wales Myocardial Ischaemia National Audit Project (MINAP) database. PARTICIPANTS:24,861 hospital admissions for myocar...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e8050

    authors: Bhaskaran K,Armstrong B,Hajat S,Haines A,Wilkinson P,Smeeth L

    更新日期:2012-12-13 00:00:00

  • The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators.

    abstract:OBJECTIVE:To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN:Longitudinal analysis. SETTING:35 medical facilities of Kaiser Permanente Northern California, 1997-2007. PARTICIPANTS:...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c1898

    authors: Lester H,Schmittdiel J,Selby J,Fireman B,Campbell S,Lee J,Whippy A,Madvig P

    更新日期:2010-05-11 00:00:00

  • Interventions used in disease management programmes for patients with chronic illness-which ones work? Meta-analysis of published reports.

    abstract:OBJECTIVE:To systematically evaluate the published evidence regarding the characteristics and effectiveness of disease management programmes. DESIGN:Meta-analysis. DATA SOURCES:Computerised databases for English language articles during 1987-2001. STUDY SELECTION:102 articles evaluating 118 disease management progra...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.325.7370.925

    authors: Weingarten SR,Henning JM,Badamgarav E,Knight K,Hasselblad V,Gano A Jr,Ofman JJ

    更新日期:2002-10-26 00:00:00

  • Run an emergency helpline.

    abstract::Telephone helplines are an effective way of dealing with health related incidents in which large numbers of people need personal counselling or information for reassurance or case finding. Helplines often have to be set up at short notice, which is labour intensive and makes recruitment of appropriate staff difficult....

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.309.6946.44

    authors: Stark C,Christie P,Marr AC

    更新日期:1994-07-02 00:00:00

  • Using clinicopathological analysis of general practitioner skin surgery to determine educational requirements and guidelines.

    abstract:OBJECTIVE:To study the impact of skin surgery in general practice on the workload of a pathology laboratory and to identify what further training might be helpful. DESIGN:Analysis of skin biopsy specimens from general practitioners before and after their new contract to determine numbers of specimens, changes in diagn...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.304.6819.93

    authors: Cox NH,Wagstaff R,Popple AW

    更新日期:1992-01-11 00:00:00

  • Associations of serum lipid concentrations and obesity with mortality in women: 20 year follow up of participants in prospective population study in Gothenburg, Sweden.

    abstract:OBJECTIVE:To examine association of different measures of serum lipid concentration and obesity with mortality in women. DESIGN:Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years. SETTING:Gothenburg, Sweden. SUBJEC...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6916.1385

    authors: Bengtsson C,Björkelund C,Lapidus L,Lissner L

    更新日期:1993-11-27 00:00:00

  • Impact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: final results of cluster randomised trial.

    abstract:OBJECTIVE:To assess the impact of a theoretically based sex education programme (SHARE) delivered by teachers compared with conventional education in terms of conceptions and terminations registered by the NHS. DESIGN:Follow-up of cluster randomised trial 4.5 years after intervention. SETTING:NHS records of women who...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.39014.503692.55

    authors: Henderson M,Wight D,Raab GM,Abraham C,Parkes A,Scott S,Hart G

    更新日期:2007-01-20 00:00:00

  • Prevalence of asthma in Finnish young men.

    abstract:OBJECTIVE:To determine the prevalence of asthma in cohorts of Finnish young men in the period 1926-89. DESIGN:A retrospective analysis using reports and statistics of Finnish defence forces. SETTING:Call up examinations of candidates for military conscription and examination of conscripts discharged because of poor h...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.301.6746.266

    authors: Haahtela T,Lindholm H,Björkstén F,Koskenvuo K,Laitinen LA

    更新日期:1990-08-04 00:00:00

  • Urinary retention and the lunisolar cycle: is it a lunatic phenomenon?

    abstract:OBJECTIVE:To determine whether a relation between urinary retention and temporal rhythms exists. DESIGN:Retrospective analysis of patients presenting over three years. SETTING:Urology departments in two hospitals. PATIENTS:815 Patients presenting as emergency admissions with urinary retention and requiring immediate...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.299.6715.1560

    authors: Payne SR,Deardon DJ,Abercrombie GF,Carlson GL

    更新日期:1989-12-23 00:00:00

  • Risk factors for lower respiratory complications of rhinovirus infections in elderly people living in the community: prospective cohort study.

    abstract:OBJECTIVE:To assess the role of rhinoviruses in elderly people living in the community. DESIGN:Prospective community based surveillance of elderly people, without intervention. Subjects were telephoned weekly to identify symptomatic upper respiratory tract infections. Symptoms and impact of illnesses were monitored, a...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7065.1119

    authors: Nicholson KG,Kent J,Hammersley V,Cancio E

    更新日期:1996-11-02 00:00:00

  • Other cities, same problems.

    abstract::London's health care problems, particularly underfunding, are mirrored in other major cities in the United Kingdom and abroad. None has found the perfect solution, but the debates on the Tomlinson report provide an opportunity to review how to manage the three major areas of service provision, medical education, and r...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6871.199

    authors: Maxwell R

    更新日期:1993-01-16 00:00:00

  • Informing participants of allocation to placebo at trial closure: postal survey.

    abstract:OBJECTIVES:To assess whether and how investigators of placebo controlled randomised trials inform participants of their treatment allocation at trial closure and to assess barriers to feedback. DESIGN:Postal survey with a semistructured questionnaire. PARTICIPANTS:All investigators who published a placebo controlled ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.325.7376.1329

    authors: Di Blasi Z,Kaptchuk TJ,Weinman J,Kleijnen J

    更新日期:2002-12-07 00:00:00