Abstract:
PURPOSE OF REVIEW:Care near the end of life is expensive and frequently not aligned with the expressed preferences of decedents, creating an opportunity to improve value, or increase quality while lowering cost. This review examines publications from 2017 and 2018 on interventions and policies associated with high-value end-of-life care. Innovations in video and web-based advance care planning are promising to improve preference-congruent care at low cost. RECENT FINDINGS:The patterns of care within hospice and in particular increased investment in patient care in hospice are shown to improve value. A meta-analysis demonstrated the role of inpatient palliative care consultations in decreasing hospitalization costs, as did several studies on inpatient palliative care units. Internationally, a range of home-based palliative care programs, implemented at the population level, demonstrated cost savings and reduced intensive care near the end of life. Finally, public policies that funded medical and long-term care and address broader inequalities were demonstrated to decrease low-value care near the end of life. SUMMARY:This review demonstrates the efficacy of a range of approaches to improve value of care at the end of life, both within the health system and across public policy sectors.
journal_name
Curr Opin Support Palliat Carejournal_title
Current opinion in supportive and palliative careauthors
Ankuda CK,Meier DEdoi
10.1097/SPC.0000000000000392subject
Has Abstractpub_date
2018-12-01 00:00:00pages
460-465issue
4eissn
1751-4258issn
1751-4266journal_volume
12pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:As the number of female cancer survivors continues to grow, there is a growing need to bridge the gap between the high rate of women's cancer-related sexual dysfunction and the lack of attention and intervention available to the majority of survivors who suffer from sexual problems. Previously identif...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000186
更新日期:2016-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Experienced breathlessness and recalled breathlessness are two different entities, which may be associated with different factors and might have different impacts on function for the individual. The aim was to review the knowledge from the last 2 years concerning experienced breathlessness and recalle...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000448
更新日期:2019-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Constipation is a common symptom in palliative care patients that can generate considerable suffering due to both unpleasant physical symptoms and psychological preoccupations that may arise. There is uncertainty about the choice from varying recommendations for management of constipation and a varyin...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e3282f53146
更新日期:2008-03-01 00:00:00
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journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e3283536413
更新日期:2012-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The balance between the rates of protein synthesis and protein degradation governs the maintenance of muscle mass in the body. The main purpose of this review is to highlight the latest understanding of the various pathways that maintain this balance between muscle atrophy and hypertrophy. RECENT FIN...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e328359b681
更新日期:2012-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Determining which palliative interventions are appropriate within and between groups remains difficult because of the lack of prospective studies and heterogeneity in dyspnoea context, assessment and reporting. This review presents an evolution of dyspnoea theories, summarizes literature published dur...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e328345d4a1
更新日期:2011-06-01 00:00:00
abstract:PURPOSE OF REVIEW:In the past 20 years, several papers have been published concerning healthcare transition from pediatric after-care to long-term follow-up in adult health service for childhood cancer survivors. Initially, the papers were optimistic and included guidelines and models of care. However, after this optim...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e32836484bb
更新日期:2013-09-01 00:00:00
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journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e32834bddf9
更新日期:2011-12-01 00:00:00
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journal_title:Current opinion in supportive and palliative care
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更新日期:2016-06-01 00:00:00
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journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000463
更新日期:2019-12-01 00:00:00
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journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e32835843d7
更新日期:2012-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The oligometastases is considered an intermediate state of the disease between localized and wide spread metastases. Local ablative therapy to oligometastatic prostate cancer is gaining significant traction and stereotactic body radiotherapy (SBRT) is an emerging treatment modality for this patient po...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000371
更新日期:2018-09-01 00:00:00
abstract:PURPOSE OF REVIEW:It is difficult to hold an organized view of psychological research related to chronic pain. There are many different theories and variables and the volume of literature is vast. The purpose of this review is to highlight some key trends in this research in 2010. RECENT FINDINGS:We conducted a search...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e328345a3ff
更新日期:2011-06-01 00:00:00
abstract:PURPOSE OF REVIEW:This review focuses on chemotherapy in the management of patients with advanced urothelial cancer, with a look towards the future and the next generation of clinical trials. RECENT FINDINGS:The recognition that the maximum benefit from conventional combination chemotherapy has been achieved has led t...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e3282f1aad1
更新日期:2007-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This review describes the role of lung volume reduction surgery (LVRS) for the management of refractory dyspnea and other debilitating conditions in patients with chronic obstructive pulmonary disease. Recent studies, including a randomized trial comparing LVRS to medical therapy, are analyzed. RECEN...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e32832ad5e1
更新日期:2009-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The widespread use of prostate-specific antigen (PSA) resulted in stage migration of prostate cancer where androgen deprivation therapy (ADT) is administered for biochemical recurrence in patients following primary treatment. A proportion of these patients progress to a disease state termed nonmetasta...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000356
更新日期:2018-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Highlight the difficulties patients, physicians, and the global economy face in relation to treatment of structural heart diseases. It is easy to be carried away by the excitement of medical advancement; however, it is difficult to demonstrate restraint. Transcatheter aortic valve replacement (TAVR) i...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000407
更新日期:2019-03-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize current knowledge about gastrointestinal radiation toxicity, with emphasis on mechanisms and clinical diagnosis and management. RECENT FINDINGS:While there has been only modest change in cancer incidence and cancer mortality rates during the past 30 years, the number of cancer survivors ...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e3281108014
更新日期:2007-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Cachexia, also known as disease-associated wasting, is an important factor in the mortality of many patients with diseases such as cancer, as well as renal and congestive heart failure. Yet the syndrome is not yet well defined, making diagnosis difficult and often subjective on the part of the physici...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e3282f14c4e
更新日期:2007-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The treatment of patients with metastatic urothelial carcinoma is evolving with recent advances holding promise for improved outcomes. Historically, patients with metastatic urothelial carcinoma had a poor prognosis with no standard treatment options in the second-line setting. Currently, with an incr...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000158
更新日期:2015-09-01 00:00:00
abstract:PURPOSE OF REVIEW:An overview on breakthrough cancer pain (BTCP), including inherent limitations of the terminology, assessment, clinical presentation, and treatment options. RECENT FINDINGS:The estimated prevalence of BTCP is dependent on the defined cutoffs for controlled background pain and the magnitude of the pai...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章
doi:10.1097/SPC.0000000000000494
更新日期:2020-06-01 00:00:00
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journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e3282ffb406
更新日期:2008-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Pelvic pain is a common complaint of women that is frequently poorly managed. This review considers the current understanding of the mechanisms of pain perception and the development of chronic pain in the context of three gynaecological pain conditions. Recent advances in the management of these cond...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e3283460b05
更新日期:2011-06-01 00:00:00
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journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e328356ab36
更新日期:2012-09-01 00:00:00
abstract:PURPOSE OF REVIEW:The palliative care needs of people with interstitial lung disease (ILD) have recently been highlighted by the National Institute for Health and Care Excellence. All people with progressive ILD should receive best supportive care to improve symptom control and quality of life and where possible this s...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000285
更新日期:2017-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Young women (<45 years of age) diagnosed with breast cancer face increased risk of sexual dysfunction as a result of their cancer-directed treatment. We will review the recent literature examining this critical challenge and discuss current efforts to address sexual dysfunction. RECENT FINDINGS:In th...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000156
更新日期:2015-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite recognition that opioids alleviate dyspnea in chronic obstructive pulmonary disease, many clinicians remain reluctant to use them outside of the final days of life. This article defines the term 'opioid responsiveness' as it pertains to dyspnea, and poses that it may be possible to predict mor...
journal_title:Current opinion in supportive and palliative care
pub_type: 社论,评审
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更新日期:2010-06-01 00:00:00
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journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0000000000000413
更新日期:2019-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Opioids are potent drugs for the treatment of severe pain, but they are burdened by detrimental side-effects, such as respiratory depression, addiction, sedation and constipation. Their clinical application is undisputed in acute (e.g. perioperative) and cancer pain, but their use in chronic nonmalign...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章
doi:10.1097/SPC.0000000000000495
更新日期:2020-06-01 00:00:00
abstract:PURPOSE OF REVIEW:This review summarizes recent developments in the palliative management of gastrointestinal symptoms experienced by advanced cancer patients and provides a framework for detailing that encompasses education, assessment and monitoring, and treatment. RECENT FINDINGS:Although many viable treatment opti...
journal_title:Current opinion in supportive and palliative care
pub_type: 杂志文章,评审
doi:10.1097/SPC.0b013e32832531ce
更新日期:2009-03-01 00:00:00