Management of venous thromboembolism in far-advanced cancer: current practice.

Abstract:

OBJECTIVES:Venous thromboembolism (VTE) is common in advanced cancer. Guidelines suggest that indefinite anticoagulation be considered for patients with ongoing active cancer. There are no data on the management of cancer-associated thrombosis (CAT) at the end of life or when to stop anticoagulation as death approaches. We reviewed current practice and associated symptoms at the end of life for patients with advanced cancer who had been anticoagulated for VTE. METHODS:Data on patients attending a regional CAT service were cross-referenced with death notifications. Hospital, hospice and community notes were reviewed to evaluate the end-of-life care within the context of VTE management. Data specific to discontinuation of anticoagulation, complications of anticoagulation and symptoms associated with VTE were recorded. RESULTS:214 patients died over a 2-year period; 98 (46%) home, 59 (27%) hospice, 53 (25%) acute hospital and 4 (2%) community hospital. 108 (50%) continued low-molecular-weight heparin (LMWH) until death, 23 (11%) up to 7 days prior to death, 23 (11%), 1 week to 1 month 29 (13.5%), over 1 month 40 (18%). Clinically relevant non-major bleeding occurred in 9/131 (7%) of the patients who continued LMWH to death or 7 days up to death. No symptoms attributable to VTE were recorded. CONCLUSION:The majority of CAT patients with metastatic disease remain anticoagulated up to or within days of death. Despite the limitations of retrospective data across healthcare settings, it appears that anticoagulation as death approaches confers a significant bleeding risk without additional benefit of preventing VTE symptoms.

authors

Noble S,Banerjee S,Pease NJ

doi

10.1136/bmjspcare-2019-001804

subject

Has Abstract

pub_date

2019-06-25 00:00:00

eissn

2045-435X

issn

2045-4368

pii

bmjspcare-2019-001804

pub_type

杂志文章
  • Preference for a single or shared room in a UK inpatient hospice: patient, family and staff perspectives.

    abstract:OBJECTIVE:This study investigated the preferences of patients, family and staff for single or shared rooms in a UK hospice. METHOD:Semistructured interviews were conducted with patients, informal carers and staff at a hospice, focusing on room type preference. RESULTS:14 current and former hospice inpatients, 15 pati...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2013-000514

    authors: Williams C,Gardiner C

    更新日期:2015-06-01 00:00:00

  • Methodological considerations for researching the financial costs of family caregiving within a palliative care context.

    abstract:BACKGROUND:The financial impact of family caregiving in a palliative care context has been identified as an issue which requires further research. However, little is known about how research should be conducted in this area. OBJECTIVE:The aim of this study was to explore the opinions of family caregivers in New Zealan...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2015-001046

    authors: Gardiner C,Allen R,Moeke-Maxwell T,Robinson J,Gott M

    更新日期:2016-12-01 00:00:00

  • Is palliative care cost-effective in low-income and middle-income countries? A mixed-methods systematic review.

    abstract:INTRODUCTION:Of the 40 million people globally in need of palliative care (PC), just 14% receive it, predominantly in high-income countries. Within fragile health systems that lack PC, incurable illness is often marked by pain and suffering, as well as burdensome costs. In high-income settings, PC decreases healthcare ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001499

    authors: Reid EA,Kovalerchik O,Jubanyik K,Brown S,Hersey D,Grant L

    更新日期:2019-06-01 00:00:00

  • Analysis of health administration data to inform health service planning for paediatric palliative care.

    abstract:BACKGROUND:Health service planning in paediatric palliative care is complex, with the diverse geographical and demographic characteristics adding to the challenge of developing services across different nations. Accurate and reliable data are essential to inform effective, efficient and equitable health services. AIM:...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002449

    authors: Bowers AP,Bradford N,Chan RJ,Herbert A,Yates P

    更新日期:2020-10-13 00:00:00

  • Association of advance care planning with place of death and utilisation of life-sustaining treatments in deceased patients at Taipei City Hospital in Taiwan.

    abstract:OBJECTIVE:Evidence is mixed regarding the impact of advance care planning (ACP) on place of death. This cohort study investigated the effect of ACP programmes on place of death and utilisation of life-sustaining treatments for patients during end-of-life (EOL) care. METHODS:This prospective cohort study identified dec...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002520

    authors: Yen YF,Lee YL,Hu HY,Sun WJ,Ko MC,Chang SS,Chen CC,Huang SJ,Chu D

    更新日期:2020-10-28 00:00:00

  • Feasibility and effectiveness of tools that support communication and decision making in life-prolonging treatments for patients in hospital: a systematic review.

    abstract:OBJECTIVE:Patients with advanced diseases and frail older adults often face decisions regarding life-prolonging treatment. Our aim was to provide an overview of the feasibility and effectiveness of tools that support communication between healthcare professionals and patients regarding decisions on life-prolonging trea...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2020-002284

    authors: Thodé M,Pasman HRW,van Vliet LM,Damman OC,Ket JCF,Francke AL,Jongerden IP

    更新日期:2020-10-05 00:00:00

  • Bereaved caregivers of patients with high-grade glioma: a systematic review.

    abstract:OBJECTIVE:Caregivers to patients with primary malignant brain tumours neglect their own physical and emotional needs during the disease trajectory. The aim of the systematic review was to explore how informal caregivers of patients with primary malignant brain tumour (high-grade glioma (HGG)) experience and manage thei...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2017-001386

    authors: Piil K,Nordentoft S,Larsen A,Jarden M

    更新日期:2019-03-01 00:00:00

  • Breast cancer prognosis and P-cadherin expression: systematic review and study-level meta-analysis.

    abstract:OBJECTIVE:P-cadherin can act both as a tumour suppressor and an oncogene. The clinical prognostic value of P-cadherin overexpression in breast cancer (BC) remains unclear. We conducted a study-level meta-analysis to determine whether P-cadherin expression can help predict prognosis in BC. METHODS:A systematic literatu...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2020-002204

    authors: Qi R,Lin J,Chen S,Jiang J,Zhang X,Yao B,Zheng H,Jin Z,Yuan Y,Hou W,Hua B,Guo Q

    更新日期:2020-09-17 00:00:00

  • Patient healthcare passports in community specialist palliative care: a mixed methods study.

    abstract:BACKGROUND:Patient held records need to be evaluated in palliative care settings. OBJECTIVES:To evaluate how patients, families and professionals in a specialist palliative setting use a patient held record created through close consultation with patients and carers. METHODS:A mixed methods prospective longitudinal c...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001589

    authors: White C,Sproule J,Brogan P,Watson M

    更新日期:2018-08-18 00:00:00

  • Quality of life after interventions for malignant pleural effusions: a systematic review.

    abstract:BACKGROUND:Malignant pleural effusion (MPE) results in breathlessness and impairment of health-related quality of life (HRQOL). This study reviews the existing literature on HRQOL following invasive interventions in MPE. METHODS:Five electronic databases were systematically searched and assessed three times during the...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001610

    authors: Sivakumar P,Saigal A,Ahmed L

    更新日期:2020-03-01 00:00:00

  • The wish to die and hastening death in amyotrophic lateral sclerosis: A scoping review.

    abstract:BACKGROUND:Amyotrophic lateral sclerosis (ALS) develops into a life-threatening condition 2 to 4 years after the onset of symptoms. Although many people with the disease decide in favour of life-sustaining measures, thoughts about hastening death are not uncommon. OBJECTIVES:Our aim was to examine the scope of literat...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2020-002640

    authors: Erdmann A,Spoden C,Hirschberg I,Neitzke G

    更新日期:2021-01-04 00:00:00

  • Postural nausea due to platypnea orthodeoxia.

    abstract::Platypnea orthodeoxia is an uncommon condition but given its associations with severe lung disease and advancing age, it might be seen in the palliative care population. Presentation is classical in the association of symptoms with postural change. It should be considered when patients present with breathlessness or d...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2019-001918

    authors: Bradley V,Sabharwal N,MacGregor E,Bond C

    更新日期:2019-09-07 00:00:00

  • Subcutaneous levetiracetam for the management of seizures at the end of life.

    abstract:OBJECTIVES:To report the results of a combined case series analysis of subcutaneous levetiracetam (Keppra) for the management of seizures in palliative care patients. METHODS:A comprehensive literature review on the use of subcutaneous levetiracetam was performed, and these data were combined with a prospective observ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2016-001261

    authors: Sutherland AE,Curtin J,Bradley V,Bush O,Presswood M,Hedges V,Naessens K

    更新日期:2018-06-01 00:00:00

  • Educational needs of nursing home staff: does a needs-based palliative care course make a difference?

    abstract:OBJECTIVE:In Singapore, more elderly are living in nursing homes (NHs), with a resultant increase in deaths occurring in NHs. However, palliative care training is limited in Singapore's core nursing curriculum, and many NHs rely on foreign-trained staff who may not have previous palliative care training. Our study aime...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002690

    authors: Phua GLG,Toh HJ,Tan L,Low JAYH

    更新日期:2020-11-09 00:00:00

  • Prazosin for nightmares in serious illness.

    abstract::Nightmares can be a distressing symptom in patients living with serious illness. Prazosin, a selective alpha-1 adrenergic antagonist, has been suggested to treat nightmares, with most data supporting its use in post-traumatic stress disorder (PTSD). We present the case of a 60-year-old woman with metastatic breast can...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002594

    authors: Santivasi W,Taylor E,Christensen A,Strand J

    更新日期:2021-01-27 00:00:00

  • Meaning in life and quality of life: palliative care patients versus the general population.

    abstract:BACKGROUND AND OBJECTIVES:Meaning in life (MIL) represent a key topic in palliative care. The aims of this study were to explore (1) the differences in perceived MIL and in the meaning-relevant life areas between a representative sample of the Swiss population and palliative care patients, and (2) to what extent MIL ca...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002211

    authors: Bernard M,Berchtold A,Strasser F,Gamondi C,Borasio GD

    更新日期:2020-07-06 00:00:00

  • "A monster that lives in our lives": experiences of caregivers of people with motor neuron disease and identifying avenues for support.

    abstract:BACKGROUND:A developing body of evidence has provided valuable insight into the experiences of caregivers of people with motor neuron disease; however, understandings of how best to support caregivers remain limited. AIM:This study sought to understand concepts related to the motor neuron disease caregiver experience ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2015-001057

    authors: Anderson NH,Gluyas C,Mathers S,Hudson P,Ugalde A

    更新日期:2019-12-01 00:00:00

  • Palliative care pain control: inpatient consultation versus corounding models compared.

    abstract:BACKGROUND:Compared with the current inpatient consultation model, a novel corounding model of care whereby palliative specialists round with oncology teams, increases healthcare collaboration and may improve quality of care for inpatients. Whether this translates to better pain control for patients is unexplored. OBJ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002540

    authors: Ng CZ,Cheung YB,Koh ARX,Teo HR,Mok NKM,Yang GM

    更新日期:2020-12-18 00:00:00

  • Collaborative palliative care for advanced heart failure: outcomes and costs from the 'Better Together' pilot study.

    abstract:BACKGROUND:Patients with heart failure often receive little supportive or palliative care. 'Better Together' was a 2-year pilot study of a palliative care service for patients with advanced congestive heart failure (CHF). OBJECTIVE:To determine if the intervention made it more likely that patients would be cared for a...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2012-000251

    authors: Pattenden JF,Mason AR,Lewin RJ

    更新日期:2013-03-01 00:00:00

  • Factors affecting recruitment to an observational multicentre palliative care study.

    abstract:OBJECTIVES:To identify those factors which adversely affected recruitment to a large multicentre palliative care study. METHODS:Patient accrual to a multicentre, observational, palliative care study was monitored at three critical junctures in the research process. (1) Eligibility-did the patient fulfil the study entr...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmjspcare-2012-000396

    authors: Stone PC,Gwilliam B,Keeley V,Todd C,Kelly LC,Barclay S

    更新日期:2013-09-01 00:00:00

  • Rose geranium in sesame oil nasal spray: a treatment for nasal vestibulitis?

    abstract:OBJECTIVES:As a rose geranium in sesame oil spray product has been anecdotally noted to improve nasal vestibulitis symptoms, this study was designed to assess whether patients with nasal vestibulitis associated with cancer-directed therapy experienced symptomatic improvements from it. METHODS:Patients with breast canc...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001569

    authors: Cathcart-Rake EJ,Smith D,Zahrieh D,Loprinzi CL

    更新日期:2020-12-01 00:00:00

  • Potential triggers for the holistic assessment of people with severe chronic obstructive pulmonary disease: analysis of multiperspective, serial qualitative interviews.

    abstract:OBJECTIVES:This study explores the narrative accounts of chronic obstructive pulmonary disease (COPD) to identify events that potentially could act as triggers for provision of supportive and palliative care. Trigger events must have meaning for the patient/carer, be visible to professionals, and have value in provokin...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2013-000629

    authors: Cawley D,Billings J,Oliver D,Kendall M,Pinnock H

    更新日期:2014-06-01 00:00:00

  • Information transfer to out-of-hours co-operatives: a survey of general practitioners' views in relation to palliative patients.

    abstract:BACKGROUND:In Ireland, weekend and night medical cover for community based patients is largely provided by general practice co-operatives. Doctors working in this service do not have direct access to patients' medical records which challenges continuity of care. OBJECTIVES:This study investigates the opinion of genera...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2012-000281

    authors: Kiely F,Murphy M,O'Brien T

    更新日期:2013-12-01 00:00:00

  • Conscientious objection and physician-assisted suicide: a viable option in the UK?

    abstract::Conscience objection is a proposed way of ensuring that medical practitioners who object to physician-assisted suicide may avoid having to be involved in such a procedure if this is legalised. This right on the part of healthcare professionals already exists in certain circumstances. This paper examines the ethical an...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001541

    authors: Willis D,George R

    更新日期:2019-12-01 00:00:00

  • Making patient and public involvement in cancer and palliative research a reality: academic support is vital for success.

    abstract:OBJECTIVE:Patient and public involvement (PPI) has become an established theme within the UK health research policy and is recognised as an essential force in the drive to improve the quality of services and research. These developments have been particularly rapid in the cancer field. METHODS:This paper outlines a mo...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2014-000750

    authors: Collins K,Boote J,Ardron D,Gath J,Green T,Ahmedzai SH,North Trent Cancer Research Network Consumer Research Panel (NTCRN CRP).

    更新日期:2015-06-01 00:00:00

  • A Cochrane systematic review of acupuncture for cancer pain in adults.

    abstract:BACKGROUND:Cancer-related pain is a significant and debilitating problem. Non-pharmacological treatments such as acupuncture may have an adjunctive role in controlling pain without the undesirable side effects of drug regimens and yet the evidence base remains limited. OBJECTIVES:The main objective of this systematic ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2011-000022

    authors: Paley CA,Tashani OA,Bagnall AM,Johnson MI

    更新日期:2011-06-01 00:00:00

  • Palliative care training in undergraduate medical, nursing and allied health: a survey.

    abstract:OBJECTIVES:Impending death is poorly recognised. Many undergraduate healthcare professionals will not have experience of meeting or caring for someone who is dying. As death can occur in any setting, at any time, it is vital that all healthcare students, regardless of the setting they go on to work in, have end-of-life...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2019-002025

    authors: White N,Oostendorp LJ,Minton O,Yardley S,Stone P

    更新日期:2019-11-20 00:00:00

  • Volunteer activity in specialist paediatric palliative care: a national survey.

    abstract:OBJECTIVE:To assess the involvement of volunteers with direct patient/family contact in UK palliative care services for children and young people. METHOD:Cross-sectional survey using a web-based questionnaire. SETTING:UK specialist paediatric palliative care services. PARTICIPANTS:Volunteer managers/coordinators fro...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2012-000355

    authors: Burbeck R,Low J,Sampson EL,Scott R,Bravery R,Candy B

    更新日期:2015-09-01 00:00:00

  • General practice physicians' and nurses' self-reported multidisciplinary end-of-life care: a systematic review.

    abstract:BACKGROUND:General practitioners (GPs) and general practice nurses (GPNs) face increasing demands to provide end-of-life care (EoLC) as the population ages. To enhance primary palliative care (PC), the care they provide needs to be understood to inform best practice models of care. OBJECTIVE:To provide a comprehensive...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2019-001852

    authors: Senior H,Grant M,Rhee JJ,Aubin M,McVey P,Johnson C,Monterosso L,Nwachukwu H,Fallon-Ferguson J,Yates P,Williams B,Mitchell G

    更新日期:2019-08-29 00:00:00

  • Palliative care in Africa since 2005: good progress, but much further to go.

    abstract::There has been rapid progress in palliative care in Africa since the World Health Assembly in 2005 which identified palliative care as an urgent humanitarian need. Palliative care is now recognised as a basic human right, and momentum has gathered to translate this into action. From being significantly present in only...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2011-000057

    authors: Grant L,Downing J,Namukwaya E,Leng M,Murray SA

    更新日期:2011-09-01 00:00:00