Abstract:
:The Research Network of the European Association for Palliative Care (EAPC) performed a survey of 3030 cancer patients from 143 palliative care centres in 21 European countries. The survey addressed pain intensity and the use of non-opioid analgesics, adjuvant analgesics and opioids. Patients were treated with analgesics corresponding to the WHO pain ladder step I (n = 855), step II (n = 509) and step III (n = 1589). The investigators assessed 32% of the patients as having moderate or severe pain. In general there were small differences between pain intensities across different countries. Cancer primary sites and the presence of metastasis had only minor influences on pain intensity. The most frequently used non-opioid analgesics were NSAIDs (26%) and paracetamol (23%). Adjuvant analgesics or co-analgesics used by >1% of the patients were corticosteroids (39%), tricylic antidepressants (11%), gabapentin (5%), bisphosphonates (4%), clonazepam (2%), carbamazepine (4%) and phenytoin (2%). The use of non-opioid analgesics and co-analgesics varied widely between countries. Opioids administered for mild to moderate pain were codeine (8%), tramadol (8%), dextropropoxyphene (5%) and dihydrocodeine (2%). Morphine was the most frequently used opioid for moderate to severe pain (oral normal release morphine: 21%; oral sustained-release morphine: 19%; i.v. or s.c. morphine: 10%). Other opioids for moderate to severe pain were transdermal fentanyl (14%), oxycodone (4%), methadone (2%), diamorphine (2%) and hydromorphone (1%). We observed large variations in the use of opioids across countries. Finally, we observed that only a minority of the patients who used morphine needed very high doses.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Klepstad P,Kaasa S,Cherny N,Hanks G,de Conno F,Research Steering Committee of the EAPC.doi
10.1191/0269216305pm1054oasubject
Has Abstractpub_date
2005-09-01 00:00:00pages
477-84issue
6eissn
0269-2163issn
1477-030Xjournal_volume
19pub_type
杂志文章,多中心研究abstract:BACKGROUND:We developed a new single point of access to integrated palliative care, respiratory medicine and physiotherapy: the breathlessness support service for patients with advanced disease and refractory breathlessness. This study aimed to describe patients' experiences of the service and identify the aspects valu...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315600103
更新日期:2016-03-01 00:00:00
abstract::Existential distress has been recognized as a source of suffering for oncology patients. This study focusses on existential issues and coping mechanisms of a unique culturally diverse Jewish/Middle Eastern oncology population. A qualitative assessment of 40 patients with advanced cancer was undertaken through an inter...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm1038oa
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain. AIM:Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital. DES...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216313487569
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Constipation affects many patients receiving long-term opioid therapy for cancer pain. Little is known about the nature of psychological distress and the burden associated with this problem. This information may inform the development of effective treatment strategies and ameliorate distress. AIM:The object...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216312450358
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Depressive disorders are common among cancer patients. Ketamine can quickly relieve depression, and its subcutaneous administration appears to be as effective as and probably safer than its standard intravenous administration. Herein, we report a case verifying the antidepressant effect of a subcutaneous esk...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320910351
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Being at peace is important for the quality of life of dying cancer patients, but its features, and the role of the doctor in facilitating peace, are unclear. AIM:We sought to understand the features of a peaceful patient, and patients' preferences regarding the role of the doctor in facilitating a sense of...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216314536455
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:No systematic meta-analysis is available on the prevalence of cancer patients' accurate prognostic awareness and differences in accurate prognostic awareness by publication year, region, assessment method, and service received. AIM:To examine the prevalence of advanced/terminal cancer patients' accurate pro...
journal_title:Palliative medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1177/0269216316663976
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Legacy has been invoked as a means for strengthening human attachments, continuing bonds, and ensuring that individuals will be remembered; however, little is known about the spectrum of approaches to, outcomes associated with, and best practices for legacy interventions. AIM:To systematically review resear...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216321989565
更新日期:2021-01-25 00:00:00
abstract:BACKGROUND:There is increasing demand for primary care practitioners to play a key role in palliative care delivery. Given this, it is important to understand their perceptions of the barriers and enablers to optimal palliative care, and how commonly these are experienced. AIM:To explore the type and prevalence of bar...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319865414
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Communities have limited understanding of palliative care, creating barriers to informed choice around consideration of a full range of care options in the event of serious illness. Few empirically tested interventions are available to educate community about palliative care, and ultimately improve timely ac...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320932766
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Psychological distress is highly prevalent among patients with metastatic colorectal cancer. AIMS:To perform an economic evaluation of a combined screening and treatment program targeting psychological distress in patients with metastatic colorectal cancer in comparison with usual care. DESIGN:Societal cos...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320913463
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Current end-of-life care policy and guidance recognises the important contribution of family carers, recommending that their needs should be assessed to support them in their caring role. How regular carer assessment is to be achieved is unclear, particularly because there is no evidence-based tool for direc...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216312440607
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:The majority of children and young people who die in the United Kingdom have pre-existing life-limiting illness. Currently, most such deaths occur in hospital, most frequently within the intensive care environment. AIM:To explore the experiences of senior medical and nursing staff regarding the challenges a...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315573000
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Benzodiazepines are widely used in palliative care, but few studies have attempted to study their use. AIM:To determine the frequency and nature of benzodiazepine prescribing in a palliative care setting. METHOD:The notes of a consecutive series of 100 patients who had died or been discharged from the hosp...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216306pm1151oa
更新日期:2006-06-01 00:00:00
abstract::Attitudes to companion animals were surveyed among 50 patients and staff at a day care hospice. Dog visits were welcomed by all but two. Of the 37 patients studied, only seven had a companion animal, often their closest companion. Many more would like to keep an animal, but were prevented by age, frailty or accommodat...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639601000410
更新日期:1996-10-01 00:00:00
abstract::Parenteral administration of mixtures of morphine with other drugs has become common practice in palliative care. Such mixtures are sometimes found to be incompatible but compatibility data are scarce. An attempt was made to develop a quick and simple investigation strategy to obtain complete information on the compat...
journal_title:Palliative medicine
pub_type: 指南,杂志文章,实务指引
doi:10.1191/0269216302pm542oa
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Of deaths in high-income countries, 75% are caused by progressive advanced chronic conditions. Palliative care needs to be extended from terminal cancer to these patients. However, direct measurement of the prevalence of people in need of palliative care in the population has not been attempted. AIM:Determi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313518266
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The perspectives of patients and relatives are important in the improvement of the quality of health care. However, the quality of end-of-life care has not been systematically evaluated in Scandinavia. AIM:To develop or adapt and subsequently validate a questionnaire assessing the quality of end-of-life car...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317740274
更新日期:2018-04-01 00:00:00
abstract::We determined the relationship between symptom severity and distress for multiple cancer symptoms, and examined patient demographic influences on severity and distress in advanced cancer. A Cochran-Armitage trend test determined whether symptom distress increased with severity. Chi-square, Fisher's exact test and logi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309356380
更新日期:2010-04-01 00:00:00
abstract::This study reports UK doctors' opinions about legalisation of medically assisted dying (euthanasia and physician-assisted suicide), comparing this with the UK general public. A postal survey of 3733 UK medical practitioners was done. The majority of UK doctors are opposed to legalisation, contrasting with the UK gener...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308102041
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Approximately one-third of rapid response team consultations involve issues of end-of-life care. We postulate a greater occurrence in patients with a life-limiting illness, in whom the opportunity for advance care planning and palliative care involvement should be offered. AIMS:We aim to review the characte...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216314560802
更新日期:2015-04-01 00:00:00
abstract::The subject of communication between palliative care physicians and their patients regarding their diagnosis and prognosis has not been extensively researched. The purpose of this survey was to compare the attitudes and beliefs of palliative care specialists regarding communication with the terminally ill in Europe, S...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1191/026921600674582192
更新日期:2000-07-01 00:00:00
abstract::The purpose of this study was to compare patient and proxy (physician and nurse) assessments of symptoms in advanced cancer patients. The sample consisted of 49 patients with advanced cancer admitted to an acute palliative care unit. Three independent assessments were completed for each patient on two occasions within...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921699675854885
更新日期:1999-07-01 00:00:00
abstract::The purpose of this study was to further validate a novel instrument to measure satisfaction with end-of-life care, called the Canadian Health Care Evaluation Project (CANHELP) questionnaire. Data were collected by a cross-sectional survey of patients who had advanced, life-limiting illnesses and their family caregive...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310373168
更新日期:2010-10-01 00:00:00
abstract::Comprehensive palliative care programs are often implemented on a community level, and to evaluate such interventions, randomization by cluster (community) may be the only feasible method. In trials randomizing individual subjects, the importance of proper concealment has been stressed. In cluster randomized trials, h...
journal_title:Palliative medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1191/0269216302pm523oa
更新日期:2002-01-01 00:00:00
abstract::Medical training teaches physicians to sit when breaking bad news, though there have been no controlled studies to support this advice. We aimed to establish cancer patients' preference for physician posture when physicians break bad news using a randomized controlled crossover trial in a department of palliative care...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216307081184
更新日期:2007-09-01 00:00:00
abstract::Health-related quality of life (HRQL) is difficult to define and measure. It is a generic term that includes concepts such as physical health, life satisfaction, psychological well-being and self-integrity. Realizing and appreciating the importance of HRQL is crucial for physicians if they are to be in a position to o...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921699669663451
更新日期:1999-09-01 00:00:00
abstract::Back pain resulting from spinal instability in metastatic bone disease can be difficult to alleviate by pharmacological methods and surgical intervention is frequently required. This paper discusses the treatment options with three illustrative case reports. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639300700311
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:While several studies have examined 'what' families want with regard to the place of a child's end-of-life care and death, few have explored 'how' parents reach a decision. AIMS:(1) to develop a model explaining how parents of a child with a life-threatening illness in Greece decide about the place of end-o...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320967547
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:In rural settings, relationships between place and self are often stronger than for urban residents, so one may expect that rural people would view dying at home as a major feature of the 'good death'. AIM:To explore the concept of the 'good death' articulated by rural patients with life-limiting illnesses,...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216318800613
更新日期:2018-12-01 00:00:00