Abstract:
:It has frequently been claimed that palliative care (PC) consultation services reduce hospital length of stay (LOS). We review 12 published studies comparing patients receiving PC or similar intervention and patients receiving usual care with regard to average total hospital LOS. None of the six observational studies showed LOS impact. Three of the four quasi-experiments and one of the two randomized controlled trials reported LOS reduction for at least one subsample. Reduced LOS was demonstrated only for decedents in intensive care unit-based interventions using experimental or quasi-experimental research designs. PC program leaders are cautioned against promising that their inpatient consultations will reduce the length of those admissions because this may be nearly impossible for a typical hospital-based PC program to demonstrate using observational data. Research to date has been handicapped by designs and methods not suitable for detecting an impact on LOS. Only three studies included survivors and decedents and disaggregated them in analysis and interpretation, despite profound differences in the meaning and implications of reduced LOS for survivors and decedents. Recommendations for future studies include conceptualizing, analyzing, and reporting outcomes separately for survivors and decedents; strengthening study design to reduce the likelihood of failing to detect actual LOS impact; using methods that allow for creation of a reasonable comparison group; and addressing the fundamental problem that LOS is both a predictor and criterion variable in observational studies of palliative care consultation services.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Cassel JB,Kerr K,Pantilat S,Smith TJdoi
10.1089/jpm.2009.0379subject
Has Abstractpub_date
2010-06-01 00:00:00pages
761-7issue
6eissn
1096-6218issn
1557-7740journal_volume
13pub_type
杂志文章,评审abstract:: Objectives: To discuss the outcomes of a formalized care transition process for palliative care patients from the hospital to the community. Background: Patients who received inpatient palliative care services from the speciali...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0090
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In 2014, Nova Scotia released a provincial palliative care strategy and implementation working groups were established. The Capacity Building and Practice Change Working Group, comprised of health professionals, public advisors, academics, educators, and a volunteer supervisor, was asked to se...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0655
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Antibiotic administration is frequent in terminal patients with cancer, yet the effects on survival are still under debate. OBJECTIVE:The aim of this study was to examine the status of infection and the benefit/burden of antibiotic administration on the survival of terminal patients with cancer with infecti...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0634
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) and palliative care (PC) organizations recommend early PC to improve the quality of life of patients living with HF. OBJECTIVE:We conducted a two-phase formative evaluation study to translate a cancer-focused concurrent PC intervention into one that would be appropriate for rural-dwelling...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0680
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Many patients with cancer involving the respiratory system suffer from the frequent recurrence of significant, submassive hemoptysis, which may result in invasive procedures, hospital stays, and a reduction in quality of life. Currently, there are no widely accepted noninvasive therapeutic options. Few case ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0167
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:As palliative care grows and evolves, robust programs to train and develop the next generation of leaders are needed. Continued integration of palliative care into the fabric of usual health care requires leaders who are prepared to develop novel programs, think creatively about integration into the current ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0086
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:This case report describes a patient whose persistent hiccups significantly improved with the use of vinegar. CASE PRESENTATION:A patient with an adenocarcinoma of the colon and hepatic metastases developed hiccups the day following chemotherapy with FOL-FOX (folinic acid (leucovorin), 5-fluorouracil, oxali...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2014.0391
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:In the United States, the American Indian and Alaska Native (AI/AN) population is aging and the leading causes of death for those 55 and older are chronic diseases such as cancer, heart disease, and the complications of diabetes. Since 1955, the federally directed Indian Health Service, along with Tribal gov...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2004.7.830
更新日期:2004-12-01 00:00:00
abstract:: Background: Guidelines on pediatric palliative care recommend to provide care for children and adolescents with life-limiting conditions at home. Since 2007, in Germany, palliative home care can be provided by specialized outpatient palliative care teams. However, teams wi...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0245
更新日期:2020-04-01 00:00:00
abstract::Stroke is a leading cause of disability and mortality worldwide. Recent advances in stroke care now enable patients with severe ischemic stroke owing to large vessel occlusion to safely undergo endovascular thrombectomy (EVT) up to 24 hours since their time of last known well, with the goal of improving functional out...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0667
更新日期:2020-05-14 00:00:00
abstract:BACKGROUND:Antiemetics are being used both for the treatment and prophylaxis of opioid-induced nausea and vomiting (OINV) in clinical practice, despite the lack of evidence for the prophylactic benefit. Data regarding the actual status of prophylactic antiemetic use for OINV remain to be elucidated. OBJECTIVE:The obje...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0203
更新日期:2015-11-01 00:00:00
abstract::The treatment of suffering is now recognized as an essential component of medical care. By referring to this treatment as "palliative care," however, we diminish its importance. In this essay, we propose a shift in our conception of the treatment of suffering and advocate for the use of a new term: "palliative treatme...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0410
更新日期:2010-06-01 00:00:00
abstract::Central pain syndromes are a complex, diverse group of clinical conditions that are poorly understood. We present a patient with progressive, debilitating central pain and co-existing mood disorders that was refractory to multimodal pharmacologic and nonpharmacologic therapies, but that ultimately responded to electro...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0344
更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION:Place of death is considered a quality indicator of end-of-life care and enabling people to die where they choose is an important aspiration of palliative care. This study aims to examine the association between involvement of palliative care services and place of death. METHODS:Data about patient charact...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0279
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:To explore how staff recognize that a resident is dying and to present a typology of comfort measures. DESIGN:Exploratory, descriptive study involving qualitative methods and semistructured in-depth interviews with staff members of one nursing home. SETTING:A 120-bed nursing home that is part of a continuum...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0053
更新日期:2009-08-01 00:00:00
abstract:: Background: Despite the association between chronic pain and post-traumatic stress disorder (PTSD), little is known about the longitudinal course of pain and PTSD during cancer treatment. Objectives: We examined the prevalence ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0458
更新日期:2020-09-01 00:00:00
abstract::Palliative care is an evolving field with extensive studies demonstrating its benefits to patients, families, and the health care system. Many health systems have developed or are developing palliative care programs. The Canadian Society of Palliative Care Physicians (CSPCP) is often asked to recommend how many pallia...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0314
更新日期:2019-11-01 00:00:00
abstract:INTRODUCTION:In geriatrics, most risk factors associated with falls have been identified and management strategies developed accordingly. This is not the case in palliative care. The incidence rate of falls, the consequences related to falls, and other related factors were determined in elderly cancer patients hospital...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2007.0241
更新日期:2008-07-01 00:00:00
abstract::An advance directive, a description of one's future preferences for medical treatment, must be easily available to care providers to ensure that one's treatment preferences are honored. The transition of our health care system to an electronic medical record complicated the availability of a patient's written advance ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662103322144880
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Patients with severe acute brain injury (SABI) raise important palliative care considerations associated with sudden devastating injury and uncertain prognosis. OBJECTIVE:The goal of this study was to explore how family members, nurses, and physicians experience the palliative and supportive care needs of p...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0286
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Methadone is an attractive medication for treating children with advanced cancer with pain as it is the only long-acting opioid available as a liquid. However, it is not frequently used due to concerns about potential toxicities and side effects. OBJECTIVE:Evaluate the efficacy and safety of methadone as th...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0712
更新日期:2018-09-01 00:00:00
abstract::In this review we discuss the history of Hospice and Palliative Medicine (HPM) physician education in the United States over the last 20 years, as there has been dramatic growth in our specialty during this time. A Medline literature search was completed and we surveyed leaders in the field of HPM education regarding ...
journal_title:Journal of palliative medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1089/jpm.2012.0436
更新日期:2013-03-01 00:00:00
abstract::Generalized severe junctional epidermolysis bullosa is a rare mechanobullous skin disorder that is uniformly fatal. We present the case of an infant who received palliative pain management and ultimately proportionate palliative sedation. However, because of the extent of the patient's skin disease, we were unable to ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0054
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:End-stage renal disease (ESRD) affects nearly 1400 new children each year in the United States. Morbidity and mortality rates remain high for pediatric patients with ESRD, including those that have received a renal transplant. OBJECTIVE:To better understand ESRD patients referred to palliative care, includi...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0353
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:Many proponents of hospice care believe that this service is underutilized. OBJECTIVE:To determine physicians' perceptions of hospice utilization and of their own hospice referral pattern; their perceived and actual knowledge of appropriate hospice referral diagnoses; and perceived barriers to hospice ref...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/1096621041349518
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to describe the perceptions of community residence (CR) staff who have cared for older adults with developmental disabilities (ADDs) that are at the end of life. DESIGN:This exploratory, descriptive study utilized qualitative methods that involved semistructured interviews with C...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0408
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:In 1997, a biweekly, 18-month Palliative Care Seminar Series was started at Mount Sinai School of Medicine as a way to explore participants' beliefs about palliative care and to instill the knowledge, skills, and attitudes needed to improve care at the end of life. The goal of this study was to examine the effe...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662102320135234
更新日期:2002-06-01 00:00:00
abstract:: Background: This study examines communication profiles and associated attitudes toward health care professionals in interviews with family caregivers of hospitalized patients with confirmed multidrug-resistant organisms (e.g., methicillin-resistant Staphylococcus aureus or...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0027
更新日期:2019-12-01 00:00:00
abstract::Symptom control for hospice patients frequently involves the use of pharmacologic agents for control of pain, dyspnea, and anxiety. Other troubling symptoms that will often require pharmacologic agents include nausea, vomiting, constipation, and delirium. While the Medicare requirement for hospice is a prognosis of si...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0095
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:The Palliative Performance Scale (PPS) is a tool that is widely used to predict end of life. In Ontario, Canada, the PPS is used to mark the terminal phase of life and eligibility for terminal care. OBJECTIVE:The aim of this retrospective study was to confirm that a PPS level of 40% can be used as a marker ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0645
更新日期:2015-01-01 00:00:00