Abstract:
OBJECTIVES:Continuity, coordination, and transitions of care are key to high-quality medical care for patients with serious and advanced illness. We conducted a systematic review to evaluate the impact of interventions targeting these areas in this population. METHODS:We searched PubMed, CINAHL, PsycINFO, Cochrane, and DARE from 2000 through 2011. We included prospective controlled studies targeting continuity, coordination, and transitions for patients with advanced illness that reported patient centered outcomes. Of 13,014 citations, 23 studies met inclusion criteria. Two investigators extracted and checked data on population, interventions, methods, outcomes, and methodological quality. RESULTS:Four of the six studies evaluating patient satisfaction (67%) and four of the six studies evaluating caregiver satisfaction (67%) showed statistically significant improvements in these outcomes in the intervention compared to the control group. Only three of the nine studies (33%) measuring quality of life and five of the 16 (31%) measuring health care utilization showed improvement. Results were similar across different types of interventions. CONCLUSIONS:Many studies were limited by methodologic issues such as use of measurement tools not developed for patients with advanced disease and small sample size. Interventions and outcomes were too heterogeneous for meta-analysis. We found moderate evidence that interventions targeting continuity, coordination, and transitions in patients with advanced and serious illness improve patient and caregiver satisfaction, but low evidence for other outcomes. Further research is needed on how to target these domains for outcomes such as health care utilization.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Dy SM,Apostol C,Martinez KA,Aslakson RAdoi
10.1089/jpm.2012.0317subject
Has Abstractpub_date
2013-04-01 00:00:00pages
436-45issue
4eissn
1096-6218issn
1557-7740journal_volume
16pub_type
杂志文章,meta分析,评审abstract:PURPOSE:To identify issues affecting the quality of life (QoL) in women receiving palliative therapy for ovarian cancer. METHODS:Twenty women with advanced recurrent ovarian cancer were interviewed to establish what issues affect QoL. All patients were receiving palliative chemotherapy or other palliative therapy in t...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.1999.2.397
更新日期:1999-01-01 00:00:00
abstract:: Background: The lack of consumer knowledge and misconception of services could impede requests for and acceptance of palliative care. YouTube has been widely used for health information dissemination. Objective: To explore the ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2019.0047
更新日期:2019-12-01 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::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:BACKGROUND:Numerous studies have focused on the treatment of non-small cell lung cancer patients with brain metastases. However, to our knowledge, few have sought to examine outcomes in patients who required whole brain radiation and developed radiation-refractory disease. METHODS:This study examined the medical recor...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0097
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVES:To continuously assess overall quality of life (QOL) and disease progression in patients with amyotrophic lateral sclerosis (ALS) at different stages of the disease and compare the results between these two variables. DESIGN/SUBJECTS:Twenty-six patients with ALS were interviewed with a questionnaire to asse...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.304
更新日期:2006-04-01 00:00:00
abstract:: Background: Lack of guidance is highlighted as a barrier to deprescribing in palliative care. Two deprescribing tools exist, but with inclusion and exclusion criteria that limit utility. The tools have not previously been compared directly or used in an unselected palliati...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0225
更新日期:2020-09-29 00:00:00
abstract:: Objective: To systematically capture patient- and family-centered data to understand variability and opportunities in end-of-life care delivery across settings in an integrated health care delivery system. Background: Improving...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0265
更新日期:2020-06-01 00:00:00
abstract:: Background: End-of-life (EOL) care in neonatal intensive care units (NICUs) can vary depending on religious beliefs of health care providers and families as well as the sociocultural environment. Although guidelines exist for EOL care in NICUs, most are based on Western st...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2018.0304
更新日期:2019-07-01 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::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:OBJECTIVE:There is a dearth of international research on hospice physiotherapy. This study aims to profile hospice physiotherapy in an Irish setting in order to inform practice internationally. DESIGN:The study design consisted of a retrospective chart audit over 6 months. SETTING:The study took place at a specialist...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0480
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Additional evidence is needed regarding the impact of inpatient palliative care (IPC) on the quality of end-of-life care and downstream utilization. AIM:Examine the effects of IPC on quality of end-of-life care and acute and postacute care use in a large integrated system. DESIGN:Retrospective cohort desig...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0275
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:There are no evidence-based recommendations for statin continuation or discontinuation near the end of life. However, some expert opinion recommends continuing statins prescribed for secondary versus primary prevention of cardiovascular disease. OBJECTIVES:Our aim was to explore statin prescribing patterns ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0158
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:End-of-life care quality deficiencies have in part been linked to inadequate physician skill in the technical and communication domains of palliative care. Yet few studies have examined physicians' perspectives regarding their experiences caring for patients approaching the end of life. OBJECTIVE:To underst...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.291
更新日期:2005-04-01 00:00:00
abstract::Palliating the whole person requires that medicine attend more fully to the phenomenon of existential suffering. The role of social factors, in particular, is often overlooked in attempts to understand why end-of-life suffering does not always respond to physiologic, psychological, and spiritual interventions. Using q...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662104322737223
更新日期:2004-02-01 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::Fentanyl is a lipophilic, short-acting, synthetic opioid with a piperidine chemical structure. Fentanyl is an effective analgesic for cancer pain, and newer formulations such as the transmucosal and buccal forms have shown efficacy for the management of cancer-related breakthrough pain. This article reviews the pharma...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2009.0051
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Pediatric intensive care units (PICUs) are highly technological settings in which advanced care is used to restore health to critically ill children; however, they are also places where children die. Understanding the needs of parents bereaved in this setting is essential for better family care. OBJECTIVE:T...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2010.0453
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The provision of complementary therapy in palliative care is rare in Canadian hospitals. An Ontario hospital's palliative care unit developed a complementary therapy pilot project within the interdisciplinary team to explore potential benefits. Massage, aromatherapy, Reiki, and Therapeutic Touch™ were provid...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0295
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Striking changes occurred in health care in the United States between 2000 and 2013, including growth of hospice and hospital-based palliative care teams, and changes in Medicare payment policies. OBJECTIVE:The aim of this study was to compare informants' reports and ratings of the quality of end-of-life ca...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0039
更新日期:2015-08-01 00:00:00
abstract:: Background: There are substantial disparities in distribution of palliative care (PC) services within Latin America, with Bolivia historically lagging behind neighboring countries in PC metrics. Comprehensive data on PC in Bolivia were last collected in 2012 through the La...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0169
更新日期:2020-09-21 00:00:00
abstract:: Background: Aggressive care at the end of life (EOL) is a persistent issue for patients with stage IV nonsmall cell lung cancer (NSCLC). We evaluated the use of concurrent care (CC) with hospice care and cancer-directed treatment simultaneously within the Veteran's Health ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0485
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:This study describes the process and population involved in pediatric advance care planning at one Midwest medical center. The outcomes and the parents' perceptions of this planning are also discussed. METHODS:Pediatric patients with advance directives were identified from ethics consultations records. Infor...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.766
更新日期:2005-08-01 00:00:00
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 ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2009.0379
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:To determine the effects of thalidomide and placebo on anorexia-cachexia and its related symptoms, body composition, resting metabolic rate, and serum cytokines and their receptors in patients with advanced cancer. METHODS:Included in the study were patients with advanced cancer with weight loss greater tha...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1089/jpm.2012.0146
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Empirical research suggests that the quality of patient care at the end of life (EOL) is influenced by the effectiveness of the collaboration between the general practitioners (GPs) and hospital physicians (HPs). AIM:To identify possible difficulties and barriers to effective collaboration at the EOL betwee...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0377
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Relief of distressful symptoms in terminally ill patients with cancer is of prime importance. Use of sedation to accomplish this has been the focus of recent medical studies in countries other than Japan. We investigated the influence on consciousness of sedative drugs in a Japanese hospice. DESIGN AND SUBJ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.20
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Key to high-quality care of dying hospice patients at home is whether the hospice provides adequate training so the caregiver can safely care for the patient. OBJECTIVE:The study objective was to develop and validate a survey of hospice training for caregivers to ensure safe, high-quality care in the home s...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0185
更新日期:2016-06-01 00:00:00
abstract:: Background: Diabetes is increasingly prevalent globally, including in palliative care. Guidelines vary as to the ideal glycemic goals for patients near the end of life. The relationship between hyperglycemia and attributable symptoms late in life remains ill defined. ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0083
更新日期:2020-03-01 00:00:00