Abstract:
BACKGROUND:Although strong evidence supports early palliative care (PC) and consistent advance care planning (ACP) for patients with poor-prognosis Stage IV solid tumors, best practice standards have not been established for hematologic malignancies. Our primary objective was to describe current access to specialty PC consultation and ACP for inpatients with high-risk leukemia. Secondary objectives were to describe components of ACP and PC practices. METHODS:We enrolled all patients with high-risk leukemia (acute leukemia ≥65 years or relapsed leukemia >18 years) admitted to the University of North Carolina Cancer Hospital from October 1, 2015, to August 1, 2016. Structured chart reviews provided data on demographics, disease characteristics, PC consultation, frequency and components of documented ACP, and quality measures for PC practices. RESULTS:Of 50 high-risk leukemia patients, 52% were 65 years of age or older with a new diagnosis of acute leukemia and 48% were under the age of 65 with relapsed leukemia. Most patients (64%) reported pain on admission. Twenty-two percent of patients died within 3 months of hospitalization. Sixteen percent of patients received PC consultation and 24% had complete ACP, with an identified surrogate decision-maker documented treatment preferences. CONCLUSIONS:In this descriptive study of inpatients with high-risk leukemia, we found that despite a poor prognosis and high symptom burden, the frequency of PC consultation and ACP documentation was low. Findings suggest missed opportunities to provide PC to a high-risk subset of hematologic malignancies, and may help to target future interventions.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Freeman AT,Wood WA,Fox A,Hanson LCdoi
10.1089/jpm.2017.0097subject
Has Abstractpub_date
2018-02-01 00:00:00pages
225-228issue
2eissn
1096-6218issn
1557-7740journal_volume
21pub_type
杂志文章abstract:BACKGROUND:When identifying patients for palliative care, medical specialists find it necessary to disclose "hidden" patients: the patient's relatives. The issue has been discussed sporadically in Bulgaria; the present study was part of a larger investigation that examined the opinion of medical specialists, patients, ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0333
更新日期:2014-01-01 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
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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: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:In advanced dementia, many difficult decisions may arise as the disease progresses, including whether to use feeding by tube. Several recent articles question the benefit of percutaneous endoscopic gastrostomy (PEG) tube placement in persons with advanced dementia. However, patients with advanced dementia are...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662103322654767
更新日期:2003-12-01 00:00:00
abstract::Palliative care consultation has been demonstrated to be useful in many situations in which expert symptom management, communication around sensitive issues, and family support may serve to enhance or improve care. The process of organ donation is an example of this concept, specifically the process of donation after ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2006.0118
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:To examine the effect of patient-directed electronic messages on health care proxy (HCP) use. DESIGN:Randomized control trial using an electronic message intervention to encourage patients to complete an HCP document. SETTING:General medical practice at a large tertiary care teaching institution. PARTICIP...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1089/jpm.2006.9.1320
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Dyspnea is a very distressing symptom present in the vast majority of patients with advanced cancer. There are limited data on the characteristics and correlates of dyspnea in this population. The purpose of this study was to characterize dyspnea, explore the differences between breakthrough and continuous p...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2008.0158
更新日期:2009-01-01 00:00:00
abstract::The purpose of this study was to describe the experiences and perceptions of hospice nurses caring for residents in long-term care facilities. The study used a fax-back survey to gather data from 69 hospice nursing and nurse managers in 24 hospices across one Midwestern state. Respondents reported negative experiences...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662102320880534
更新日期:2002-10-01 00:00:00
abstract:INTRODUCTION:Methadone (ME) is a highly effective opioid agonist used for difficult pain syndromes. However, in the management of cancer pain with strong opioids, rotation to a different opioid (opioid rotation) may be required because of side effects or poor pain control. Rotation from methadone to another opioid has ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2007.0285
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Although the role of volunteers is at the heart of hospice care, little is known about hospice volunteer training and volunteer activity. METHOD:A survey was used to assess current training programs for hospice volunteers. Hospices were invited to participate in the study from a link on the website for the ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0240
更新日期:2010-03-01 00:00:00
abstract::A faculty development course was offered at the Medical College of Wisconsin to bolster existing medical student and housestaff training opportunities in palliative medicine. An 8- week, 12 contact-hour course was designed to provide up to 15 faculty members training in the practice and teaching of end-of-life care. F...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.1998.1.35
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:For the better part of 100 years, acetaminophen (or paracetamol as it is known outside of the United States) has been a common first-line analgesic in pediatrics and is typically well tolerated with minimal side effects. Its use as an anti-pyretic is also well-documented and thus it is used broadly for sympt...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0117
更新日期:2013-12-01 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:: 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
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1089/jpm.2012.0270
更新日期:2013-03-01 00:00:00
abstract:CONTEXT:Research shows an increased symptom burden in young adult (YA) cancer patients compared with their older adult counterpart. OBJECTIVES:The purpose of this study was to identify differences in clinical characteristics and related outcomes between YA and older adult cancer patients admitted for cancer-related pa...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0212
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Previous research has reported improved pain after adding methadone to another opioid, but did not quantify this benefit using a validated outcome measure. OBJECTIVE:To assess quantitatively the effectiveness of adding methadone to another opioid for moderate to severe cancer-related pain. DESIGN:All outpa...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0335
更新日期:2013-03-01 00:00:00
abstract::Securing a first job following training is an exciting and daunting task. Little formal guidance is available and trainees often find themselves confused, uncertain, and overwhelmed. This article is designed to provide a basic framework for fellows and new graduates to search for positions, apply, interview, and negot...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0002
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Recent studies suggest that surrogate decision makers may be too optimistic about their end-of-life decision making abilities for loved ones. We examined surrogates' decision making confidence with an emphasis on its linkages to their understandings of patients' values and goals for end-of-life care. METHOD...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0330
更新日期:2012-04-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0005
更新日期:2011-07-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0256
更新日期:2014-07-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0036
更新日期:2013-09-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0213
更新日期:2010-02-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2020-05-14 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0238
更新日期:2010-12-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/10966210252785042
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:Despite the growing use of opioids to treat cancer pain and the probability of opioid aberrancy in the cancer setting, clinical practice guidelines (CPGs) or recommendations for active screening and monitoring of opioid compliance are lacking. OBJECTIVES:To evaluate the current practices and attitudes clini...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2006-08-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2008.0082
更新日期:2008-11-01 00:00:00