Abstract:
CONTEXT:Intermountain Healthcare, in collaboration with Cerner Corporation, developed a hospital-based electronic palliative care algorithm. OBJECTIVES:This study aims to improve identification of patients who would benefit from palliative care services, and calculate palliative care penetration rates. METHODS:This study used a mixed-methods nonrandomized retrospective study design. Three 30-day iterations of clinical data were analyzed for patients identified by the electronic algorithm. During the second and third 30-day iterations, palliative care clinicians conducted chart reviews on a weekly basis for identified patients and determined whether the patients were appropriate for a palliative care consult. Positive predictive values (PPVs) were calculated. Based on the PPV, palliative care consult penetration rates were also calculated. RESULTS:During the first iteration, the algorithm triggered 2995 times on 1384 unique patient encounters (69.3% of the total inpatient population). In the second iteration, the algorithm triggered 851 times on 477 unique patient encounters (26.4% of the total inpatient population). Eight hundred twenty-one chart reviews were completed on 420 unique patient encounters. The PPV was 68.3%. Based on the PPV, the projected palliative care penetration rate was 17.6%. During the third iteration, the algorithm triggered 1229 times on 539 unique patient encounters (33.3% of the total inpatient population). Nine hundred sixty-seven chart reviews were completed on 505 unique patient encounters. The PPV was 80.1%. Based on the PPV, the projected palliative care penetration rate was 26.4%. CONCLUSION:This study successfully optimized an electronic palliative care identification algorithm with a PPV of 80.1% and indicates appropriate palliative care penetration rates may be as high as 26.4% of the total inpatient population.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Gruhler H,Krutka A,Luetke-Stahlman H,Gardner Edoi
10.1016/j.jpainsymman.2017.09.013subject
Has Abstractpub_date
2018-02-01 00:00:00pages
226-235issue
2eissn
0885-3924issn
1873-6513pii
S0885-3924(17)30477-3journal_volume
55pub_type
杂志文章abstract::Many painful disorders, including joint dysfunctions such as rheumatoid arthritis (RA) or temporomandibular joint disorders (TMD), are associated with hyperthermia of the overlying skin. The same is true of certain intractable chronic pain conditions, such as chronic orofacial pain, which may be associated with TMD. W...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/s0885-3924(97)00178-4
更新日期:1997-10-01 00:00:00
abstract::The aim of this study was to longitudinally assess breakthrough pain (BP) in advanced cancer patients who were admitted to home palliative care. One hundred and one consecutive patients who were admitted to one of the two home care programs and were representative of the cancer population followed at home in Italy wer...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2008.12.008
更新日期:2009-10-01 00:00:00
abstract:CONTEXT:Chronic pain impacts one-third of the U.S. population, and its effects are debilitating for individuals and costly to the medical system. Although opioids are commonly prescribed to address chronic pain, they confer risk for misuse and addiction in some patients and may not fully restore life function-particula...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2014.03.006
更新日期:2014-12-01 00:00:00
abstract::The intravenous (i.v.) administration of opioids to neonates is a common method of providing analgesia in the intensive care setting. This paper reviews and critiques the studies that have investigated this intervention. The studies are grouped into four major areas: pharmacokinetic studies; i.v. opioids for anesthesi...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/S0885-3924(97)00272-8
更新日期:1998-01-01 00:00:00
abstract::Concerns about the safety of therapy with methadone, which may arise because of its pharmacokinetic characteristics and inappropriate dosing, may deter clinicians from using this drug, especially in elderly patients. Experience is accumulating that the drug may be used safely and successfully if low doses are given in...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/s0885-3924(99)00048-2
更新日期:1999-09-01 00:00:00
abstract::Infection is common among advanced cancer patients. This study was undertaken to review the pattern of use of antibiotics and to identify potential factors that could affect outcomes after infection. The medical records of all patients with advanced cancer who were enrolled into the palliative care service of a distri...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2005.06.005
更新日期:2005-12-01 00:00:00
abstract:CONTEXT:Past religiosity/spirituality (R/S) research has mainly relied on self-report instruments, which may result in self-presentation and defensive biases. OBJECTIVES:To address these limitations, we reviewed the writing samples that were generated as part of an expressive writing (EW) trial, coded the samples for ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.04.029
更新日期:2020-10-01 00:00:00
abstract::Although colorectal cancer is one of the most preventable forms of visceral cancer, it remains the second leading cause of cancer death in the United States. Most colorectal cancers are believed to arise from adenomatous polyps, premalignant mucosal masses that account for up to two thirds of colorectal polyps. Early ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/s0885-3924(02)00375-5
更新日期:2002-04-01 00:00:00
abstract::The purpose of this study was to describe hospice social workers' perceptions of cases where hospice patients or their family members expressed a desire to hasten the patient's death. Surveys were mailed to hospice social workers (n=212) in two Southeastern states. Response rate was 36%. Of the 73 respondents, 56.2% h...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2003.10.010
更新日期:2004-06-01 00:00:00
abstract:CONTEXT:Multiple studies have demonstrated that adults do not store prescription opioids safely. Increased prescription opioid rates have led to an increased incidence of opioid poisonings in children and adolescents. OBJECTIVES:We investigated whether parents practiced safe storage, use, and disposal techniques of op...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.09.018
更新日期:2020-02-01 00:00:00
abstract::Pain is a multidimensional phenomenon with physical, psychological, and social components and is a significant problem for 50% of hemodialysis (HD) patients. Failure to treat pain adequately may lead to disruption in many aspects of life. This study examines the relationship between moderate to severe chronic pain and...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2005.05.013
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess the characteristics of breakthrough cancer pain (BTcP) in patients with abdominal cancer pain, and the eventual factors associated with its presentation. METHODS:Patients with abdominal visceral cancer presenting BTcP were included in the analysis. Pain intensity, cu...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2019.02.014
更新日期:2019-05-01 00:00:00
abstract:CONTEXT:Cancer is widely acknowledged to impact on the whole family. Yet, we do not know if there is benefit (or harm) from patient-family carer interventions in the context of cancer care. OBJECTIVES:To report a systematic search for and narrative review of patient-family carer interventions tested in the context of ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpainsymman.2011.03.013
更新日期:2012-01-01 00:00:00
abstract:CONTEXT:Oncology patients with persistent pain treated in outpatient settings and their family caregivers have significant responsibility for managing pain medications. However, little is known about their practical day-to-day experiences with pain medication management. OBJECTIVES:The aim was to describe day-to-day p...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2013.12.242
更新日期:2014-11-01 00:00:00
abstract:CONTEXT:Fatigue is the most common symptom among Hodgkin's lymphoma survivors. OBJECTIVES:To evaluate the psychometric properties of the Brazilian version of the Multidimensional Fatigue Inventory (MFI). METHODS:The MFI was translated into Brazilian Portuguese using established forward-backward translation procedures...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2011.12.275
更新日期:2012-12-01 00:00:00
abstract::Delirium often causes severe distress for terminally ill cancer patients, and treatment of underlying pathologies is important to achieve symptom alleviation. Although accumulation of morphine metabolites may play an important role in development of delirium, empirical findings are conflicting due to a large inter-ind...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(01)00392-x
更新日期:2002-02-01 00:00:00
abstract:CONTEXT:Cancer-related fatigue (CRF) is one of the most common symptoms experienced by cancer patients after hematopoietic cell transplantation (HCT). Yoga is an approach with supportive evidence to improve CRF in different cancer populations, but to our knowledge, it has not been tested in an adult HCT population. OB...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.11.012
更新日期:2020-03-01 00:00:00
abstract::Visual analogue scales (VAS) and verbal rating scales (VRS) are widely used to assess pain. This paper presents a secondary analysis of a subsection of data collected as part of an evaluation of an intervention to improve nighttime pain. The aims were to describe the relationship between the VAS and VRS; to compare ch...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/s0885-3924(99)00092-5
更新日期:1999-12-01 00:00:00
abstract::Cancer-related fatigue (CRF) is a significant clinical symptom. Effective assessment of CRF attributes from the patients' perspective is essential. This study tested the psychometric properties of the Wu Cancer Fatigue Scale (WCFS). A total of 172 outpatients with breast cancer, who were at various stages and on vario...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2006.06.001
更新日期:2006-09-01 00:00:00
abstract::The aims of this study were (a) to estimate the prevalence of pain and eight other common symptoms in a large population of patients with advanced cancer from different palliative care centers, and (b) to assess the differences in prevalence of the symptoms by primary site. In 1990-1991, the prevalence of eight major ...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0885-3924(96)00042-5
更新日期:1996-07-01 00:00:00
abstract:CONTEXT:General practitioners (GPs) and community nurses (CNs) have a central role in palliative care. With health policy focusing more and more on enabling patients to die at home, primary health care professionals are increasingly responsible for symptom management of patients near the end of life. OBJECTIVES:1) To ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2012.09.004
更新日期:2013-09-01 00:00:00
abstract:CONTEXT:Thirst is a prevalent distressing symptom often reported by patients in the intensive care unit (ICU). Little is known about the association of thirst with delirium. OBJECTIVE:We aimed to investigate the relationship between thirst and delirium. METHODS:This retrospective cross-sectional study enrolled 401 pa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.02.022
更新日期:2019-06-01 00:00:00
abstract::The microcirculation appears to be impaired in cold chronic complex regional pain syndrome (CRPS). This double-blind, placebo-controlled, randomized trial investigated the effect of the nitric oxide (NO) donor isosorbide dinitrate (ISDN) on the peripheral blood flow in patients with chronic CRPS. Twenty-four patients ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2008.10.006
更新日期:2009-09-01 00:00:00
abstract:CONTEXT:Undertreatment of cancer pain among outpatient cancer patients needs to be addressed to enhance care and improve patients' quality of life (QoL). OBJECTIVES:This prospective, cross-sectional, patient-focused study aimed to explore the prevalence of pain and undertreatment of cancer pain in outpatients in Taiwa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2017.02.018
更新日期:2017-07-01 00:00:00
abstract:CONTEXT:Anxiety in terminal cancer is linked to diminished quality of life, yet overall it is poorly understood with regard to prevalence and relationship to other aspects of psychological distress. OBJECTIVES:This study examines anxiety in terminally ill cancer patients, including the prevalence of anxiety symptoms, ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2011.01.013
更新日期:2011-11-01 00:00:00
abstract::Although sialorrhea and drooling are uncommon symptoms in cancer patients, they can cause considerable discomfort, inconvenience and social embarrassment. In this article we describe a patient with tongue cancer who was successfully treated with oral glycopyrrolate 0.4 mg 3 times daily. Glycopyrrolate is a quaternary ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(99)00080-9
更新日期:1999-10-01 00:00:00
abstract::We report an open, uncontrolled study designed to assess the effects of subcutaneous (SC) morphine on dyspnea of terminal cancer. Twenty patients with dyspnea caused by restrictive respiratory failure received an SC dose of morphine of 5 mg (5 patients who were not receiving narcotics), or equivalent to 2.5 times thei...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(90)90027-h
更新日期:1990-12-01 00:00:00
abstract::The United States Agency for Health Care Policy and Research (AHCPR) Acute Pain Management Guidelines were written to provide a scientific basis for practice. Educational programs designed to promote use of the guidelines may change practice in community hospitals. This article describes the development and implementa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(98)00142-0
更新日期:1999-04-01 00:00:00
abstract::Inadequate nursing education is a major impediment to effective pain relief for cancer patients throughout the world. This study was conducted to identify the level of cancer pain knowledge among baccalaureate student nurses and to determine whether specific activities affect this level of knowledge. Two questionnaire...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(92)90134-4
更新日期:1992-11-01 00:00:00
abstract::A retrospective analysis was performed to describe the course of terminal care provided to dying hospitalized children in terms of symptom assessment and management, and communication and decision-making, at the end of life. Seventy-seven of 236 infants and children who died after hospital admission in Edmonton, Canad...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(00)00212-8
更新日期:2000-12-01 00:00:00