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Palliative Care

Perspective | Reconsidering the language of serious illness

26 Jul, 2023 | 13:29h | UTC

Reconsidering the Language of Serious Illness – JAMA (free for a limited period)

 

Commentary on Twitter

 


Giving a voice to patients at high risk of dying in the intensive care unit: a multiple source approach

26 Jul, 2023 | 13:20h | UTC

Giving a voice to patients at high risk of dying in the intensive care unit: a multiple source approach – Intensive Care Medicine (free for a limited period)

 

Commentary on Twitter

 


ASCO Guideline | Practical assessment and management of vulnerabilities in older patients receiving systemic cancer therapy

19 Jul, 2023 | 14:31h | UTC

Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update – Journal of Clinical Oncology

 


Systematic Review | An evidence-base for the implementation of hospital-based palliative care programs in routine cancer practice

19 Jul, 2023 | 14:23h | UTC

An evidence-base for the implementation of hospital-based palliative care programs in routine cancer practice: A systematic review – Palliative Medicine

 


Consensus Paper | Subcutaneous infusions of hydration and medication in adults

7 Jul, 2023 | 16:27h | UTC

International Consensus Recommendation Guidelines for Subcutaneous Infusions of Hydration and Medication in Adults: An e-Delphi Consensus Study – Journal of Infusion Nursing

 


SR | Medically assisted hydration in palliative care: uncertain effects on quality of life and survival

27 Jun, 2023 | 13:47h | UTC

Summary: The Cochrane Review analyzed Randomized Controlled Trials (RCTs) to evaluate the impact of Medically Assisted Hydration (MAH) on the Quality of Life (QoL) and survival of adults receiving palliative care. A total of four studies involving 422 participants, all diagnosed with advanced cancer, were considered. Two studies compared MAH with placebo, and two compared it with standard care.

The primary outcome was QoL, assessed through validated scales, with survival and adverse events being secondary outcomes. Mean differences (MD) and risk ratios (RR) were calculated for continuous and dichotomous outcomes, respectively. However, results were inconclusive due to a very low certainty of evidence. Hence, it is unclear whether MAH improves QoL, prolongs survival, or leads to adverse events when compared to placebo or standard care.

The findings are only applicable to inpatients with advanced cancer at the end of life and do not transfer to other adults in palliative care with non-cancer, dementia, or neurodegenerative diseases, or those with an extended prognosis. The lack of high-quality evidence leaves clinicians to make decisions based on perceived benefits and harms for individual circumstances.

Article: Medically assisted hydration for adults receiving palliative care – Cochrane Library

 


Choosing Wisely | Recommendations for advance care planning

22 Jun, 2023 | 15:18h | UTC

Choosing Wisely: Canadian Neurological Society Recommendations for Advance Care Planning – Canadian Journal of Neurological Sciences

See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada

 


M-A | Advance care planning for frail elderly: are we missing a golden opportunity?

7 Jun, 2023 | 13:53h | UTC

Advance care planning for frail elderly: are we missing a golden opportunity? A mixed-method systematic review and meta-analysis – BMJ Open

 


RCT | Communication-priming intervention boosts goals-of-care discussions for seriously ill patients

29 May, 2023 | 11:12h | UTC

Intervention to Promote Communication About Goals of Care for Hospitalized Patients With Serious Illness: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Conversations on Goals of Care With Hospitalized, Seriously Ill Patients – JAMA (free for a limited period)

See also: Visual Abstract

Commentary: Some Surrogate Endpoints Are Fine – By Dr John Mandrola

 


Pre-Post Study | Machine learning informs mortality risk, increases advanced care planning rates in hospitalized patients

28 Apr, 2023 | 12:54h | UTC

Advanced Care Planning for Hospitalized Patients Following Clinician Notification of Patient Mortality by a Machine Learning Algorithm – JAMA Network Open

 

Commentary on Twitter

 


Extracorporeal CPR dissemination and integration with organ preservation in the USA: ethical and logistical considerations

28 Apr, 2023 | 12:47h | UTC

Extracorporeal cardiopulmonary resuscitation dissemination and integration with organ preservation in the USA: ethical and logistical considerations – Critical Care

 


Guideline | Significance of the comprehensive geriatric assessment in the administration of chemotherapy to older adults with cancer

28 Apr, 2023 | 12:43h | UTC

Significance of the comprehensive geriatric assessment in the administration of chemotherapy to older adults with cancer: Recommendations by the Japanese Geriatric Oncology Guideline Committee – Journal of Geriatric Oncology

 


A systematic review on clinical guidelines of home health care in heart failure patients

28 Apr, 2023 | 12:41h | UTC

A systematic review on clinical guidelines of home health care in heart failure patients – BMC Nursing

 


Opinion | Precision palliative care as a pragmatic solution for a care delivery problem

26 Apr, 2023 | 14:19h | UTC

Precision Palliative Care as a Pragmatic Solution for a Care Delivery Problem – Journal of Clinical Oncology

 

Commentary from the author on Twitter (thread – click for more)

 


ESMO Guideline | Prognostic evaluation in patients with advanced cancer in the last months of life

26 Apr, 2023 | 14:07h | UTC

Prognostic evaluation in patients with advanced cancer in the last months of life: ESMO Clinical Practice Guideline – ESMO Open

 


SR | Association between advanced care planning and emergency department visits

18 Apr, 2023 | 13:21h | UTC

Association between advanced care planning and emergency department visits: A systematic review – The American Journal of Emergency Medicine

 


Palliative care in the intensive care unit: not just end-of-life care

31 Mar, 2023 | 13:21h | UTC

Palliative Care in the Intensive Care Unit: Not Just End-of-life Care – Intensive Care Research

 


Advantages and challenges of using telehealth for home-based palliative care | Systematic mixed studies review

16 Mar, 2023 | 13:14h | UTC

Advantages and Challenges of Using Telehealth for Home-Based Palliative Care: Systematic Mixed Studies Review – Journal of Medical Internet Research

 


The adult and pediatric palliative care: differences and shared issues

28 Feb, 2023 | 13:30h | UTC

The adult and pediatric palliative care: differences and shared issues – Journal of Anesthesia, Analgesia and Critical Care

 


Cohort Study | Aggressive end-of-life care is still common among older adults with metastatic cancer in the US

27 Feb, 2023 | 13:11h | UTC

Summary: The study aimed to compare the markers of aggressive end-of-life (EOL) care between older adults with metastatic cancer who are nursing home (NH) residents and those who live in community settings. The study analyzed data from 146,329 patients who died from metastatic breast, colorectal, lung, pancreas, or prostate cancer between 2013 and 2017, and found that aggressive EOL care was more common among NH residents than community-dwelling residents (63.6% vs. 58.3%). More than one hospital admission in the last 30 days of life and death in the hospital were the key markers associated with a higher prevalence of aggressive EOL care. The authors suggest that interventions targeting these factors could improve the quality of end-of-life care.

Article: Incidence of Aggressive End-of-Life Care Among Older Adults With Metastatic Cancer Living in Nursing Homes and Community Settings – JAMA Network Open

 


Prevalence of long-term decision regret and associated risk factors in a large cohort of ICU surrogate decision makers

22 Feb, 2023 | 12:22h | UTC

Prevalence of long-term decision regret and associated risk factors in a large cohort of ICU surrogate decision makers – Critical Care

 

Commentary on Twitter

 


Regulations on palliative sedation: an international survey across eight European countries

16 Feb, 2023 | 15:17h | UTC

Regulations on palliative sedation: an international survey across eight European countries – European Journal of Public Health

 


Developments under assisted dying legislation: the experience in Belgium and other countries

14 Feb, 2023 | 11:02h | UTC

Summary: The legalization of assisted dying (including euthanasia and physician-assisted suicide) remains a controversial issue as more countries consider such laws. A selective literature review was conducted to examine the developments globally, and the experience in Belgium was found to be instructive. Since legalization, the practice of assisted dying has increased gradually, accompanied by a growing acceptance among the public and physicians. Although fears have been largely alleviated, ongoing monitoring and research are necessary to address important concerns. Research in Belgium has not found evidence of harmful effects, but the implementation of assisted dying laws should always consider integration into the healthcare system, physician training, conscientious objection, availability of palliative care, public education, and monitoring systems. To ensure the quality of end-of-life care, it is advisable to set up monitoring and evaluation systems and carry out impartial studies. It is important to have high levels of openness and involvement with healthcare providers and the general public.

(By ChatGPT, reviewed and edited)

 

Article: Developments Under Assisted Dying Legislation: The Experience in Belgium and other countries – Deutsches Ärzteblatt international

 


Perspective | Five new realities in critical care for patients with cancer

13 Feb, 2023 | 12:53h | UTC

Five new realities in critical care for patients with cancer – Intensive Care Medicine

Related:

Consensus Conference: Critically ill cancer patient’s resuscitation.

Raising awareness for time-limited trial discussion upon ICU triage and admission.

Trends in clinical profiles, organ support use and outcomes of patients with cancer requiring unplanned ICU admission: a multicenter cohort study

 

Commentary on Twitter

 


Consensus Paper | Use of cerebral CT angiography to support a clinical diagnosis of death using neurological criteria

10 Feb, 2023 | 13:48h | UTC

The use of cerebral computed tomographic angiography as an ancillary investigation to support a clinical diagnosis of death using neurological criteria: a consensus guideline – Anaesthesia

 


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