Instruments to evaluate complexity in end-of-life care

Purpose of review The growing number of patients with terminal and chronic conditions and co-morbidities constitutes a challenge for any healthcare system, to provide effective and efficient patient-centred care at the end of life. Resources are limited, and complexity is rising within patients’ situations and healthcare professionals interventions. This review presents the state of art of the role of complexity in specialist palliative care provision. Recent findings Although studies related to complexity in palliative care are still limited, interesting reviews on complexity frameworks in co-morbidity conditions and palliative care are growing more present in current literature. They identify multidimensional issues, resource utilisation, and the relationship between them as fundamental aspects of complexity constructs, helping to define and understand complexity, and to therefore design validated tools to support healthcare professionals identifying the most complex patients, such as Hui's criteria, PALCOM, INTERMED, and IDC-Pal which is presented in this review. Summary There is an urgent need to guarantee quality and equity of care for all the patients eligible for palliative care, from those who need a palliative care approach to those needing specialist intensive palliative care. Implementing complexity theory into practice is paramount. In this review, complexity science, complexity frameworks, as well as tools evaluating complexity in palliative care ar...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

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With a lot of vague talk about salary/compensation/etc., what do people think is fair market value for a mid career non-academic radiation oncologist? Presuming an average workload of 15-20 on beam with a mix of EBRT, SRS, palliative, curative cases, this is what I think is hypothetically fair market value (not a real job!!!) in a reasonable metro area. Think Kansas City or Pittsburgh or Albuquerque, not Rhinelander or San Francisco. Salary + bonus - $450-500k PTO (vacation + sick + CME) -... Fair Market Value
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Radiation Oncology Source Type: forums
Publication date: 19–25 October 2019Source: The Lancet, Volume 394, Issue 10207Author(s): Evelien Dekker, Pieter J Tanis, Jasper L A Vleugels, Pashtoon M Kasi, Michael B WallaceSummarySeveral decades ago, colorectal cancer was infrequently diagnosed. Nowadays, it is the world's fourth most deadly cancer with almost 900 000 deaths annually. Besides an ageing population and dietary habits of high-income countries, unfavourable risk factors such as obesity, lack of physical exercise, and smoking increase the risk of colorectal cancer. Advancements in pathophysiological understanding have increased the array of treatme...
Source: The Lancet - Category: General Medicine Source Type: research
This study was conducted to enhance the rate of advance care planning conversations and documentation by improving knowledge, attitudes, and skills of caregivers.      Read more   Violence and Trauma ...
Source: Johns Hopkins University and Health Systems Archive - Category: Nursing Source Type: news
The aim of this review was to examine efficacy of palliative interventional radiotherapy (IRT) in esophageal cancer compared with other treatment in terms of dysphagia-free survival (DyFS) and safety.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Tags: Review Article Source Type: research
Authors: Houchard G, Kullgren J, Saphire M, Porter K, Abel S Abstract Evidence guiding inpatient management of buprenorphine is lacking-this retrospective cohort study evaluated the clinical impact of hospital continuation versus discontinuation of buprenorphine at an academic medical center. The primary outcome was inpatient oral morphine equivalents (OME). Secondary outcomes included patient pain levels, functional assessment, and hospital length of stay. One hundred thirty-one patients (74 continued buprenorphine, 57 discontinued) were included in the analysis. Median OME were significantly lower among patients ...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
The RPS in Wales has submitted proposals to the All Wales Chief Pharmacists Group around the implementation of recommendations made in our recent policy on pharmacy’s role in palliative and end
Source: Royal Pharmaceutical Society News - Category: Drugs & Pharmacology Source Type: news
Source: Therapeutics and Clinical Risk Management - Category: Drugs & Pharmacology Tags: HIV/AIDS - Research and Palliative Care Source Type: research
Publication date: Available online 15 October 2019Source: Journal of Vascular and Interventional RadiologyAuthor(s): Elisabeth Dhondt, Peter Vanlangenhove, Marc De Man, Lynn Huyck, Luc DefreyneAbstractPurposeTo prove that covered stents are more efficacious than uncovered stents regarding patency, safety, enabling of chemotherapy, and survival in percutaneous palliation of malignant infrahilar biliary obstruction.Materials and MethodsAfter failed endoscopic treatment, 154 patients with obstructive jaundice caused by unresectable infrahilar malignancy were randomly allocated to receive an expanded polytetrafluoroethylene an...
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
The distress of patients suffering from a terminal illness can lead to a state of despair and requests for euthanasia and assisted suicide. It is a major challenge for palliative care workers. The Distress The...
Source: BMC Palliative Care - Category: Palliative Care Authors: Tags: Research article Source Type: research
A decision to refrain from cardiopulmonary resuscitation (CPR) in the case of cardiac arrest is recommended in terminally ill patients to avoid unnecessary suffering at time of death. The aim of this study was...
Source: BMC Palliative Care - Category: Palliative Care Authors: Tags: Research article Source Type: research
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