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Facilitating supportive care in cardiac intensive care units
Purpose of review The number of patients who die in the hospital in the Western world is high, and 20–30% of them are admitted to an ICU in the last month of life, including those in cardiac ICUs (CICUs) where invasive procedures are performed and mortality is high. Palliative consultation is provided in only a few cases. The ethical and decisional aspects associated with the advanced stages of illness are very rarely discussed. Recent findings The epidemiological and clinical landscape of CICUs has changed in the last decade; the incidence of acute coronary syndromes has decreased, whereas noncardiovascular disease...
Source: Current Opinion in Supportive and Palliative Care - January 30, 2020 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Spirituality in heart failure: a review of the literature from 2014 to 2019 to identify spiritual care needs and spiritual interventions
Purpose of review The burden of heart failure is significant and its management is complex. Current evidence confirms a high level of spiritual distress and a strong desire for spiritual support, which is endorsed by healthcare policy, yet spiritual support is rarely provided for this patient group. There is a need to identify how spiritual support might be meaningfully included within holistic heart failure multidisciplinary care and how its effectiveness might be demonstrated. Recent findings A literature review was undertaken to identify recent evidence (2014–2019) of the spiritual care needs of heart failure pat...
Source: Current Opinion in Supportive and Palliative Care - January 30, 2020 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Social work involvement in palliative care heart failure research: a review of recent literature
Purpose of review The aim of the review is to examine the findings of empirical studies of palliative care interventions for patients with heart failure in which a social worker was identified as a key member of the interprofessional clinical team. Recent findings Our systematic review of the empirical literature from January 2016 to August 2019 found five palliative care interventions with heart failure patients that cited involvement of a social worker as a key team member. The reviewed studies highlighted social workers’ roles in the areas of psychosocial assessments and support, advance care planning, and patien...
Source: Current Opinion in Supportive and Palliative Care - January 30, 2020 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Editorial: Supportive care for people living with the manifold burden of heart failure
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - January 30, 2020 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - January 30, 2020 Category: Palliative Care Tags: EDITORIAL INTRODUCTIONS Source Type: research

Mechanisms and treatment of bone pain in multiple myeloma
Purpose of review Multiple myeloma is a haematological malignancy of differentiated B lymphocytes, known as plasma cells. The disease is common in the UK (incidence of 9 cases per 100 000 people) and the most frequent presentation is bone pain caused by skeletal damage. Patients with myeloma also experience neuropathic pain induced by chemotherapy. The management of pain in multiple myeloma is frequently demanding and often sub-optimally addressed. This review seeks to summarize a rational approach to the management of pain experienced by multiple myeloma patients. Recent findings Bone pain has a dramatic detrimenta...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Christopher Dalley Source Type: research

Ketamine and lidocaine infusions decrease opioid consumption during vaso-occlusive crisis in adolescents with sickle cell disease
This study evaluated the utility of ketamine and/or lidocaine in decreasing opioid consumption during acute pain episodes in adolescents with sickle cell disease. There has been an increased effort to promote opioid-sparing pain relieving methods given the ongoing opioid epidemic. Recent findings There have been six studies published over the past decade that highlight the ability of ketamine to reduce opioid consumption in the management of sickle cell disease-related pain, primarily in adult patients. There has been one study (2015) that demonstrated a similar benefit with lidocaine, however this was also in adult pat...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Christopher Dalley Source Type: research

Autologous haematopoietic stem cell therapy for multiple sclerosis: a review for supportive care clinicians on behalf of the Autoimmune Diseases Working Party of the European Society for Blood and Marrow Transplantation
Purpose of review In this review, we summarize the recently published literature that demonstrates the efficacy and safety of autologous haematopoietic stem cell therapy (AHSCT) in multiple sclerosis (MS) and highlight the importance of supportive care required for the safe and well-tolerated delivery of AHSCT. Recent findings MS is an autoimmune inflammatory and degenerative disorder of the central nervous system (CNS). In the majority of patients, the illness runs a relapsing remitting course (RRMS), culminating in a secondary progressive phase with gradual accumulation of fixed disabilities. Currently available dis...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Christopher Dalley Source Type: research

Editorial: Expanding the indications for autologous stem cell transplantation: do we need a new approach to supportive care for patients with multiple sclerosis?
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Christopher Dalley Source Type: research

Evaluating the effects of the pharmacological and nonpharmacological interventions to manage delirium symptoms in palliative care patients: systematic review
Purpose of review There is a high prevalence of delirium in palliative care patients. This review aims to evaluate the effects of the pharmacological and nonpharmacological interventions used to manage delirium symptoms in this patient group. Recent findings A recent study has suggested there is no role for antipsychotic medication in the management of delirium in palliative care patients, which is a move away from previous expert opinion. In addition, recent findings suggest there may be a role for the use of antipsychotics in combination with benzodiazepines in the management of agitated delirium. Summary It is t...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

Death rattle: reassuring harbinger of imminent death or a perfect example of inadequacies in evidence-based practice
Purpose of review Death is the inevitable consequence of life. Although clinicians are unlikely to accurately pinpoint when death is likely to occur in the people they care for, the death in a person with a diagnosis of malignant and nonmalignant tends to involve a period of predictable progressive clinical and functional deterioration. During this time, it is common for death rattle to occur. Due to its presentation, death rattle can cause stress and distress to caregivers. This often prompts clinicians to consider medical interventions that are not only ineffective in treating the problem but may also do harm. Recent ...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

Specific challenges in end-of-life care for patients with hematological malignancies
Purpose of review The disease-related burden of patients with hematological malignancies is comparable with patients suffering from solid tumors. Palliative care offers relief from suffering independent of type of disease and prognosis. The prevalence of hematological malignancies is expected to increase in the next 20 years because of better therapeutic options with longer survival and because of the aging population. However, patients with hematological malignancies are underrepresented in palliative care as these diseases are associated with special care needs and prognostic uncertainty, which differ from the unambigu...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

Dealing with prognostic uncertainty: the role of prognostic models and websites for patients with advanced cancer
Purpose of review To provide an updated overview of prognostic models in advanced cancer and highlight the role of prognostic calculators. Recent findings In the advanced cancer setting, many important healthcare decisions are driven by a patient's prognosis. However, there is much uncertainty in formulating prognosis, particularly in the era of novel cancer therapeutics. Multiple prognostic models have been validated for patients seen by palliative care and have a life expectancy of a few months or less, such as the Palliative Performance Scale, Palliative Prognostic Score, Palliative Prognostic Index, Objective Prog...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

Measuring the success of interventions for caregivers: a focussed systematic review
Purpose of review The selection and application of outcome measures are fundamental steps in the research process because they inform decisions around intervention efficacy. We aimed to describe the outcomes used in trials of supportive interventions for adult caregivers of people with three exemplar life-limiting conditions: heart failure, dementia or stroke. Recent findings We performed a focussed review of 134 published trials that included interventions designed to improve caregivers’ health and wellbeing and/or ability to function in their caring role. We extracted and categorized all caregiver outcomes describ...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

Withdrawing noninvasive ventilation at end-of-life care: is there a right time?
Purpose of review The purpose of this review is the ‘when’ and ‘how’ of the matter of withdrawing noninvasive ventilation (NIV) at end-of-life (EoL) setting, having in mind the implications for patients, families and healthcare team. Recent findings Several recent publications raised the place and potential applications of NIV at EoL setting. However, there are no clear guidelines about when and how to withdraw NIV in these patients. Continuing NIV in a failing clinical condition may unnecessarily prolong the dying process. This is particularly relevant as frequently, EoL discussions are started only when pati...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research