Goals-of-Care Decisions by Hospitalized Patients with Advanced Cancer: Missed Clinician Opportunities for Facilitating Shared Decision-Making
Hospitalized patients with advanced cancer often face complex, preference-sensitive decisions. How clinicians and patients engage in shared decision-making during goals-of-care discussions is not well understood. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 14, 2019 Category: Palliative Care Authors: Rashmi K. Sharma, Kenzie A. Cameron, Jennifer M. Zech, Sasha F. Jones, J.Randall Curtis, Ruth A. Engelberg Source Type: research

Reliability and Validity of the Turkish version of the FACIT-PAL quality of life instrument
The accurate measurement of quality of life (QoL) among people with chronic and incurable illnesses is essential for evaluating service delivery, understanding the impact of illness and treatment effects, and testing intervention effectiveness. Palliative care interventions are relatively new in Turkey, therefore it is important that reliable and valid QoL instruments are available to evaluate palliative care effectiveness in Turkish speakers. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 13, 2019 Category: Palliative Care Authors: Gulcan Bagcivan, Jason Bredle, Marie Bakitas, Bahar Guciz Dogan Tags: Brief Methodological Report Source Type: research

Preferences regarding end-of-life care among adolescents and young adults with cancer: results from a comprehensive multicenter survey in Japan
Patient preferences influence end-of-life (EOL) care which patients receive. However, preferences regarding EOL care among adolescent and young adult (AYA) cancer population remain unclear. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 8, 2019 Category: Palliative Care Authors: Hidekazu Hirano, Chikako Shimizu, Asuka Kawachi, Miwa Ozawa, Akiko Higuchi, Saran Yoshida, Ken Shimizu, Ryohei Tatara, Keizo Horibe Tags: Original Article Source Type: research

Prescribing in chronic severe hepatic impairment
The recommendations in this paper are not comprehensive, more a direction of travel than a detailed road map. Specific recommendations are limited to common classes and types of drugs used in palliative care. For other drugs, see the relevant PCF monograph and the manufacturer ’s PI. However, some PIs are unnecessarily restrictive.1 (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 8, 2019 Category: Palliative Care Authors: Andrew Wilcock, Sarah Charlesworth, Wendy Prentice, Paul Selby, Maria McKenna, Sarah Cripps, Aisling Considine, Alison Orr, Mark Wright, Mary Mihalyo, Stephen Oxberry Source Type: research

Symptom Clusters in Patients with Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience
Patients with gastrointestinal (GI) cancers undergoing chemotherapy (CTX) experience multiple co-occurring symptoms. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 8, 2019 Category: Palliative Care Authors: Claire J. Han, Kerryn Reding, Bruce A. Cooper, Steven M. Paul, Yvette P. Conley, Marilyn Hammer, Fay Wright, Frances Cartwright, Jon D. Levine, Christine Miaskowski Source Type: research

Pc-facs
PC-FACS (Fast Article Critical Summaries for Clinicians in Palliative Care) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PCFACS, please encourage them to join the AAHPM at aahpm.org. Comments from readers are welcomed at pcfacs@aahpm.org. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 7, 2019 Category: Palliative Care Authors: Mellar P. Davis Source Type: research

PC-FACS for July 2019
PC-FACS (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 7, 2019 Category: Palliative Care Authors: Andie Bernard Source Type: research

Percutaneous Transesophageal Gastrostomy (PTEG): A safe and well-tolerated procedure for palliation of end-stage malignant bowel obstruction
Malignant bowel obstruction (MBO) is a frequent complication for patients with advanced cancer. Symptom management for patients with end-stage MBO can be challenging especially when venting gastrostomy is contraindicated. Percutaneous transesophageal gastrostomy (PTEG) is an alternative option allowing safe and effective symptom management in palliative care patients. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 6, 2019 Category: Palliative Care Authors: Debbie Selby, Amy Nolen, Cheromi Sittambalam, Karen Johansen, Robyn Pugash Source Type: research

Preparing Older Patients with Serious Illness for Advance Care Planning Discussions in Primary Care
Little is known about how to prepare older patients for advance care planning (ACP) discussions in primary care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 6, 2019 Category: Palliative Care Authors: Nebras Abu Al Hamayel, Sarina R. Isenberg, Joshua Sixon, Katherine Clegg Smith, Samantha I. Pitts, Sydney M. Dy, Susan M. Hannum Source Type: research

Teamwork when Conducting Family Meetings: Concepts, Terminology, and the Importance of Team-Team Practices
Family meetings, which bring together members of a seriously ill patient ’s family and the interprofessional team (IPT), have been widely recognized as promoting shared decision making for hospitalized patients, particularly those in intensive care units. The planning and conducting of interprofessional family meetings is hampered, however, by a lack of clarity about w ho is doing what and when, which in turn can lead to inefficiencies and uncoordinated efforts. This manuscript describes how members of the IPT interact with one another (what we have termed team-team practices), distinguishing these interactions from ...
Source: Journal of Pain and Symptom Management - April 30, 2019 Category: Palliative Care Authors: Jennifer K. Walter, Robert M. Arnold, Martha A.Q. Curley, Chris Feudtner Tags: Special Article Source Type: research

Deleterious Effects of Higher Body Mass Index on Subjective and Objective Measures of Chemotherapy-Induced Peripheral Neuropathy in Cancer Survivors
Recent albeit limited evidence suggests that body mass index (BMI) may be a modifiable risk factor to reduce the deleterious effects of chemotherapy-induced peripheral neuropathy (CIPN) in cancer survivors. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 29, 2019 Category: Palliative Care Authors: Iva Petrovchich, Kord M. Kober, Laura Wagner, Steven M. Paul, Gary Abrams, Margaret A. Chesney, Kimberly Topp, Betty Smoot, Mark Schumacher, Yvette P. Conley, Marilyn Hammer, Jon D. Levine, Christine Miaskowski Source Type: research

Giving Voice to Patient Values Throughout Cancer: A Novel Nurse-Led Intervention
Optimal advance care planning allows patients to articulate their values as a touchstone for medical decision-making. Ideally, this occurs when patients are clinically stable, and with opportunities for iteration as the clinical situation unfolds. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 26, 2019 Category: Palliative Care Authors: Andrew S. Epstein, Anjali V. Desai, Camila Bernal, Danielle Romano, Peter J. Wan, Molly Okpako, Kelly Anderson, Kimberly Chow, Dana Kramer, Claudia Calderon, Virginia V. Klimek, Robin Rawlins-Duell, Diane L. Reidy, Jessica I. Goldberg, Elizabeth Cruz, Jud Tags: Original Article Source Type: research

The Use of Continuous Positive Airway Pressure Ventilation in the Palliative Management of Stridor in a Head and Neck Cancer Patient
Upper airway obstruction and stridor are common symptoms faced by head and neck cancer patients. Progression of cancers of the head and neck region often results in an audible stridor when the primary tumor occupies an already anatomically restricted space in the upper airway. Management of upper airway obstruction includes nonpharmacological maneuvers such as head tilt, chin lift, and jaw thrust.1 Pharmacological measures are usually limited to the relief of symptoms associated with the airway obstruction such as breathlessness and stridor. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 25, 2019 Category: Palliative Care Authors: Jasvin Lee, Kyaw Naing, Zhi Zheng Yeo, Poh Heng Chong Tags: Letter Source Type: research

Nearly Half of Metastatic Brain Disease Patients Prescribed 10 Fractions of Whole-Brain Radiation Therapy Die Without Completing Treatment
Since 1954, whole-brain radiation therapy (WBRT) has been an integral palliative treatment modality for brain metastases.1 For over 40  years, the standard palliative WBRT regimen in the U.S. has been 30 Gy in 10 fractions over two weeks, although shorter regimens have been reported.2-4 Although prolonged (≥10 fractions) WBRT regimens have historically been favored owing to a perceived improvement in neurocognitive side effect profile, hypofractionated WBRT is equally effective for disease control2,3 and reduces the burden of prolonged treatment on patients and caregivers near the end of life. (Source: Journal...
Source: Journal of Pain and Symptom Management - April 25, 2019 Category: Palliative Care Authors: Shearwood McClelland, Namita Agrawal, Kevin Shiue, Gregory K. Bartlett, Richard C. Zellars, Gordon A. Watson, Susannah G. Ellsworth Tags: Letter Source Type: research

Nearly Half of Metastatic Brain Disease Patients Prescribed Ten Fractions of Whole Brain Radiation Therapy Die Without Completing Treatment
Since 1954, whole brain radiation therapy (WBRT) has been an integral palliative treatment modality for brain metastases1. For over 40 years, the standard palliative WBRT regimen in the United States has been 30 Gy in 10 fractions over two weeks, although shorter regimens have been reported2-4. While prolonged ( ≥10 fractions) WBRT regimens have historically been favored due to a perceived improvement in neurocognitive side effect profile, hypofractionated WBRT is equally effective for disease control2,3 and reduces the burden of prolonged treatment on patients and caregivers near the end of life. (Source: Journal of Pa...
Source: Journal of Pain and Symptom Management - April 25, 2019 Category: Palliative Care Authors: Shearwood McClelland, Namita Agrawal, Kevin Shiue, Gregory K. Bartlett, Richard C. Zellars, Gordon A. Watson, Susannah G. Ellsworth Source Type: research

The challenge of perioperative advance care planning
As our population ages there will be an increasing number of patients with life-limiting disease who may be referred for major elective surgery and more pressingly may present acutely, requiring major emergency surgical intervention.Due to the high risk of perioperative and postoperative complications associated this group of patients, it is paramount that specific advance care planning that encompasses a patient ’s goals of care and resuscitative status be clarified before undergoing surgery in this acute period. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 25, 2019 Category: Palliative Care Authors: Jonathan Ramachenderan, Kirsten Auret Source Type: research

The Use of Continuous Positive Airway Pressure CPAP Ventilation in the Palliative Management of Stridor in a Head and Neck Cancer Patient
Upper airway obstruction and stridor are common symptoms faced by Head and Neck Cancer patients. Progression of cancers of the head and neck region often result in an audible stridor when the primary tumor occupies an already anatomically restricted space in the upper airway. Management of upper airway obstruction includes non-pharmacological maneuvers such as head tilt, chin lift and jaw thrust 1. Pharmacological measures are usually limited to the relief of symptoms associated with the airway obstruction such as breathlessness and stridor. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 25, 2019 Category: Palliative Care Authors: Jasvin Lee, Kyaw Naing, Yeo Zhi Zheng, Chong Poh Heng Source Type: research

Concordance between self-reported completion of advance care planning documentation and availability of documentation in Australian health and residential aged care services
Advance care planning (ACP) documentation needs to be available at the point of care to guide and inform medical treatment decision-making. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 25, 2019 Category: Palliative Care Authors: Kimberly Buck, Karen M. Detering, Annabel Pollard, Marcus Sellars, Rasa Ruseckaite, Helana Kelly, Ben White, Craig Sinclair, Linda Nolte Source Type: research

Patients Perspective of Timeliness and Usefulness of an Outpatient Supportive Care Referral at a Comprehensive Cancer Center
Current guidelines recommend early referral to palliative care for patients with advanced cancer; however, no studies have examined the optimal timing of referral from the patients ’ perspective. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 25, 2019 Category: Palliative Care Authors: Angelique Wong, Marieberta Vidal, Bernard Prado, David Hui, Margeaux Epner, Vishidha Reddy Balankari, Vera J. De la Cruz, Hilda Cantu, Kresnier Perez Zapata, Diane D. Liu, Janet L. Williams, Taekyu Lim, Eduardo Bruera Source Type: research

Perspectives on volunteer-professional collaboration in palliative care: a qualitative study among volunteers, patients, family carers and healthcare professionals
Governments intend to meet resource constraints in professional palliative care by stimulating informal care, including volunteerism. However, little is known about current volunteer-professional collaboration. Such insights are relevant for future policy development regarding volunteer efficiency, quality of care and the capacity of volunteer care to support healthcare services and professionals. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 24, 2019 Category: Palliative Care Authors: Steven Vanderstichelen, Joachim Cohen, Yanna Van Wesemael, Luc Deliens, Kenneth Chambaere Source Type: research

Editorial Board
(Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 23, 2019 Category: Palliative Care Source Type: research

Table of Contents
(Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 23, 2019 Category: Palliative Care Source Type: research

Clinical Patterns of Continuous and Intermittent Palliative Sedation in Patients With Terminal Cancer: A Descriptive, Observational Study
Limited information is available regarding the detailed clinical patterns of palliative sedation (PS), that is, the symptom control rate, salvage medication, and the effectiveness of intermittent PS (IPS) versus continuous PS (CPS). (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 23, 2019 Category: Palliative Care Authors: Young-Woong Won, Hye Sook Chun, Minjeong Seo, Rock Bum Kim, Jung Hoon Kim, Jung Hun Kang Tags: Original Article Source Type: research

Changes Over Time in Good-Parent Beliefs Among Parents of Children with Serious Illness: A Two-Year Cohort Study
Parents of seriously ill children hold personal beliefs about what they should do to be good parents. How these beliefs change over time is unknown. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 23, 2019 Category: Palliative Care Authors: Douglas L. Hill, Jennifer A. Faerber, Yimei Li, Victoria A. Miller, Karen W. Carroll, Wynne Morrison, Pamela S. Hinds, Chris Feudtner Source Type: research

Clinical Patterns of Continuous and Intermittent Palliative Sedation in Terminal Cancer Patients: A Descriptive, Observational Study
Limited information is available regarding the detailed clinical patterns of palliative sedation (PS), i.e., the symptom control rate, salvage medication, and the effectiveness of intermittent PS (IPS) versus continuous PS (CPS). (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 23, 2019 Category: Palliative Care Authors: Young-Woong Won, Chun Hye Sook, Min Jeong Seo, Rock Bum Kim, Jung Hoon Kim, Jung Hun Kang Tags: Original Article Source Type: research

Assessing the Impact of Serious Illness on Patient Intimacy and Sexuality in Palliative Care
Palliative care (PC) clinical practice guidelines recommend providers assess the impact of illness on intimacy and sexuality. Previous studies around sexuality and intimacy in patients with advanced illness have largely focused on patients with a cancer diagnosis in the outpatient setting. Little is known about such impact of illness on inpatients receiving PC consultation. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 22, 2019 Category: Palliative Care Authors: Anne Kelemen, John Cagle, Julia Chung, Hunter Groninger Tags: Brief Report Source Type: research

Community palliative care initiatives to reduce end-of-life hospital utilization and in-hospital deaths: A population-based observational study evaluating two home care interventions
The end-of-life period is characterized by increased hospital utilization despite patients ’ preferences to receive care and die at home. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 22, 2019 Category: Palliative Care Authors: Colleen Webber, Raymond Viola, Christine Knott, Yingwei Peng, Patti Groome Source Type: research

Prevalence, Severity, and Correlates of Symptoms of Anxiety and Depression at the Very End of Life
Rates of psychological symptoms for patients with serious illness are high, but there has been limited research investigating psychological symptoms at the very end of life (EOL). (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Elissa Kozlov, Veerawat Phongtankuel, Holly Prigerson, Ronald Adelman, Ariel Shalev, Sara Czaja, Ritchell Dignam, Rosemary Baughn, M. Carrington Reid Tags: Brief Report Source Type: research

Extent and Determinants of Terminally Ill Cancer Patients' Concordance Between Preferred and Received Life-Sustaining Treatment States: An Advance Care Planning Randomized Trial in Taiwan
Promoting patient value-concordant end-of-life care is a priority in health care systems but has rarely been examined in randomized clinical trials. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Fur-Hsing Wen, Jen-Shi Chen, Wen-Chi Chou, Wen-Cheng Chang, Chia-Hsun Hsieh, Siew Tzuh Tang Tags: Original Article Source Type: research

Are We Evolving Toward Greater and Earlier Use of Palliative Home Care Support? A Trend Analysis Using Population-Level Data From 2010 to 2015
The need for increased use and earlier initiation of palliative home care has been advocated by several international organizations. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Arno Maetens, Luc Deliens, Lieve Van den Block, Kim Beernaert, Joachim Cohen Tags: Original Article Source Type: research

Interprofessional Team Member Communication Patterns, Teamwork, and Collaboration in Pre –family Meeting Huddles in a Pediatric Cardiac Intensive Care Unit
Interprofessional teams often develop a care plan before engaging in a family meeting in the pediatric cardiac intensive care unit (CICU) —a process that can affect the course of the family meeting and alter team dynamics but that has not been studied. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Jennifer K. Walter, Theodore E. Schall, Aaron G. DeWitt, Jennifer Faerber, Heather Griffis, Meghan Galligan, Victoria Miller, Robert M. Arnold, Chris Feudtner Tags: Original Article Source Type: research

Are we evolving towards greater and earlier use of palliative home care support? A trend analysis using population-level data from 2010-2015
The need for increased use and earlier initiation of palliative home care has been advocated by several international organizations. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Arno Maetens, Luc Deliens, Lieve Van den Block, Kim Beernaert, Joachim Cohen Tags: Original Article Source Type: research

Interprofessional Team Member Communication Patterns, Teamwork, and Collaboration in Pre-Family Meeting Huddles in a Pediatric Cardiac Intensive Care Unit
Interprofessional teams often develop a care plan prior to engaging in a family meeting in the pediatric cardiac intensive care unit (CICU) —a process that can affect the course of the family meeting and alter team dynamics, but that has not been studied. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Jennifer K. Walter, Theodore E. Schall, Aaron G. DeWitt, Jennifer Faerber, Heather Griffis, Meghan Galligan, Victoria Miller, Robert M. Arnold, Chris Feudtner Tags: Original Article Source Type: research

Extent and Determinants of Terminally Ill Cancer Patients ’ Concordance between Preferred and Received Life-Sustaining Treatment States: An Advance Care Planning Randomized Trial in Taiwan
To examine the effectiveness of an advance care planning (ACP) intervention in facilitating concordance between cancer patients ’ preferred and received life-sustaining treatment (LST) states and to explore modifiable factors facilitating or impeding such concordance. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Fur-Hsing Wen, Jen-Shi Chen, Wen-Chi Chou, Wen-Cheng Chang, Chia-Hsun Hsieh, Siew Tzuh Tang Source Type: research

Fan Therapy for the Treatment of Dyspnea in Adults: a Systematic Review
The use of a handheld or electric fan has been proposed as one component of the complex clinical interventions used in the relief of dyspnea; however, there is a lack of consensus regarding its efficacy. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Yu Qian, Yuan Wu, Aline Rozman de Moraes, Xue Yi, Yimin Geng, Seyedeh Dibaj, Diane Liu, Jane Naberhuis, Eduardo Bruera Source Type: research

Prevalence, Severity and Correlates of Symptoms of Anxiety and Depression at the Very End of Life
Rates of psychological symptoms for patients with serious illness are high, but there has been limited research investigating psychological symptoms at the very end of life. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Elissa Kozlov, Veerawat Phongtankuel, Holly Prigerson, Ronald Adelman, Ariel Shalev, Sara Czaja, Ritchell Dignam, Rosemary Baughn, M.Carrington Reid Tags: Brief Report Source Type: research

How should end-of-life advance care planning discussions be conducted according to patients and informal carers? A qualitative review of reviews
The goal of advance care planning (ACP) is to help ensure that the care people receive during periods of serious illness is consistent with their preferences and values. There is a lack of clear understanding about how patients and their informal carers feel ACP discussions should be conducted. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Alex Hall, Christine Rowland, Gunn Grande Tags: Review Article Source Type: research

Physician and Patient Characteristics Associated With More Intensive End-of-Life Care
Although patient and physician characteristics are thought to be predictive of discretionary interventions at the end of life (DIALs), few studies have data on both parties. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 17, 2019 Category: Palliative Care Authors: Paul R. Duberstein, Richard L. Kravitz, Joshua J. Fenton, Guibo Xing, Daniel J. Tancredi., Michael Hoerger, Supriya G. Mohile, Sally A. Norton, Holly G. Prigerson, Ronald M. Epstein Tags: Original Article Source Type: research

Preloss Psychosocial Resources Predict Depressive Symptom Trajectories Among Terminally Ill Cancer Patients' Caregivers in Their First Two Years of Bereavement
Postloss depressive symptom trajectories are heterogeneous and predicted by preloss psychosocial resources, but this evidence was from one old study on caregivers of patients with terminal cancer for whom these issues are highly relevant. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 16, 2019 Category: Palliative Care Authors: Su-Ching Kuo, Fur-Hsing Wen, Jen-Shi Chen, Wen-Chi Chou, Wen-Chi Shen, Siew Tzuh Tang Tags: Original Article Source Type: research

Preloss Psychosocial Resources Predict Depressive-Symptom Trajectories among Terminally Ill Cancer Patients ’ Caregivers in their First Two Years of Bereavement
Postloss depressive-symptom trajectories are heterogeneous and predicted by preloss psychosocial resources, but this evidence was from one old study on terminal cancer patients ’ caregivers for whom these issues are highly relevant. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 16, 2019 Category: Palliative Care Authors: Su-Ching Kuo, Fur-Hsing Wen, Jen-Shi Chen, Wen-Chi Chou, Wen-Chi Shen, Siew Tzuh Tang Tags: Original Article Source Type: research

Authors' Response
We would like to thank you for the opportunity to respond to the issues raised in Dr. Rodr íguez-Prat et al.'s letter concerning our critical review on patients' autonomy at the end of life1 and to offer an explanation of our comment to their systematic review.2 We would also like to thank Dr. Rodríguez-Prat and her colleagues for their interest in our paper and for taking the time to express their concerns. In their letter to the editor, Dr. Rodríguez-Prat et al. argue that their results show autonomy as a determining factor of dignity only at one particular context and not in general and al...
Source: Journal of Pain and Symptom Management - April 15, 2019 Category: Palliative Care Authors: Adam Houska, Martin Lou čka Tags: Letter Source Type: research

Response to: “Patients' Autonomy at the End of Life: A Critical Review”
Dr. Houska et  al. carried out a critical review about patients' autonomy at the end of life1 in which they compare their results to a previous systematic review conducted by our research group.2 We appreciate the comments of Dr. Houska et al. regarding our review. As the authors highlight, our conclusions abou t the relationship between dignity and autonomy are similar to their autonomy model among patients at the end of life. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 15, 2019 Category: Palliative Care Authors: Andrea Rodr íguez-Prat, Cristina Monforte-Royo, Albert Balaguer Tags: Letter Source Type: research

Palliative Care Physicians' Practice in the Titration of Parenteral Opioids for Dyspnea in Terminally Ill Cancer Patients: A Nationwide Survey
Dyspnea is among the most prevalent and distressful symptoms in terminally ill cancer patients.1,2 Opioids remain the mainstream treatment for dyspnea. In the last phase of life, parenteral routes such as continuous subcutaneous/intravenous administration are frequently used to ensure timely titration and reliable administration in the setting of impaired oral intake and decreased consciousness. Guidelines suggest how to start parenteral opioids,3 but the evidence is scarce regarding further management. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 15, 2019 Category: Palliative Care Authors: Masanori Mori, Ryo Matsunuma, Kozue Suzuki, Yoshinobu Matsuda, Hiroaki Watanabe, Takashi Yamaguchi Tags: Letter Source Type: research

Authors' Response
We would like to thank Dr. Sanz and Dr. del Valle for their comment on our letter Predatory Open-Access Publishing in Palliative and Supporting Care published in the Journal.1 They give us the opportunity to apologize for not being able to consider their valuable and informative work on this topic published in Medicina Paliativa, which seems to be not indexed in PubMed.2 In their work, they classified 16 of the 32 retrieved palliative care journals as “suspected” predatory journals. Although we agree about the fact that Beall list has been heavily criticized for subjectivity, it may be argued that the classific...
Source: Journal of Pain and Symptom Management - April 15, 2019 Category: Palliative Care Authors: Andrea Cortegiani, Antonino Giarratano Tags: Letter Source Type: research

The combination of superior hypogastric plexus block and the block of the ganglium impair in a patient with abdominal and perineal pain poorly responsive to opioids
More than 10 million people worldwide are diagnosed with cancer. About 2/3 of them will experience pain during the course of the disease (1). The management of cancer pain requires an appropriate multidisciplinary approach involving consideration of the pain ’s physiopathology, analgesic pharmacology, and the patient’s psychosocial concerns. Drug therapy with the use of opioids and adjuvants is successful in 70% to 90% of patients with varied types of cancer pain (2). Standards for the management of cancer pain have been recently released (3). (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 15, 2019 Category: Palliative Care Authors: Sebastiano Mercadante Source Type: research

Reply to Dr Sanz and Dr. del Valle about Predatory publishing in Palliative Care
We would like to thank Dr. Sanz and Dr. del Valle for their comment on our letter Predatory Open-Access Publishing in Palliative and Supporting Care published in the Journal 1. They give us the opportunity to apologize for not being able to consider their valuable and informative work on this topic published in Medicina Paliativa, which seems to be not indexed in Pubmed 2. In their work, they classified 16 of the 32 retrieved palliative care journals as “suspected” predatory journals. Although we agree about the fact that Beall list has been heavily criticized for subjectivity, it may be argued that the classif...
Source: Journal of Pain and Symptom Management - April 15, 2019 Category: Palliative Care Authors: Andrea Cortegiani, Antonino Giarratano Tags: Letter Source Type: research

Response to: “Patients’ Autonomy at the End of Life: A Critical Review”
Dr Houska et al. carried out a critical review about patients ’ autonomy at the end of life (1) in which they compare their results to a previous systematic review conducted by our research group (2). We appreciate the comments of Dr. Houska et al. regarding our review. As the authors highlight, our conclusions about the relationship between dignity and auto nomy are similar to their autonomy model among patients at the end of life. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 15, 2019 Category: Palliative Care Authors: Andrea Rodr íguez-Prat, Cristina Monforte-Royo, Albert Balaguer Tags: letter Source Type: research

Authors ’ Response
we would like to thank you for the opportunity to respond to the issues raised in Dr. Rodr íguez-Prat et. al.’s letter concerning our critical review on patients´ autonomy at the end of life (1) and to offer an explanation of our comment to their systematic review (2). We would also like to thank Dr. Rodríguez-Prat and her colleagues for their interest in our paper and for taking the time to express their concerns. In their letter to the editor, Dr. Rodríguez-Prat et al. argue that their results show autonomy as a determining factor of dignity only at one particular context and not in gener...
Source: Journal of Pain and Symptom Management - April 15, 2019 Category: Palliative Care Authors: Adam Houska, Martin Lou čka Tags: letter Source Type: research

Palliative care physicians ’ practice in the titration of parenteral opioids for dyspnea in terminally-ill cancer patients: A nationwide survey
Dyspnea is among the most prevalent and distressful symptoms in terminally-ill cancer patients 1, 2. Opioids remain the mainstream treatment for dyspnea. In the last phase of life, parenteral routes such as continuous subcutaneous/intravenous administration are frequently used to ensure timely titration and reliable administration in the setting of impaired oral intake and decreased consciousness. Guidelines suggest how to start parenteral opioids 3, but the evidence is scarce regarding further management. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 15, 2019 Category: Palliative Care Authors: Masanori Mori, Ryo Matsunuma, Kozue Suzuki, Yoshinobu Matsuda, Hiroaki Watanabe, Takashi Yamaguchi Tags: Letter Source Type: research

Disparities in Hospice Utilization for Older Cancer Patients Living in the Deep South
Hospice utilization is an end-of-life quality indicator. The Deep South has known disparities in palliative care that may affect hospice utilization. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - April 11, 2019 Category: Palliative Care Authors: Y.E. Turkman, C.P. Williams, B.E. Jackson, J.N. Dionne-Odom, R. Taylor, D. Ejem, E. Kvale, M. Pisu, M. Bakitas, G.B. Rocque Tags: Brief Report Source Type: research