Living with advanced cancer and an uncertain disease trajectory: an emerging patient population in palliative care?

BMJ Support Palliat Care 2015; vol/is 5/4, p 352-357
Elizabeth A Lobb, Judith Lacey, John Kearsley, Winston Liauw, Lesley White and Annmarie Hosie

Participants in this study represent an emerging cancer patient population who are receiving palliative therapies. Our study suggests that a flexible model of care is needed to support the needs of people who may still be receiving some form of chemotherapy and/or radiotherapy, and remain well. This model may need to take more of an intermittent approach, that is, as required for specific symptom management, rather than patients being linked continuously to a palliative care service for long periods of time.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Defining the palliative care patient: its challenges and implications for service delivery

BMJ Support Palliat Care 2015; vol/is 5/4, p 46-52

Helen Mitchell, Simon Noble, Ilora Finlay and Annmarie Nelson

Within the UK, general practitioners (GPs) are required to maintain a register of palliative patients under their care. We explored GPs' views of what defines a palliative care patient in the context of identifying clinical service needs.  Achieving health policy targets which require identification of palliative patients will continue to be a challenge until a workable and reliable definition of the term ‘palliative’ is agreed upon.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Service user perspectives on palliative care education for health and social care professionals supporting people with learning disabilities

BMJ Support Palliat Care 2015 December, vol/is 5/5, p 531-7
Dorry McLaughlin, Owen Barr, Sonja McIlfatrick and Roy McConkey

Evidence from European and American studies indicates limited referrals of people with learning (intellectual) disabilities to palliative care services. This study aimed to elicit the views of people with learning disabilities, and their family carers concerning palliative care, to inform healthcare professional education and training.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Prognostic factors of 30-day mortality after palliative procedures in patients with malignant pleural effusion

Annals of surgical oncology, Nov 2015, vol. 22, no. 12, p. 4083-4088 

Abrao, Fernando Conrado, de Abreu, Igor Renato Louro Bruno, Fogarolli, Mariana, Caxeiro, Giovanna, Bezerra, Camila Borges Saes, de Cerqueira Cesar, Fernanda Prado, Rocha, Poline Spitti, Younes, Riad Naim

The aim of this study was to identify predictors of 30-day mortality in patients with malignant pleural effusion (MPE) who need pleural palliative procedures. The authors identified four factors that are easily recognized in daily practice and can help select patients with low life expectancy, therefore preventing invasive procedures and hospitalizations for this subgroup of patients.

Internet-based exposure and behavioral activation for complicated grief and rumination: a randomized controlled trial

Behavior therapy, Nov 2015, vol. 46, no. 6, p. 729-748

Eisma, Maarten C, Boelen, Paul A, van den Bout, Jan, Stroebe, Wolfgang, Schut, Henk A W, Lancee, Jaap, Stroebe, Margaret S

This study examined the effectiveness and feasibility of therapist-guided internet-delivered exposure (EX) and behavioral activation (BA) for complicated grief and rumination. Results supported potential applicability of online exposure but not behavioral activation to decrease complicated grief and rumination. 

Fulltext available from Elsevier in Behavior Therapy

Palliative care in patients with ovarian cancer and bowel obstruction

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, Nov 2015, vol. 23, no. 11, p. 3157-3163

Daniele, Alberto, Ferrero, A, Fuso, L, Mineccia, M, Porcellana, V, Vassallo, D, Biglia, N, Menato, G

Malignant bowel obstruction (MBO) is usually a pre-terminal event in patients with ovarian cancer. The authors analyzed medical and surgical procedures, performance status, nutritional status, cachexia, and their prognostic value in this group of patients. Cachexia, low performance status, and poor nutritional status were significant predictors of worse survival after MBO, independent of the treatment. The authors conclude that surgery has to be considered in patients without serious contraindications; otherwise, a medical protocol, including antisecretory drugs, is the standard of care in frail patients. 

Symptom management and end-of-life care in amyotrophic lateral sclerosis

Neurologic clinics, Nov 2015, vol. 33, no. 4, p. 889-908

Jackson, Carlayne E, McVey, April L, Rudnicki, Stacy, Dimachkie, Mazen M, Barohn, Richard J

The number of available symptomatic treatments has markedly enhanced the care of patients with amyotrophic lateral sclerosis (ALS). Once thought to be untreatable, patients with ALS today clearly benefit from multidisciplinary care. Unfortunately, there are few randomized controlled trials of medications or interventions addressing symptom management. In this review, the authors provide the level of evidence, when available, for each intervention that is currently considered standard of care by consensus opinion. 

Fulltext available from Elsevier in Neurologic Clinics

Tools to assess pain or lack of comfort in dementia: a content analysis

Journal of pain and symptom management, Nov 2015, vol. 50, no. 5, p. 659-675

van der Steen, Jenny T, Sampson, Elizabeth L, Van den Block, Lieve, Lord, Kathryn, Vankova, Hana, Pautex, Sophie, Vandervoort, An, Radbruch, Lukas, Shvartzman, Pesach, Sacchi, Valentina, de Vet, Henrica C W, Van Den Noortgate, Nele J A.

The authors aim was to map and compare items in tools that assess pain and the broader notion of discomfort or comfort in people with severe dementia or at the end of life.

Fulltext available from Elsevier in Journal of Pain and Symptom Management

Available in print in Arthur Rank House Library, Brookfields Hospital

Palliative care of urologic patients at end of life

Clinics in geriatric medicine, Nov 2015, vol. 31, no. 4, p. 667-678

Sinclair, Christian T, Kalender-Rich, Jessica L, Griebling, Tomas L, Porter-Williamson, Karin

This article focuses on the issues facing patients with advanced and terminal urologic illness, from the framework of care planning based on defining patient-specific and family-specific goals of care, to palliative management strategies for common symptoms and syndromes that these patients and their families experience. It also discusses the management of common urologic issues that may arise in the course of care for all patients at the end of life, as well as the impact of these conditions on caregivers 

Fulltext available from Elsevier in Clinics in Geriatric Medicine