Initiating discussions about end-of-life care with patients with incurable cancers early in their disease was associated with a decrease in late-stage aggressive cancer treatments such as chemotherapy or acute care, and with an increase in the use of hospice care at the end of life.
Giving patients at the end of life regular parenteral hydration of 1 L of saline per day did not improve symptoms associated with hydration, quality of life, or survival, according to a randomized, placebo controlled study.
Although the number of metastatic cancer patients receiving radiation in the last year of life did not significantly change from 2000 to 2007, a new study has found a shift in radiation use from the simplest radiation treatments to more advanced treatment.
A new study in the United Kingdom has found an increasing trend in opioid prescribing by general practitioners for cancer pain during a patient’s last 3 months of life. However, data also revealed that older patients had a significantly lower chance of receiving opioids to address cancer pain compared with patients aged 50 years or younger.
In this podcast we discuss integrating palliative care into standard oncology care with Thomas J. Smith, director of palliative medicine at Sidney Kimmel Comprehensive Cancer Center.
A significant portion of patients with incurable lung cancer believe that palliative radiation therapy will cure the disease or at least help them live longer, according to a new study. Only about one-third of patients acknowledged that the treatment was not at all likely to cure their cancer.
Adolescents and young adults want to be more involved in specific aspects of their end-of-life care and found a planning document to aid in those decisions helpful, according to the results of a recently published study.
When facing decisions involving children with cancer at the end of life, three themes drove parental decision making--communication, extending time, and understanding prognosis, according to a recent meta-analysis.
The family of a young woman with a brainstem glioma has been haranguing her physician to continue bevacizumab treatment despite a significant decline in her functional status. How to respond?
I have come to the conclusion that a successful systematic approach to earlier transitions from disease-directed cancer therapy to end-of-life and palliative care can only come from better communication in the context of more trusting relationships.
Initiating discussions about end-of-life care with patients with incurable cancers early in their disease was associated with a decrease in late-stage... More »
Giving patients at the end of life regular parenteral hydration of 1 L of saline per day did not improve symptoms associated with hydration, quality... More »
A significant portion of patients with incurable lung cancer believe that palliative radiation therapy will cure the disease or at least help them... More »
Adolescents and young adults want to be more involved in specific aspects of their end-of-life care and found a planning document to aid in those... More »
When facing decisions involving children with cancer at the end of life, three themes drove parental decision making--communication, extending time,... More »
Commentary on: Kent B, Anderson NE, Owens RG. Nurses’ early experiences with patient death: the results of an on-line survey of Registered Nurses in New Zealand. Int J Nurs Stud 2012;49:1255–65.
Implications for practice and research
The study draws attention to the issue of patient death and its impact on staff well-being, moral and mental health, calling for these areas to be taken more seriously.
This Registered Nurses' Association of Ontario (RNAO) clinical best practice guideline provide evidence-based recommendations for registered nurses and registered practical nurses on best nursing practices for end-of-life care during the last day
Advance directives (ADs) are one of the few means for patients to indicate their end-of-life (EOL) treatment option preference. An effective and consistent solution for increasing the AD completion rate remains elusive. A literature search revealed three studies completed in the United States that employed an identical methodology and focused on registered nurses (RNs). These studies examined a variety of concepts, including nurses' knowledge, attitudes, experience, and confidence with regard to ADs.|This review completed a systematic synthesis of reported results from three survey studies that focused, respectively, on oncology, critical care, and emergency RNs who were members of various professional nursing organizations.|Our investigation addressed the following research questions: What are the knowledge, attitudes, experience, and confidence of RNs with regard to ADs, and what is the relationship among these study variables? Each study used the Knowledge, Attitudes, and
Medical end-of-life decisions, defined as end-of-life practices with a potential or certain life-shortening effect, precede almost 50% of deaths in Western countries, and receive ample medical-ethical attention. This systematic review aims to detect whether there are differences in the prevalence of medical end-of-life decisions in 'vulnerable' patient groups. In 2009, five major databases were scrutinized for publications containing original data on the prevalence of euthanasia/physician-assisted suicide, life-ending without explicit patient request, intensified symptom alleviation, non-treatment decisions and palliative sedation by social factors (eg age, gender and SES). Heterogeneous findings were pooled using a random effects model. We identified 6377 papers of which 51 papers were selected, involving over 1.09 million patients. Most publications reported the prevalence of non-treatment decisions. The most studied social factors were age and gender. Among patients older than
William S. Breitbard, MD, acting chair at the department of psychiatry and behavioral sciences and chief of psychiatry service at Memorial Sloan-Kettering Cancer Center, discusses how to have an effective end-of-life conversation with a patient.
Five Steps to Improving Patient Access Judy Capko, May 21, 2013 Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
Growing HIPAA Threat – Ignore Windows XP at Your Own Peril Marion K. Jenkins, May 21, 2013 Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
Three Areas to Reduce Costs at Your Medical Practice Greg Mertz, May 19, 2013 By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
Dos and Don’ts for Starting a Physician Blog Michael Woo-Ming, MD, May 18, 2013 Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
Giving patients at the end of life regular parenteral hydration of 1 L of saline per day did not improve symptoms associated with hydration, quality of life, or survival, according to a randomized, placebo controlled study.
In this podcast we discuss integrating palliative care into standard oncology care with Thomas J. Smith, director of palliative medicine at Sidney Kimmel Comprehensive Cancer Center.
A significant portion of patients with incurable lung cancer believe that palliative radiation therapy will cure the disease or at least help them live longer, according to a new study. Only about one-third of patients acknowledged that the treatment was not at all likely to cure their cancer.
I have come to the conclusion that a successful systematic approach to earlier transitions from disease-directed cancer therapy to end-of-life and palliative care can only come from better communication in the context of more trusting relationships.
