Integrating Screening and Referral to Palliative Care on Hospital Discharge Improves Symptom Scores in Patients with Severe COPD

Author(s):  
K.R. Prendecki ◽  
I.R. Allon ◽  
S. Klinger ◽  
K. Roy
2018 ◽  
Vol 56 (6) ◽  
pp. e44
Author(s):  
Gloria Mabel Carrillo ◽  
Sonia Carreño ◽  
Rocio Lopez ◽  
Olga Gómez ◽  
Diana Cárdenas ◽  
...  

Author(s):  
Jean-Paul Janssens ◽  
Catherine Weber ◽  
Jerôme Stirnemann ◽  
François Herrmann ◽  
Chloë Cantero ◽  
...  

2018 ◽  
Vol 21 (1) ◽  
pp. 85-88 ◽  
Author(s):  
Nikki Miller ◽  
John Shuler ◽  
Deon Hayley ◽  
Jianghua He ◽  
Karin Porter-Williamson ◽  
...  

Author(s):  
John Politis ◽  
Peter Eastman ◽  
Brian Le ◽  
John Furler ◽  
Louis Irving ◽  
...  

Context: Patients with advanced chronic obstructive pulmonary disease (COPD) can develop increasing breathlessness, which can persist despite optimal medical management—refractory breathlessness. Management can be challenging for all clinicians and requires a broad approach that includes optimization of disease directed therapies, non-pharmacological strategies to manage breathlessness and for some patients opioids. Objectives: To explore the approaches to breathlessness management and palliative care undertaken by Australian General Practitioners (GP) for patients with severe COPD and refractory breathlessness. Methods: A case-vignette based survey was conducted with Australian GPs to determine their approaches to breathlessness management and palliative care in COPD. Results: Of the 137 GPs, 66% recommended commencing an additional medication to manage refractory breathlessness. Thirty-eight GPs (28%) recommended opioids and 26 (19%) recommended guideline discordant treatments. Two-thirds of GPs had concerns regarding the use of opioids in COPD. Half (55%) of GPs were comfortable providing general palliative care to patients with COPD and 62 (45%) had referred patients with COPD to specialist palliative care services. Most respondents wanted further training to manage severe COPD and severe chronic breathlessness. Conclusion: Most GPs recognized and were willing to add specific treatments for severe chronic breathlessness. However, experience prescribing opioids for severe chronic breathlessness was low, with many practitioners holding significant concerns regarding adverse effects. Many GPs are uncomfortable offering a palliative approach to their COPD patients, yet these patients are not routinely referred to specialist palliative care services despite their immense needs. GPs therefore desire education and support to overcome these barriers.


2014 ◽  
Vol 4 (Suppl 1) ◽  
pp. A95.2-A95
Author(s):  
Fiona Cambell ◽  
Jo Leek ◽  
Sharon Hudson ◽  
Rachael Colclough ◽  
Bruce Pereira ◽  
...  

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 770
Author(s):  
Mohamed Abdelaal ◽  
Pamela J. Mosher ◽  
Abha Gupta ◽  
Breffni Hannon ◽  
Christine Cameron ◽  
...  

Clinical guidelines aimed at cancer care for adolescents and young adults (AYAs) encourage early integration of palliative care, yet there are scarce data to support these recommendations. We conducted a retrospective chart review of AYA patients, aged 15 to 39 years, who were referred to the Integrated AYA Palliative Care and Psychiatry Clinic (IAPCPC) at the Princess Margaret Cancer Centre between May 2017 and November 2019 (n = 69). Demographic data, symptom prevalence, change in symptom scores between baseline consultation and first follow-up, and intensity of end-of-life care were collected from the patients’ medical charts, analyzed, and reported. Of the 69 patients, 59% were female, and sarcoma was the most common cancer. A majority of patients had at least one symptom scored as moderate to severe; tiredness, pain, and sleep problems were the highest scored symptoms. More than one-third used medical cannabis to manage their symptoms. Symptom scores improved in 61% after the first clinic visit. Out of the 69 patients, 50 (72.5%) had died by October 2020, with a median time between the initial clinic referral and death of 5 months (range 1–32). Three patients (6%) received chemotherapy, and eight (16%) were admitted to an intensive care unit during the last month of life. In conclusion, AYAs with advanced cancer have a high burden of palliative and psychosocial symptoms. Creating a specialized AYA palliative care clinic integrated with psychiatry showed promising results in improving symptom scores and end-of-life planning.


Sign in / Sign up

Export Citation Format

Share Document