Oct 22, 2024 · Objectives To investigate the efficacy and safety of oral (PO) and subcutaneous (SC) lacosamide for refractory symptoms in the palliative setting. Methods We conducted a retrospective chart review of the use of lacosamide since it was introduced in our palliative care service 1½ years ago. All clinical notes, medication administration records and infusion monitoring documentation were ...

Introduction. Most patients with a deteriorating chronic illness have a reduced oral intake at the end of life. This may be due to illness or treatment-related symptoms or complications, such as dysphagia, nausea or vomiting, generalised weakness and, in the last days of life, to a decreased level of consciousness or a loss of desire to drink.1 2 …

Objectives Financial pressures and competing demands for limited resources highlight the importance of defining the unmet need for specialty inpatient palliative care (PC), demonstrating the value of the service line and making decisions about staffing. One measure of access to specialty PC is penetration, the percentage of hospitalised adults receiving PC consultations. Although useful ...

Palliative care professionals often care for patients who would benefit from treatment to suppresses gastric acid secretions. Such patients include those with malignant bowel obstruction, gastrointestinal (GI) bleeding and dyspepsia. When faced with a patient population who commonly have swallowing difficulties, alternate routes to administer medications are …

Requesting that serious diagnoses be concealed from patients, a widespread phenomenon in many cultures, presents a professional dilemma. Practical and sensitive communication strategies are needed. Methodology In this paper, we use analysis of the existing literature to develop a communication tool for practitioners facing requests for diagnostic non-disclosure. Our approach builds on existing ...

Pulmonary lymphangitic carcinomatosis (PLC) is a type of lymphangitic spread of cancer cells, from a primary site to the pulmonary vasculature and lymphatics. Corticosteroids are recommended for PLC by clinical guidelines, although scientific evidence for this traditional practice is still lacking. We report a patient with lung cancer who developed clinically diagnosed PLC and was successfully ...

Nov 28, 2024 · In palliative care, we can often predict that a patient is entering a deteriorating phase and the prognosis is limited. We can also anticipate a shift from the oral route to the parental route using continuous subcutaneous infusion (CSCI) as this deterioration progresses. However, how should we appropriately manage medications such as antidepressants that are not amenable to administration by ...

Methods Cross-sectional secondary analysis of the intervention arm of a randomised controlled trial. 45 patients with COPD and moderate-to-very severe chronic breathlessness despite optimal treatment received 20–30 mg oral sustained-release morphine daily for 4 weeks. Using binary logistic regression, the relationship between a clinically meaningful improvement in breathlessness (≥1 point ...

Chronic breathlessness is a disabling and distressing condition for which there is a growing evidence base for a range of interventions. Non-pharmacological interventions are the mainstay of management and should be optimised prior to use of opioid medication. Opioids are being implemented variably in practice for chronic breathlessness. This narrative review summarises the evidence defining ...

2 Wang˜M, ea MJ Suoive aiaive Cae 224019 111362244984 Review as single-arm trials,6 cluster randomised trials7 and adaptive trials,8 have been developed. Single-arm trials refer to a design method in clin-ical research where only one experimental group