The barriers in offering timely integrated PC services to COPD patients are complex. Despite the identification of validated prognostic variables and multidimensional indices, none of them are sufficiently reliable to predict survival and implicit the moment to start PC in COPD patients. The decision to initiate PC should be rather based on the presence of refractory chronic symptoms and patients’ unmet needs and preferences. Despite the current advances, the ideal model to initiate longitudinal palliative care from the moment COPD is diagnosed, alongside the usual management of the disease and intensified care in the end-of-life stages, is a goal for clinicians trained in and capable of providing palliative care in any COPD patient.
Methadone is a low-cost, strong opioid that is increasingly used as a first-line treatment for pain in palliative care (PC). Its long and unpredictable half-life and slow elimination phase can make titration challenging. Evidence for titration modalities is scarce.
Today we come to you with a special literature blog post highlighting 10 key deprescribing articles that together provide an overview of the field of deprescribing – covering the mindset of deprescribing, the complexity of and challenges related to deprescribing in clinical practice, the development and testing of deprescribing interventions, and perspectives of future deprescribing research. We believe each of these 10 articles offer important insights or findings related to deprescribing.
The list is based on careful deliberation between the two of us, after considering a number of worthy candidates. Of course, this list is based on our opinion only and we limited ourselves to 10 articles (which wasn’t easy at all!). We would love to hear your input on our list, so let us know if we have missed any important papers or topics. We will then follow up with a complete list of recommended deprescribing articles for use of all deprescribers out there!
Previous studies have found an association between aggressive cancer care and lower quality end of life. Despite international recommendations, late or very late referral to palliative care seems frequent. This study aimed to evaluate the association between the duration of involvement of a palliative care team (PCT), and aggressive cancer care, and to identify factors associated with aggressive cancer care.
Early provision of palliative care, at least 3–4 months before death, can improve patient quality of life and reduce burdensome treatments and financial costs. However, there is wide variation in the duration of palliative care received before death reported across the research literature. This study aims to determine the duration of time from initiation of palliative care to death for adults receiving palliative care across the international literature.