Related Articles Palliative sedation: A safety net for the relief of refractory and intolerable symptoms at the end of life. Aust J Gen Pract. 2019 12;48(12):838-845 Authors: Patel C, Kleinig P, Bakker M, Tait P Abstract BACKGROUND: Evidence exists for the use of palliative sedation for people approaching the last days of life with refractory and intolerable symptoms. It is a third-line intervention that deliberately lowers the conscious state to relieve intolerable and refractory symptoms. This level of intervention is not routinely used in primary care, and there is a lack of guidelines for palliative sedation in this context. OBJECTIVE: This…
Origen: Palliative sedation: A safety net for the relief of refractory and intolerable symptoms at the end of life. – PubMed

Related Articles Venous thromboembolism and palliative care. Clin Med (Lond). 2019 07;19(4):315-318 Authors: Noble S Abstract The management of cancer-associated thrombosis (CAT) is largely informed by data from adequately powered randomised control trials. However, their exclusion criteria have invariably rendered the study populations unrepresentative of those seen day-to-day by palliative care practitioners.Recent observational data has given insights into the unique challenges of CAT management within the palliative care setting including the natural history of thrombosis in advanced cancer and end-of-life decision making around anticoagulationDespite developments and some on-going uncertainties, one constant remains; the patient and their experiences. We should, wherever…
Origen: Venous thromboembolism and palliative care. – PubMed

Related Articles Deprescribing in palliative care. Clin Med (Lond). 2019 07;19(4):311-314 Authors: Thompson J Abstract The use of multiple medications is common in palliative care, putting patients at risk of adverse events and a high tablet burden. Deprescribing is the process of reviewing and stopping potentially inappropriate medications in order to improve quality of life. Barriers to deprescribing exist meaning many patients will take multiple medications despite being in the final months of life. The OncPal deprescribing guideline is a useful tool to support the process for patients with a limited life expectancy. There is evidence for the safety of…
Origen: Deprescribing in palliative care. – PubMed

Related Articles Prognostication in palliative care. Clin Med (Lond). 2019 07;19(4):306-310 Authors: Chu C, White N, Stone P Abstract An accurate prognosis about how long a terminally ill patient has left to live, when disclosed sensitively in open discussions, can facilitate patient-centred care and shared decision making. In addition, several guidelines, policies and funding streams rely, to some extent, on a clinician estimated prognosis. However, clinician predictions alone have been shown to be unreliable and over-optimistic. The factors underlying clinicians’ prognostic decisions (particularly at the very end of life) are beginning to be elucidated. As an alternative to clinicians’ subjective…
Origen: Prognostication in palliative care. – PubMed

Related Articles Sleep problems in advanced disease . Clin Med (Lond). 2019 07;19(4):302-305 Authors: Davies A Abstract Sleep problems are relatively common in patients with advanced disease, and are associated with significant morbidity in these groups of patients. The focus of this article is sleep problems in patients with advanced cancer, and specifically insomnia, ‘vivid’ dreams and nightmares. However, other sleep problems are also relatively common in this group of patients, including sleep-related breathing disorders and circadian rhythm sleep-wake disorders. Healthcare professionals should screen all patients with advanced diseases for sleep problems and, equally, initiate appropriate (evidence-based) interventions when they are…
Origen: Sleep problems in advanced disease . – PubMed