Palliative Care for Patients With Noncancer Illnesses

Harrison, Krista L.; Kotwal, Ashwin; Smith, Alexander K.

doi:10.1001/jama.2020.15075

Cited by 17 publications

(8 citation statements)

References 15 publications

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“…Palliative care has been developed mainly in the field of cancer patients and its coverage has expanded to many non-cancer patients [ 19 ]. In addition to the complexity of palliative care itself, there are several challenges and barriers to its implementation in the field of cardiovascular disease compared to that of cancer.…”

Section: The Definition Of Palliative Care and Several Barriers In Im...mentioning

confidence: 99%

Quality indicators of palliative care for cardiovascular intensive care

et al. 2022

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Healthcare providers working for cardiovascular intensive care often face challenges and they play an essential role in palliative care and end-of-life care because of the high mortality rates in the cardiac intensive care unit. Unfortunately, there are several barriers to integrating palliative care, cardiovascular care, and intensive care. The main reasons are as follows: cardiovascular disease-specific trajectories differ from cancer, there is uncertainty associated with treatments and diagnoses, aggressive treatments are necessary for symptom relief, and there is ethical dilemma regarding withholding and withdrawal of life-sustaining therapy. Quality indicators that can iterate the minimum requirements of each medical discipline could be used to overcome these barriers and effectively practice palliative care in cardiovascular intensive care. Unfortunately, there are no specific quality indicators for palliative care in cardiovascular intensive care. A few indicators and their domains are useful for understanding current palliative care in cardiovascular intensive care. Among them, several domains, such as symptom palliation, patient- and family-centered decision-making, continuity of care, and support for health care providers that are particularly important in cardiovascular intensive care.Historically, the motivation for using quality indicators is to summarize mechanisms for external accountability and verification, and formative mechanisms for quality improvement. Practically, when using quality indicators, it is necessary to check structural indicators in each healthcare service line, screen palliative care at the first visit, and integrate palliative care teams with other professionals. Finally, we would like to state that quality indicators in cardiovascular intensive care could be useful as an educational tool for practicing palliative care, understanding the minimum requirements, and as a basic structure for future discussions.

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Section: The Definition Of Palliative Care and Several Barriers In Im...mentioning

confidence: 99%

Quality indicators of palliative care for cardiovascular intensive care

et al. 2022

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“…Dzięki rozwojowi medycyny choroby uznawane jeszcze niedawno za śmiertelne, stały się chorobami przewlekłymi, a chorujący na nie pacjenci niejednokrotnie doświadczają cierpienia z powodu towarzyszących im niekontrolowanych objawów, wymagając wieloletniej opieki. Przebieg powyższych chorób jest zazwyczaj zmienny, przebiegający z okresami zaostrzeń i remisji [35]. W związku z tym niektórzy eksperci sugerują, że w najbliższym czasie konieczne będzie doprecyzowanie populacji wymagającej opieki paliatywnej świadczonej na poziomie podstawowym (np.…”

Section: Poprawa Dostępności Pediatrycznej Opieki Paliatywnejunclassified

Directions of development of palliative care based on the literature

Zasowska-Nowak¹

2022

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Rosnące zapotrzebowanie na opiekę paliatywną oraz wyrównanie różnic w dostępie do tej formy opieki stanowią najbardziej istotne wyzwania dla współczesnego świata. Pomimo znacznego postępu jaki dokonał się w ostatnich latach w dostępie do opieki paliatywnej oraz uznania prawa człowieka do łagodzenia cierpienia za jedno z podstawowych jego praw, w wielu regionach geograficznych dostęp do leków opioidowych oraz leczenie bólu nadal są niewystarczające. W najbliższym czasie opieka paliatywna musi być przygotowana na kolejne wyzwania związane ze wzrostem liczby chorych oraz koniecznością zapewnienia im zindywidualizowanej opieki dostosowanej nie tylko do stadium choroby i zgłaszanych objawów somatycznych, ale i zależnej od uwarunkowań społecznych, kulturowych i religijnych. Do osiągniecia powyższych celów niezbędna jest poprawa dostępu do edukacji, jak również odpowiedni wzrost gospodarczy poszczególnych krajów, pozwalający na optymalne wykorzystanie istniejących zasobów ludzkich i infrastruktury. Poprawa jakości opieki paliatywnej nad chorymi na nowotwory poprzez jej integrację z opieką onkologiczną jest niewątpliwie kolejnym działaniem ukierunkowanym na potrzeby tej grupy pacjentów w celu poprawy jakości życia. Szczególnie istotna jest również zmiana definicji opieki paliatywnej oraz dostosowanie jej do zmieniających się potrzeb współczesnego świata.Słowa kluczowe: leczenie bólu, opieka paliatywna, pediatryczna opieka paliatywna, wyzwania opieki paliatywnej.

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“…Multiple methods of delivering PC have been tested and found to be effective. Unfortunately, this heterogeneity of PC models and inconsistent reporting of the components, methodological limitations, and lack of consensus on outcome measures has made it difficult to compare and contrast different approaches [ 33 , 34 ••]. Limited research has been done on models of care for ALD.…”

Section: Healthcare Delivery Models Of Integrated Palliative Carementioning

confidence: 99%

Creating Effective Models for Delivering Palliative Care in Advanced Liver Disease

Bakitas

2021

Curr Hepatology Rep

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Purpose of Review The current healthcare system is not fully equipped to provide comprehensive support for patients with advanced liver disease (ALD) and their caregivers resulting in concomitant suffering and reduced quality of life (QoL). Integration of palliative care (PC) within routine care has demonstrated benefits in improving symptoms and QoL and reducing healthcare utilization for other serious illnesses but has been underutilized or delayed for ALD care. The purpose of this article is to outline the domains and benefits of PC and discuss the misconceptions and barriers for PC integration, and healthcare delivery models supporting PC integration within ALD care. Recent Findings PC has eight key domains related to physical and mental health, goals for future care, and care of the caregivers. PC offers benefits to improve health outcomes and patient satisfaction and reduce healthcare utilization. To date there have been successful models of PC that are primarily hospital- or community-based; successful models have been PC specialist- or primary/generalist-led. Summary Concurrent PC within oncology has formed the basis for most evidence-based guidelines. PC integration within ALD care is still in its infancy. While amassing evidence in ALD, hepatology organizations can promote consensus-based integrated PC models that can guide research and practice efforts to increase supportive care for these patients in need and their family caregivers.

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Palliative Care for Patients With Noncancer Illnesses

Cited by 17 publications

References 15 publications

Quality indicators of palliative care for cardiovascular intensive care

Quality indicators of palliative care for cardiovascular intensive care

Directions of development of palliative care based on the literature

Creating Effective Models for Delivering Palliative Care in Advanced Liver Disease

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