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Improving serious illness care for surgical patients - quality indicators for surgical palliative care

LEE, Katherine C. ; WALLING, Anne M. ; SENGLAUB, Steven S. ; BERNACKI, Rachelle ; FLEISHER, Lee A. ; RUSSELL, Marcia M. ; WENGER, Neil S. ; COOPER, Zara
Annals of surgery, 03/06/2020, Pagination inconnue

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Quality indicators of palliative care for acute cardiovascular diseases

MIZUNO, Atsushi ; MIYASHITA, Mitsunori ; KOHNO, Takashi ; TOKUDA, Yasuharu ; FUJIMOTO, Shuhei ; NAKAMURA, Masato ; TAKAYAMA, Morimasa ; NIWA, Koichiro ; FUKUDA, Terunobu ; ISHIMATSU, Shinichi ; KINOSHITA, Satomi ; OISHI, Shogo ; MOCHIZUKI, Hiroki ; UTSUNOMIYA, Akemi ; TAKADA, Yasuko ; OCHIAI, Ryota ; MOCHIZUKI, Toshiaki ; NAGAO, Ken ; YOSHIDA, Saran ; HAYASHI, Akitoshi ; SEKINE, Ryuichi ; ANZAI, Toshihisa
Journal of cardiology, 18/03/2020, Pagination inconnue

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Thème : Recherche - Evaluation - Méthodologie.

INDICATEUR SANTE ; DEMARCHE PALLIATIVE ; CARDIOLOGIE ; JAPON

Background: Although recent attention to palliative care for patients with cardiovascular diseases has been increasing, there are no specific recommendations on detailed palliative care practices. We proceed on a discussion of the appropriateness and applicability of potential quality indicators for acute cardiovascular diseases according to our previous systematic review.
Methods: We created a multidisciplinary panel of 20 team members and 7 external validation clinicians composed of clinical cardiologists, a nutritionist, a physiotherapist, a clinical psychologist, a critical and emergent care specialist, a catheterization specialist, a primary care specialist, a palliative care specialist, and nurses. After crafting potential indicators, we performed a Delphi rating, ranging from “1 = minimum” to “9 = maximum”. The criterion for the adoption of candidate indicators was set at a total mean score of seven or more. Finally, we subcategorized these indicators into several domains by using exploratory factor analysis.
Results: Sixteen of the panel members (80%) were men (age, 49.5 ± 13.7 years old). Among the initial 32 indicators, consensus was initially reached on total 23 indicators (71.8%), which were then summarized into 21 measures by selecting relatively feasible time variations. The major domains were “symptom palliation” and “supporting the decision-making process”. Factor analysis could not find optimal model. Narratively-developed seven sub-categories included “presence of palliative care team”, “patient-family relationship”, “multidisciplinary team approach”, “policy of approaching patients”, “symptom screening and management”, “presence of ethical review board”, “collecting and providing information for decision-maker”, and “determination of treatment strategy and the sharing of the care team’s decision”.
Conclusion: In this study we developed 21 quality indicators, which were categorized into 2 major domains and 7 sub-categories. These indicators might be useful for many healthcare providers in the initiation and enhancement of palliative care practices for acute cardiovascular diseases in Japan.

Origine : PubMed

Conceptual and operational definitions for the indicators of the nursing outcome classification - symptom control in patients with heart failure in palliative care

QUIRINO AFONSO, Beatriz ; DA COSTA FERREIRA, Natany ; DE CASSIA GENGO E SILVA BUTCHER, Rita
Enfermeria clinica, 29/02/2020, Pagination inconnue

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The importance of the rate of pure "attended deaths at home" for objective outcome indicator for assessing the prevalence of home care in Japan

KAKIUCHI, Yasuhiro ; NAGAO, Ryoko ; OCHIAI, Eriko ; KAKIMOTO, Yu ; OSAWA, Motoki
ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE, 17/12/2019, vol.24, n°1, p. 1-6

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Validation of claims data to identify death among aged persons utilizing enrollment data from health insurance unions

SAKAI, M. ; OHTERA, S. ; IWAO, T. ; NEFF, Y. ; KATO, G. ; TAKAHASHI, Y. ; NAKAYAMA, T. ; BIDAME (BIG DATA ANALYSIS OF MEDICAL CARE FOR THE ELDERLY IN KYOTO)
ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE, 23/11/2019, vol.24, n°1, p. 1-6

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Mapping levels of palliative care development in 198 countries - the situation in 2017

CLARK, David ; BAUR, Nicole ; CLELLAND, David ; GARRALDA, Eduardo ; LOPEZ-FIDALGO, Jesus ; CONNOR, Stephen ; CENTENO, Carlos
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 04/2020, vol.59, n°4, p. 794-807

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Underprescription of step III opioids in French cancer survivors with chronic pain - a call for integrated early palliative care in oncology

JANAH, Asmaa ; BOUHNIK, Anne-Déborah ; TOUZANI, Rajae ; BENDIANE, Marc-Karim ; PERETTI-WATEL, Patrick
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 04/2020, vol.59, n°4, p. 836-847

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Population-based quality indicators for end-of-life cancer care - a systematic review

HENSON, Lesley Anne ; EDMONDS, Polly ; JOHNSTON, Anna ; JOHNSON, Halle Elizabeth ; NG YIN LING, Clarissa ; SKLAVOUNOS, Alexandros ; ELLIS-SMITH, Clare ; GAO, Wei
JAMA oncology, 24/10/2019, Pagination inconnue

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Thème : Recherche - Evaluation - Méthodologie.

FIN VIE ; CANCER ; REVUE LITTÉRATURE ; QUALITE SOIN ; INDICATEUR SANTE

Importance: Improving the quality of cancer care is an international priority. Population-based quality indicators (QIs) are key to this process yet remain almost exclusively used for evaluating care during the early, often curative, stages of disease.
Objectives: To identify all existing QIs for the care of patients with cancer who have advanced disease and/or are at the end of life and to evaluate each indicator's measurement properties and appropriateness for use.
Evidence Review: For this systematic review, 5 electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, and the Cochrane Library) were searched from inception through February 4, 2019, for studies describing the development, review, and/or testing of QIs for the care of patients with cancer who have advanced disease and/or are at the end of life. For each QI identified, descriptive information was extracted and 6 measurement properties (acceptability, evidence base, definition, feasibility, reliability, and validity) were assessed using previously established criteria, with 4 possible ratings: positive, intermediate, negative, and unknown. Ratings were collated and each QI classified as appropriate for use, inappropriate for use, or of limited testing. Among the QIs determined as appropriate for use, a recommended shortlist was generated by excluding those that were specific to patient subgroups and/or care settings; related QIs were identified, and the indicator with the highest rating was retained.
Findings: The search yielded 7231 references, 35 of which (from 28 individual studies) met the eligibility criteria. Of 288 QIs extracted (260 unique), 103 (35.8%) evaluated physical aspects of care and 109 (37.8%) evaluated processes of care. Quality indicators relevant to psychosocial (18 [6.3%]) or spiritual and cultural (3 [1.0%]) care domains were limited. Eighty QIs (27.8%) were determined to be appropriate for use, 116 (40.3%) inappropriate for use, and 92 (31.9%) of limited testing. The measurement properties with the fewest positive assessments were acceptability (38 [13.2%]) and validity (63 [21.9%]). Benchmarking data were reported for only 16 QIs (5.6%). The final 15 recommended QIs came from 6 studies.
Conclusions and Relevance: The findings suggest that only a small proportion of QIs developed for the care of patients with cancer who have advanced disease and/or are at the end of life have received adequate testing and/or are appropriate for use. Further testing may be needed, as is research to establish benchmarking data and to expand QIs relevant to psychosocial, cultural, and spiritual care domains.

Origine : PubMed

Days spent at home in the last 6 months of life - a quality indicator of end of life care in patients with hematologic malignancies

CHEUNG, Matthew C. ; CROXFORD, Ruth ; EARLE, Craig C. ; SINGH, Simron
Leukemia and lymphoma, 22/08/2019, p. 1-9

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Development and validation of a deep learning algorithm for mortality prediction in selecting patients with dementia for earlier palliative care interventions

WANG, Liqin ; SHA, Long ; LAKIN, Joshua R. ; BYNUM, Julie ; BATES, David W. ; HONG, Pengyu ; ZHOU, Li
JAMA network open, 03/07/2019, vol.2, n°7, p. 1-14

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Which outcome domains are important in palliative care and when? - an international expert consensus workshop, using the nominal group technique

DE WOLF-LINDER, Susanne ; DAWKINS, Marsha ; WICKS, Francesca ; PASK, Sophie ; EAGAR, Kathy ; EVANS, Catherine J. ; HIGGINSON, Irene J. ; MURTAGH, Fliss E. M.
PALLIATIVE MEDICINE, 09/2019, vol.33, n°8, p. 1058-1068

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Consensus building on health indicators to assess PC global development with an international group of experts

ARIAS-CASAIS, Natalia ; GARRALDA, Eduardo ; LOPEZ-FIDALGO, Jesús ; RHEE, John Y. ; PONS, Juan José ; DE LIMA, Liliana ; CENTENO, Carlos
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 01/06/2019, Pagination inconnue

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Quality indicator rates for seriously ill home care clients - analysis of resident assessment instrument for home care data in six Canadian provinces

GUTHRIE, Dawn M. ; HARMAN, Lisa E. ; BARBERA, Lisa ; BURGE, Fred ; LAWSON, Beverley ; MCGRAIL, Kimberlyn ; SUTRADHAR, Rinku ; SEOW, Hsien
JOURNAL OF PALLIATIVE MEDICINE, 11/2019, vol.22, n°11, p. 1346-1356

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Improving quality of palliative care through implementation of national guidelines for palliative care

LO, Tong Jen ; NEO, Patricia S. H. ; PEH, Tan Ying ; AKHILESWARAN, Ramaswamy ; CHEN, Wei Ting ; LEE, Angel ; STANDARDS DEVELOPMENT SUBGROUP OF THE NATIONAL STRATEGY FOR PALLIATIVE CARE IMPLEMENTATION TASKFORCE, GUIDELINES IIMPLEMENTATION WORKGROUP
JOURNAL OF PALLIATIVE MEDICINE, 11/2019, vol.22, n°11, p. 1439-1444

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A systematic review and critical appraisal of quality indicators to assess optimal palliative care for older people with dementia

AMADOR, Sarah ; SAMPSON, Elizabeth L. ; GOODMAN, Claire ; ROBINSON, Louise ; SEED RESEARCH TEAM
PALLIATIVE MEDICINE, 04/2019, vol.33, n°4, p. 415-429

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Palliative care quality measures - an exploratory study

BUJA, Alessandra ; RIVERA, Michele ; BALDO, Vincenzo ; SOATTIN, Marta ; RIZZOLO, Ylenia ; ZAMENGO, Giuseppe ; BOSCOLO, Sarah ; GHIOTTO, Maria Cristina ; DAMIANI, Gianfranco
BMJ supportive and palliative care, 14/02/2019, Pagination inconnue

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Etats généraux de la bioéthique 2018 - rapport de synthèse du Comité consultatif national d'éthique, Travaux du comité citoyen

Comité Consultatif National d'Ethique pour les sciences de la vie et de la santé
CCNE , 06/2018 , 196 p.

Low transthyretin levels predict poor prognosis in cancer patients in palliative care settings

MIURA, Tomofumi ; AMANO, Koji ; SHIRADO, Akemi ; BABA, Mika ; OZAWA, Taketoshi ; NAKAJIMA, Nobuhisa ; SUGA, Akihiko ; MATSUMOTO, Yoshihisa ; SHIMIZU, Mie ; SHIMOYAMA, Satofumi ; KURIYAMA, Toshiyuki ; MATSUDA, Yoshinobu ; IWASHITA, Tomoyuki ; MORI, Ichiro ; KINOSHITA, Hiroya
Nutrition and cancer, 20/01/2019, p. 1-7

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Potential quality indicators for seriously ill home care clients - a cross-sectional analysis using resident assessment instrument for home care (RAI-HC) data for Ontario

HARMAN, Lisa E. ; GUTHRIE, Dawn M. ; COHEN, Joachim ; DECLERCQ, Anja ; FISHER, Kathryn ; GOODRIDGE, Donna ; HIRDES, John P. ; SEOW, Hsien
BMC palliative care, 09/01/2019, vol.18, n°1, p. 1-10

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A life or 'good death' situation? - a worldwide ecological study of the national contexts of countries which have and have not implemented palliative care

CLARK, Joseph ; BARNES, Amy ; CAMPBELL, Mike ; GARDINER, Clare
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 27/12/2018, Pagination inconnue

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Thème : Santé.

DEMARCHE PALLIATIVE ; POLITIQUE SANITAIRE ; SANTE PUBLIQUE ; INDICATEUR SANTE

CONTEXT: Palliative Care advocates argue that service implementation is feasible in all settings. Yet, services have developed patchily in low and middle-income settings. Beyond Human Development Index indicators, there has been limited engagement with the broader development challenges facing nations tasked with implementing palliative care.
OBJECTIVE: To describe how indicators of national development relate to levels of palliative care services in 207 countries around the world.
METHODS: Ecological study to identify relationships between potential predictor variables and the level of national palliative care development. A total of 28 predictor variables from the following 6 domains were selected using hypothesised relationships with levels of palliative care development: disease demographics, socioeconomics, health systems, politics, demographics and economics. The outcome variable was level of national palliative care development on a six-point scale. Spearman's correlation was used to measure the strength of the association.
RESULTS: Twenty-six out of 28 variables were statistically significantly associated with levels of palliative care development in 207 countries. Palliative care is more developed in countries with high: percentage of deaths from non-communicable disease; population proportion aged 65+; gross national income and tourism. Development is lower in countries with high levels of: political corruption; infant mortality; deaths by infectious diseases; and weak democracy. Prevalence of under-nourishment and levels of private health expenditure were not significantly associated with palliative care development.
CONCLUSION: Palliative care development is highly consistent with broader national development indicators. It is less in countries where sudden deaths are more likely and benefits from palliative care provision are likely to be very limited. In such countries, resources may be prioritised towards life prolonging therapies and key aspects of palliative care need only be implemented prior to fully integrated palliative services. Findings suggest that there may be a 'tipping point' in societies, where the relative need for life-prolonging therapies becomes less than the need for integrated palliative care services.

Origine : PubMed

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