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Advance directives state requirements, center practices, and participant prevalence in adult day services centers - findings from the 2016 national study of long-term care providers

PENN LENDON, Jessica ; CAFFREY, Christine ; LAU, Denys T.
The Journals of gerontology. Series B, psychological sciences and social sciences, 05/07/2020, 6 p.

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Advance directives in Austrian intensive care units - an analysis of prevalence and barriers

KOSTENBERGER, Markus ; DIEGELMANN, Svenja ; TERLUTTER, Ralf ; BIDMON, Sonja ; NEUWERSCH, Stefan ; LIKAR, Rudolf
Resuscitation plus, 01/09/2020, vol.3, p. 1-7

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The occurrence and timing of delirium in acute care hospitalizations in the last year of life - a population-based retrospective cohort study

WEBBER, Colleen ; WATT, Christine L ; BUSH, Shirley H ; LAWLOR, Peter G ; TALARICO, Robert ; TANUSEPUTRO, Peter
PALLIATIVE MEDICINE, 09/06/2020, Pagination inconnue

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Unmet device reprogramming needs at the end of life among patients with implantable cardioverter defibrillator - a systematic review and meta-analysis

GONZALEZ-JARAMILLO, Valentina ; SOBANSKI, Piotr ; CALVACHE, Jose A ; ARENAS-OCHOA, Luisa F ; FRANCO, Oscar H ; HUNZIKER, Lukas ; EYCHMÜLLER, Steffen ; MAESSEN, Maud
PALLIATIVE MEDICINE, 26/06/2020, p. 1-11

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Cross-sectional survey of the wish to die among palliative patients in Spain - one phenomenon, different experiences

BELAR, Alazne ; ARANTZAMENDI, Maria ; SANTESTEBAN, Yolanda ; LOPEZ-FIDALGO, Jesús ; MARTINEZ, Marina ; LAMA, Marcos ; RULLAN, Maria ; OLZA, Inés ; BREEZE, Ruth ; CENTENO, Carlos
BMJ supportive and palliative care, 24/06/2020, p. 1-7

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Off-label and unlicensed drugs in pediatric palliative care - a prospective observational study

GARCIA-LOPEZ, Isabel ; CUERVAS-MONS VENDRELL, Margarita ; ROMERO, Irene Martin ; DE NORIEGA, Iñigo ; GONZALEZ, Juana Benedí ; MARTINO-ALBA, Ricardo
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 06/2020, p. 1-26

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Severe pain at the end of life - a population-level observational study

HAGARTY, A. Meaghen ; BUSH, Shirley H. ; TALARICO, Robert ; LAPENSKIE, Julie ; TANUSEPUTRO, Peter
BMC palliative care, 30/04/2020, vol.19, n°1, p. 1-13

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Prescribing medications of questionable benefit prior to death - a retrospective study on older nursing home residents with and without dementia in Germany

RAUSCH, Christian ; HOFFMANN, Falk
European journal of clinical pharmacology, 26/03/2020, p. 1-9

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Transcatheter aortic valve implantation-related futility - prevalence, predictors, and clinical risk model

HIGUCHI, Ryosuke ; SAJI, Mike ; HAGIYA, Kenichi ; TAKAMISAWA, Itaru ; SHIMIZU, Jun ; TOBARU, Tetsuya ; IGUCHI, Nobuo ; TAKANASHI, Shuichiro ; TAKAYAMA, Morimasa ; ISOBE, Mitsuaki
Heart and vessels, 06/04/2020, Pagination inconnue

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Prevalence of multidrug-resistant organisms on palliative care patients in a university hospital-bound palliative care unit - a prospective cohort analysis

STRAPATSAS, Tobias Georg ; SIMONS, Viola ; GHEBREMEDHIN, Beniam ; AHMAD-NEJAD, Parviz ; SCHMALZ, Oliver
PALLIATIVE MEDICINE, 18/03/2020, Pagination inconnue

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Thème : Santé.

ETUDE COHORTE ; ETUDE PROSPECTIVE ; INFECTION NOSOCOMIALE ; PREVALENCE

Background: Multidrug-resistant organisms are a growing challenge and burden to patient care. To date, there are only data concerning the prevalence of methicillin-resistant Staphylococcus aureus infections. Thus, numbers of other multidrug-resistant organisms can only be extrapolated and inferred from more or less comparable cohorts.
Aim: To evaluate the prevalence of multidrug-resistant organisms on palliative care in-patients.
Design: A prospective cohort analysis
Setting/participants: A University Hospital–bound palliative care unit, in which all patients admitted to the unit were screened for inclusion.
Results: In total, 304 patients were included in this study. The prevalence for methicillin-resistant Staphylococcus aureus of 5.2% (95% confidence interval: 2.9%–8.4%), for vancomycin-resistant Enterococcus faecium of 10.5% (95% confidence interval: 7.2%–14.8%), for Ciprofloxacin-resistant-extended spectrum beta-lactamases isolates of 5.8% (95% confidence interval: 3.4%–9.3%) and Ciprofloxacin-resistant Carbapenem-resistant Gram-negative bacteria of 0.3% (95% confidence interval: 0%–1.3%) was calculated. Except for methicillin-resistant Staphylococcus aureus, patients carrying a multidrug-resistant organism had a significant longer duration of hospitalization. Median length of stay was 12 days (interquartile range: 14.5, no multidrug-resistant organisms), 14.5 days (interquartile range: 15, methicillin-resistant Staphylococcus aureus), 21 days (interquartile range: 16.5, vancomycin-resistant enterococci), 22 days (interquartilsabstand: 20.75, Ciprofloxacin-resistant-extended spectrum beta-lactamases) and 32 days (interquartilsabstand: 22.00) for patients carrying two organisms.
Conclusion: There is a high prevalence of all multidrug-resistant organisms within the hospitalized palliative care patients. However, the multidrug-resistant organisms do not seem to impact the survival within this cohort. Further studies should evaluate additional end-points, for example, quality of life, which are of special interest in this cohort.

Origine : PubMed

Systematic review of the prevalence, predictors, and treatment of insomnia in palliative care

NZWALO, Isa ; ABOIM, Maria Ana ; JOAQUIM, Natercia ; MARREIROS, Ana ; ALLENDE-PEREZ, Silvia
The American journal of hospice and palliative care, 26/02/2020, Pagination inconnue

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Prevalent statin use in long-stay nursing home residents with life-limiting illness

MACK, Deborah S. ; TJIA, Jennifer ; HUME, Anne L. ; LAPANE, Kate L.
Journal of the American Geriatrics Society, 14/02/2020, Pagination inconnue

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Thème : Médicaments - Pharmacie.

THERAPEUTIQUE MEDICAMENTEUSE ; PREVALENCE ; MAISON RETRAITE ; MALADIE LETALE ; ETATS-UNIS

OBJECTIVES; To evaluate the prevalence and factors associated with statin pharmacotherapy in long-stay nursing home residents with life-limiting illness.
DESIGN: Cross-sectional.
SETTING: US Medicare- and Medicaid-certified nursing home facilities.
PARTICIPANTS: Long-stay nursing home resident Medicare fee-for-service beneficiaries aged 65 years or older with life-limiting illness (n = 424 212).
MEASUREMENTS: Prevalent statin use was estimated as any low-moderate intensity (daily dose low-density lipoprotein-cholesterol [LDL-C] reduction <30%-50%) and high-intensity (daily dose LDL-C reduction >50%) use via Medicare Part D claims for a prescription supply on September 30, 2016, with a 90-day look-back period. Life-limiting illness was operationally defined to capture those near the end of life using evidence-based criteria to identify progressive terminal conditions or limited prognoses (<6 mo). Poisson models provided estimates of adjusted prevalence ratios and 95% confidence intervals for resident factors.
RESULTS: A total of 34% of residents with life-limiting illness were prescribed statins (65--75 y = 44.0%, high intensity = 11.1%; >75 y = 31.1%, high intensity = 5.4%). Prevalence of statins varied by life-limiting illness definition. Of those with a prognosis of less than 6 months, 23% of the 65 to 75 and 12% of the older than 75 age groups were on statins. Factors positively associated with statin use included minority race or ethnicity, use of more than five concurrent medications, and atherosclerotic cardiovascular disease or risk factors.
CONCLUSION: Despite having a life-limiting illness, more than one-third of clinically compromised long-stay nursing home residents remain on statins. Although recent national guidelines have expanded indications for statins, the benefit of continued therapy in an advanced age population near the end of life is questionable. Efforts to deprescribe statins in the nursing home setting may be warranted.

Origine : PubMed

End-of-life experience for older adults in Ireland - results from the Irish longitudinal study on ageing (TILDA)

MAY, Peter ; ROE, Lorna ; MCGARRIGLE, Christine A. ; KENNY, Rose Anne ; NORMAND, Charles E.
BMC health services research, 14/02/2020, vol.20, n°1, p. 1-10

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Coping strategies of patients with advanced lung or colorectal cancer in six European countries - insights from the ACTION study

JABBARIAN, Lea J. ; KORFAGE, Ida J. ; CERV, Branka ; VAN DELDEN, Johannes J. M. ; DELIENS, Luc ; MICCINESI, Guido ; PAYNE, Sheila ; THIT JOHNSEN, Anna ; VERKISSEN, Mariëtte N. ; WILCOCK, Andrew ; VAN DER HEIDE, Agnes ; RIETJENS, Judith A. C. ; ACTION CONSORTIUM
Psycho-oncology, 02/2020, vol.29, n°2, p. 347-355

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"Hospice inpatient deep vein thrombosis detection (hidden) in advanced non-malignant diseases" - a longitudinal pilot study

WHITE, Clare ; NOBLE, Simon ; SWAN, Flavia ; WATSON, Max ; ALLGAR, Victoria ; NAPIER, Eoin ; NELSON, Annmarie ; JOHNSON, Miriam J.
BMJ supportive and palliative care, 11/02/2020, Pagination inconnue

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Availability of advance directives in the emergency department

SLANKAMENAC, Ksenija ; RUTSCHE, Noëmi ; KELLER, Dagmar I.
Swiss medical weekly, 13/01/2020, vol.150, p. 1-8

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Thème : Soins. Cote : eD02.03.00

SERVICE URGENCES ; DIRECTIVE ANTICIPEE ; PREVALENCE ; ETUDE PROSPECTIVE

BACKGROUND: Emergency departments (EDs) are crowded with critically ill patients, many of whom are no longer able to communicate with the emergency staff. Substitute decision makers are often unknown or not reachable in time. The availability of advance directives (ADs) among Swiss ED patients has not yet been evaluated. The purpose of this prospective survey was to investigate the prevalence of ADs among ED patients and to identify factors associated with the existence or absence of ADs.
METHODS: In a prospective survey, we enrolled consecutive patients from 10–30 July 2017 who visited a tertiary care ED. Patients completed a written, standardised and self-administrated questionnaire during the waiting time. The primary endpoint was the prevalence of ADs in ED patients. Secondarily, we defined predictors associated with the existence or absence of ADs. Two months after the first survey, there was a written follow-up survey asking patients without ADs whether they had completed an AD in the meantime.
RESULTS: Fifty-eight of 292 enrolled ED patients (19.9%) had a completed AD. Overall, 49.3% of the survey population was female. Patients having an AD were older (69.5 years, interquartile range [IQR] 57–81 vs 39 years, IQR 27–56) and had more comorbidities (67.2% vs 38.9%) compared with patients without ADs. The four leading reasons given for not having an AD were: 33.6% never considered completing one, 26% did not know about ADs, 14% preferred family to make decisions, 11.6% felt it was too early to make such a decision. Predictors for having an AD were older age (p <0.001), being in long-term medical treatment by a specialist (p = 0.050), being Swiss (p = 0.021) and living with nursing care (p = 0.043). Of the ED patients with ADs, 46.6% discussed their AD with the family and 31% with their general practitioner. Results of the follow-up survey showed that eight participants had completed an AD in the meantime. The prevalence of ADs increased from 19.9% to 22.6%.
DISCUSSION: During the last 20 years, the percentage of patients having an AD has not changed. Even today, only every fifth ED patient has a completed AD. Nearly two thirds of ED patients never considered completing one or did not know about ADs. Therefore, there is an urgent need to better inform and sensitise the public, so that they will define in a timely manner legally valid and specifically defined decisions about future medical treatments and wishes by completing individual directives.

Origine : PubMed

Chronic non-malignant pain in patients with cancer seen at a timely outpatient palliative care clinic

HUI, David ; ABDELGHANI, Eman ; CHEN, Joseph ; DIBAJ, Shiva ; ZHUKOVSKY, Donna S. ; DEV, Rony ; TANCO, Kimberson ; HAIDER, Ali ; AZHAR, Ahsan ; REDDY, Akhila ; EPNER, Daniel ; ARTHUR, Joseph ; DALAL, Shalini ; HEUNG, Yvonne ; REDDY, Suresh K. ; DE LA CRUZ, Maxine ; LIU, Diane ; BRUERA, Eduardo
Cancers, 15/01/2020, vol.12, n°1, p. 1-11

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Prevalence of diabetes mellitus at the end of life - an investigation using individually linked cause-of-death and medical register data

MITRATZA, Marianna ; KUNST, Anton E. ; PM HARTELOH, Peter ; MJ NIELEN, Markus ; KLIJS, Bart
Diabetes research and clinical practice, 02/2020, vol.160, n°108003, p. 1-9

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Symptomatic events in a community palliative care population - a prospective pilot study

TO, Timothy H. M. ; COLLIER, Aileen ; AGAR, Meera R. ; ROWETT, Debra ; CURROW, David
JOURNAL OF PALLIATIVE MEDICINE, 08/01/2020, Pagination inconnue

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Balancing medication use in nursing home residents with life-limiting disease

PAQUE, Kristel ; ELSEVIERS, Monique ; VANDER STICHELE, Robert ; PARDON, Koen ; VINKEROYE, Cinzia ; DELIENS, Luc ; CHRISTIAENS, Thierry ; DILLES, Tinne
European journal of clinical pharmacology, 07/2019, vol.75, n°7, p. 969-977

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