scholarly journals Estimation of need for palliative care among noncancer patients attending a tertiary care hospital

2017 ◽  
Vol 23 (4) ◽  
pp. 403 ◽  
Author(s):  
Parvathy Prasad ◽  
Sonali Sarkar ◽  
Biswajit Dubashi ◽  
S Adinarayanan
Keyword(s):  
Palliative Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals Impact of legalization of Medical Assistance in Dying on the Use of Palliative Sedation in a Tertiary Care Hospital: A Retrospective Chart Review

2021 ◽  
pp. 104990912110304
Author(s):  
Amy Nolen ◽  
Rawaa Olwi ◽  
Selby Debbie
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Palliative Sedation ◽  
Palliative Care Unit ◽  
Care Hospital ◽  
Medical Assistance ◽  
Medical Assistance In Dying ◽  
Before And After

Background: Patients approaching end of life may experience intractable symptoms managed with palliative sedation. The legalization of Medical Assistance in Dying (MAiD) in Canada in 2016 offers a new option for relief of intolerable suffering, and there is limited evidence examining how the use of palliative sedation has evolved with the introduction of MAiD. Objectives: To compare rates of palliative sedation at a tertiary care hospital before and after the legalization of MAiD. Methods: This study is a retrospective chart analysis of all deaths of patients followed by the palliative care consult team in acute care, or admitted to the palliative care unit. We compared the use of palliative sedation during 1-year periods before and after the legalization of MAiD, and screened charts for MAiD requests during the second time period. Results: 4.7% (n = 25) of patients who died in the palliative care unit pre-legalization of MAiD received palliative sedation compared to 14.6% (n = 82) post-MAiD, with no change in acute care. Post-MAiD, 4.1% of deaths were medically-assisted deaths in the palliative care unit (n = 23) and acute care (n = 14). For patients who requested MAiD but instead received palliative sedation, the primary reason was loss of decisional capacity to consent for MAiD. Conclusion: We believe that the mainstream presence of MAiD has resulted in an increased recognition of MAiD and palliative sedation as distinct entities, and rates of palliative sedation increased post-MAiD due to greater awareness about patient choice and increased comfort with end-of-life options.

Referral timing of in-hospital cancer deaths to palliative care in a Saudi tertiary care hospital

2010 ◽  
Vol 18 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Samy A. Alsirafy ◽  
Mahmoud Y. Sroor ◽  
Mohammad Z. Al-Shahri
Keyword(s):  
Palliative Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

Experience with palliative care in patients with advanced cancer at a tertiary care hospital in a developing country

2010 ◽  
Vol 19 (4) ◽  
pp. 573-575 ◽  
Author(s):  
Marwan Ghosn ◽  
Céline Boutros ◽  
Salma Geara ◽  
Joseph Kattan ◽  
Fadi Nasr ◽  
...  
Keyword(s):  
Palliative Care ◽  
Developing Country ◽  
Advanced Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

Pattern of Cancer Deaths in a Saudi Tertiary Care Hospital

2012 ◽  
Vol 30 (1) ◽  
pp. 21-24 ◽  
Author(s):  
Abdullah S. Al-Zahrani ◽  
Amr T. El-Kashif ◽  
Rasha M. Haggag ◽  
Samy A. Alsirafy
Keyword(s):  
Palliative Care ◽  
Emergency Room ◽  
End Of Life ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Care Program ◽  
Care Hospital ◽  
Incurable Cancer ◽  
Palliative Intent

The medical records of deceased patients were reviewed to describe the pattern of cancer deaths in a newly established Saudi tertiary care hospital. During eleven months, 87 patients died of cancer. The majority (80 patients, 92%) died of incurable cancer; among which 53% did not receive any systemic anti-cancer therapy (SAT) and 43% received SAT with palliative intent. Younger age (< 65 years), relatively chemosensitive tumours and initial presentation in a potentially curable stage were associated with higher prevalence of palliative SAT administration (p = 0.009, 0.019 and 0.001, respectively). The last palliative SAT was administered during the last two months of life in 66% and during the last two weeks in 14%. During the last admission, 54% of patients were admitted through emergency room, 50% stayed >14 days and 14% died in intensive care unit or emergency room. The results demonstrate that palliative care is a realistic treatment for the majority of patients in our setting and that a significant proportion of these patients receive aggressive care at the end-of-life. There is a need to establish an integrative palliative care program to improve the quality-of-life of dying cancer patients in our region and to minimize the aggressiveness of end-of-life care.

Conformity in Prescription and Administration of Respiratory Distress Protocols in a Tertiary Care Hospital in the Province of Quebec: RELIEVE Study

2019 ◽  
Vol 35 (1) ◽  
pp. 21-28
Author(s):  
Camille Dufort-Rouleau ◽  
Benjamin Martin ◽  
Vincent Barré ◽  
Véronique Bédard ◽  
Émilie Dufort Rouleau ◽  
...  
Keyword(s):  
Palliative Care ◽  
Respiratory Distress ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Adult Patients ◽  
Care Hospital ◽  
Trial Period ◽  
Appropriateness Criteria ◽  
Provider Training

Background: Respiratory distress protocols (RDPs) are protocolized prescriptions comprised of 3 medications (a benzodiazepine, an opioid, and an anticholinergic) administered simultaneously as an emergency treatment for respiratory distress in palliative care patients in the province of Quebec, Canada. However, data on appropriate use that justifies the combination of all 3 components is scarce and based on individual pharmacodynamic properties along with expert consensus. Objectives: Our study aimed to evaluate the conformity and the effectiveness of RDPs prescribed and administered to hospitalized adult patients. Methods: This was a prospective and descriptive study conducted in a single center. Prescription and administration conformity were assessed based on predefined appropriateness criteria. Results: A total of 467 adult patients were prescribed a RDP, 175 administrations were documented, and 78 patients received at least 1 RDP. Prescription conformity was assessed on 1473 separate occasions over the trial period. Overall prescription conformity was found to be 37% (95% confidence interval [CI]: 33.6-40.4), and administration conformity was 37.7% (95% CI: 26.2-50.7). Low administration conformity was primarily explained by incorrect indications for RDP use. Seemingly important determinants of higher conformity were prescriber’s speciality in palliative care, use of preprinted orders, pharmacist involvement, and hospitalization in the palliative care unit. Conclusion: This study highlights important gaps in the use of RDPs in our institution. Health-care provider training appears necessary in order to ensure adequate conformity and allow for further evaluation of RDP effectiveness.

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