Management of hiccups in palliative care patients
Treatment algorithm for persistent and intractable hiccups in palliative care patients. PPI, proton pump inhibitor. If intractable hiccups are caused by a central type of condition, baclofen (level II) is recommended as first-line treatment. It is the only drug that …
Opioids for breathlessness: a narrative review | BMJ Supportive ...
Chronic breathlessness is a disabling and distressing condition for which there is a growing evidence base for a range of interventions. Non-pharmacological interventions are the mainstay of management and should be optimised prior to use of opioid medication. Opioids are being implemented variably in practice for chronic breathlessness. This narrative review summarises the evidence defining ...
Medically assisted dying in Western Europe: legislation review – …
The field of ethics and end-of-life legislation (eg, euthanasia, physician-assisted suicide and medically assisted dying) is rapidly changing in Western Europe due to shifting cultural and religious values.1 Moreover, the COVID-19 pandemic has brought death and end-of-life questions to the fore, thereby fuelling the debate further.2 There is increasing support for the idea that patients should ...
Homepage | BMJ Supportive & Palliative Care
3 days ago — BMJ Supportive & Palliative Care is a Plan S compliant Transformative Journal.. BMJ Supportive & Palliative Care holds an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and ...
Impact of dementia on informal care: a systematic review of family ...
Introduction Caregivers play a major role in providing all the support and care in daily activities for their relatives with dementia. To fully describe the influence of dementia caregiving on family caregivers’ life, we conducted a systematic review including caregivers’ perceptions about the positive and negative aspects of caring and the expressed factors. Materials and methods We ...
Anticipatory syringe drivers: a step too far | BMJ Supportive ...
The recent Gosport War Memorial Hospital inquiry1 has increased UK patient, public and clinician awareness about syringe drivers for continuous subcutaneous delivery of opioids and other medications at the end of life.2 3 The inquiry found that at least 456 patients died where opioids had been prescribed and administered in unjustified doses, commonly via syringe drivers. In …
Palliative care in Creutzfeldt-Jakob disease: looking back, thinking ...
Creutzfeldt-Jakob disease (CJD) is a rare and fatal neurodegenerative disease for which there is no cure. However, it is difficult to diagnose and is unique in that it is both a genetic and transmissible disease. The disease is characterised by symptoms of a rapidly progressive dementia. Palliation is the only treatment and early diagnosis is an important aspect in relation to gaining speedy ...
Hydration and symptoms in the last days of life
Introduction. Most patients with a deteriorating chronic illness have a reduced oral intake at the end of life. This may be due to illness or treatment-related symptoms or complications, such as dysphagia, nausea or vomiting, generalised weakness and, in the last days of life, to a decreased level of consciousness or a loss of desire to drink.1 2 …
Opioids are being implemented variably in practice for chronic breathlessness. This narrative review summarises the evidence defining current opioids for breathlessness best practice and identifies remaining research gaps. There is level 1a evidence to support the use of opioids for breathlessness. The best evidence is for 10–30 mg daily de ...
Morphine for chronic breathlessness in COPD: improvement …
Methods Cross-sectional secondary analysis of the intervention arm of a randomised controlled trial. 45 patients with COPD and moderate-to-very severe chronic breathlessness despite optimal treatment received 20–30 mg oral sustained-release morphine daily for 4 weeks. Using binary logistic regression, the relationship between a clinically meaningful improvement in breathlessness (≥1 point ...