Publications by authors named "Frank P Brennan"
Article Synopsis
- Integrated kidney care connects preventative measures for chronic kidney disease with health services for those already affected, focusing on smooth transitions between different stages of the disease and treatment options.
- Supportive care is crucial for individuals with kidney failure, yet it is often lacking or poorly integrated, particularly in low- and middle-income countries where resources are limited.
- The International Society of Nephrology has developed consensus definitions and guidelines to improve the understanding and implementation of conservative kidney management and supportive care in these under-resourced settings.
Background: For patients with motor neuron disease (MND), the final 12 months of life can be a tumultuous period, with rapid and significant losses in function and independence, regular contact with the health system and carer stress.
Objective: The aim of this article is to provide an outline of the challenges encountered during the last 12 months of life and the role of the specialised multidisciplinary team in managing the challenges that may arise.
Discussion: While MND remains rare overall, it is likely that most general practitioners (GPs) will encounter at least one patient with MND during their career.
Article Synopsis
- Chronic kidney disease (CKD) is becoming more common in Australia's older population, with a growing understanding that dialysis may not always be beneficial for elderly patients with other serious health issues.
- The article aims to highlight important considerations in caring for patients with end-stage kidney disease (ESKD), including symptom management, advance care planning, and end-of-life care.
- It emphasizes the crucial role of general practitioners (GPs) in the early management of CKD to improve patient outcomes.
Cancer Rehabilitation and Palliative Care-Exploring the Synergies.
J Pain Symptom Manage
December 2020
With perpetual research, management refinement, and increasing survivorship, cancer care is steadily evolving into a chronic disease model. Rehabilitation physicians are quite accustomed to managing chronic conditions, yet, cancer rehabilitation remains unexplored. Palliative care physicians, along with rehabilitationists, are true generalists, who focus on the whole patient and their social context, in addition to the diseased organ system.
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- * Researchers analyzed data from 298 ESKD patients, finding that 38% experienced taste changes, which were linked to gastrointestinal symptoms like nausea and anorexia.
- * The results suggest that taste changes are prevalent in ESKD patients and may contribute to malnutrition, highlighting the need for further research on effective management strategies.
Article Synopsis
- Patients with end-stage kidney disease often experience a heavy symptom burden, which can negatively affect their quality of life and survival; however, renal supportive care (RSC) has shown effectiveness in managing symptoms for those not on dialysis.
- This study aimed to evaluate the effects of RSC on symptom management in dialysis patients, following 127 individuals referred to an RSC clinic over a span of several years.
- Results indicated a significant improvement in physical and emotional symptoms after RSC intervention, with the most severe symptoms (like difficulty sleeping and pain) showing the greatest improvement, sustained even after long-term follow-up without altering dialysis treatments.
Background: Motor neurone disease (MND) is the term for a group of progressive, debilitating, neurodegenerative disorders that affect various aspects of a patient's life, including speech, swallowing, breathing and limb function.
Objective: This review outlines the common symptoms and issues in MND and the latest available treatment options. A multidisciplinary approach to MND, involving the general practitioner (GP) and rehabilitation, palliative care and allied health services, is discussed.
Aim: To explore the quality of deaths in an acute hospital under a nephrology service at two teaching hospitals in Sydney with renal supportive care services over time.
Methods: Retrospective chart review of all deaths in the years 2004, 2009 and 2014 at St George Hospital (SGH) and in 2014 at the Concord Repatriation General Hospital. Domains assessed were recognition of dying, invasive interventions, symptom assessment, anticipatory prescribing, documentation of spiritual needs and bereavement information for families.
A doctor has a legal duty to secure the informed consent of a patient prior to performing a medical or surgical procedure. The elements of the legal doctrine of informed consent include capacity, voluntariness and the provision and understanding of relevant information. This article examines the doctrine in the context of renal dialysis.
View Article and Find Full Text PDFRenal Supportive Care is an alternative treatment pathway in advanced chronic kidney disease that is being increasingly adopted, particularly in the elderly. Renal Supportive Care uses principles of palliative care and has been developed to enhance the care for dialysis patients with a high symptom burden and those being managed on a non-dialysis pathway. Nutrition management is often an under-recognized component of care and can play an important role in improving patients' quality of life to reduce symptom burden, support physical function and independence and provide appropriate counselling to patients and their families to ensure the goals of Renal Supportive Care are met.
View Article and Find Full Text PDFBackground And Objectives: Survival, symptom burden, and quality of life (QOL) are uncertain for elderly patients with advanced CKD managed without dialysis. We examined these outcomes in patients managed with renal supportive care without dialysis (RSC-NFD) and those planned for or commencing dialysis.
Design, Setting, Participants, & Measurements: In this prospective observational study, symptoms were measured using the Memorial Symptom Assessment Scale and the Palliative care Outcomes Scale - Symptoms (renal) inventory and QOL was measured using the Short Form-36 survey.