The impact of and response to the COVID-19 pandemic on a hospital palliative care team.

London was at the forefront of the COVID-19 pandemic in the UK, with an exponential rise in hospital admissions from March 2020. This case study appraises the impact on and response of a hospital palliative care service based in a large inner-city teaching hospital. Referrals increased from a mean of 39 to 75 per week; deaths from 13 to 52 per week.

Symptoms and anxiety predict declining health-related quality of life in multiple myeloma: A prospective, multi-centre longitudinal study.

Background: Patients with multiple myeloma, an incurable haematological cancer, often receive palliative care only late in their trajectory. Criteria for early referral are lacking.

Aim: To identify which patients might benefit from early integration, by identifying trajectories of health-related quality of life and the determinants for declining or poor Health related quality of life .

The Myeloma Patient Outcome Scale is the first quality of life tool developed for clinical use and validated in patients with follicular lymphoma.

Objectives: The development of novel agents and an ageing population has led to an increasing number of patients with follicular lymphoma (FL) living longer with their disease. Health-related quality of life (HRQOL) is a priority for patients and should guide clinical decisions. The Myeloma Patient Outcome Scale (MyPOS), originally developed for myeloma, was validated in a cross-sectional survey recruiting 124 FL patients.

Prevalence of symptoms in patients with multiple myeloma: a systematic review and meta-analysis.

Objectives: Multiple myeloma (MM) is an incurable haematological disease. Due to novel agents, overall survival has improved in this group, yet there are no systematic reviews to understand the symptom profiles resulting from disease and treatment-related toxicities. We aimed to synthesise data on the prevalence of symptoms in patients with MM.

The impact of disease-related symptoms and palliative care concerns on health-related quality of life in multiple myeloma: a multi-centre study.

Background: Multiple myeloma, the second most common haematological cancer, remains incurable. Its incidence is rising due to population ageing. Despite the impact of the disease and its treatment, not much is known on who is most in need of supportive and palliative care.

Improving the assessment of quality of life in the clinical care of myeloma patients: the development and validation of the Myeloma Patient Outcome Scale (MyPOS).

Background: Multiple myeloma is an incurable cancer with a rising incidence globally. Less toxic treatments are increasingly available, so patients are living longer and treatment decisions are increasingly guided by QOL concerns. There is no QOL assessment tool designed specifically for use in the clinical care of people with myeloma.

Supporting patients with uncertain recovery: the use of the AMBER care bundle in an acute hospital.

Objectives: Patients who are deteriorating, with uncertain recovery and with a short prognosis often have complex needs. The AMBER care bundle systematically manages these patients by promoting consistent communication and care planning. To describe how the AMBER bundle is applied in a UK hospital.

Understanding what matters most to people with multiple myeloma: a qualitative study of views on quality of life.

Background: Multiple myeloma is an incurable haematological cancer that affects physical, psychological and social domains of quality of life (QOL). Treatment decisions are increasingly guided by QOL issues, creating a need to monitor QOL within clinical practice. The development of myeloma-specific QOL questionnaires has been limited by a paucity of research to fully characterise QOL in this group.

What issues matter most to people with multiple myeloma and how well are we measuring them? A systematic review of quality of life tools.

Introduction: Treatment advances in multiple myeloma have increased expected survival from months to years for some patients. Alongside improved survival emerges a need to better understand and measure health-related quality of life (HRQOL), both in research and clinical settings.

Objectives: (i) Identify HRQOL tools validated for use in myeloma; (ii) identify issues important to HRQOL from the point of view of patients with myeloma; (iii) describe the measurement properties of each HRQOL tool; (iv) evaluate the content validity of HRQOL tools in terms of their ability to capture all issues important to patients and (v) explore the suitability of each HRQOL tool for use in different settings.

Is short-term palliative care cost-effective in multiple sclerosis? A randomized phase II trial.

Context: Palliative care is being advocated for noncancer patients but needs evidence of effectiveness and cost-effectiveness.

Objective: We evaluated the cost-effectiveness of a new palliative care service for people with multiple sclerosis (MS).

Methods: We used a randomized fast-track Phase II controlled trial.

Symptoms in advanced renal disease: a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis.

Background: Numbers of patients with stage 5 chronic kidney disease (CKD) managed conservatively (without dialysis) are increasing steadily but prevalence and severity of symptoms in this population are not yet known.

Aim: To describe symptom prevalence, symptom severity, and total symptom burden in patients with stage 5 CKD managed conservatively.

Method: A cross-sectional survey of patients with stage 5 CKD managed conservatively, in three U.

The use of opioid analgesia in end-stage renal disease patients managed without dialysis: recommendations for practice.

The numbers of patients dying with end-stage renal disease (ESRD), particularly those managed conservatively (without dialysis) or withdrawing from dialysis is increasing rapidly in developed countries. There is growing awareness of the extensive symptom control needs of these patients. Pain is a common problem, and has been both under-recognized and under-treated.

Patient descriptions of breathlessness in heart failure.

Objective: To explore patient experience of breathlessness in heart failure.

Methods: Semi-structured interviews were undertaken with 27 patients with chronic heart failure and were analysed using a constant comparative approach.

Results: The patients had a mean age of 69 (range 38-94 years).

A qualitative study of chronic heart failure patients' understanding of their symptoms and drug therapy.

Objectives: To explore patients' understanding of their symptoms and the treatment of their heart failure.

Design: Qualitative analysis of in-depth interviews, using a constant comparative approach.

Subjects: 27 patients identified by Cardiology and Care of the Elderly physicians as having (a) symptomatic heart failure (New York Heart Association functional classes II, III and IV) and (b) a hospital admission for heart failure in the previous 20 months.