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Context: Use of palliative care interventions in chronic obstructive pulmonary disease (COPD) has increased in recent years and inclusion criteria used to identify patients with COPD appropriate for palliative care vary widely. We evaluated the inclusion criteria to identify ways to improve enrollment opportunities for patients with COPD.
Objectives: To determine inclusion criteria used to select patients with COPD for palliative care trials.
Methods: A systematic review was conducted to determine criteria used to select patients with COPD for palliative care randomized controlled trials. A narrative synthesis was conducted for all trials.
Results: Inclusion criteria were highly heterogeneous. Most studies (n = 11, 79%) used a combination of criteria to identify patients with COPD. Commonly used criteria included hospitalization for an acute exacerbation of COPD (n = 8, 57%), home supplemental oxygen use (n = 8, 57%), and spirometry values confirming COPD (n = 6, 43%). Three studies (21.4%) used Modified Medical Research Council score and two studies (21%) used physician prognosis or a performance scale.
Conclusion: The most common criteria, a hospitalization for acute exacerbation of COPD or supplemental oxygen use at home, both have the benefit of selecting patients who have a higher symptom burden or higher healthcare utilization who might therefore benefit more from palliative care. By describing the landscape and variability of previously used inclusion criteria, this article serves as a resource for clinicians and researchers. Developing a consistent set of inclusion criteria in the future would help generate generalizable results that can be translated into clinical practice to improve the lives of patients with COPD.
Prospero Registration Number: CRD42022306752.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11088983 | PMC |
http://dx.doi.org/10.1016/j.jpainsymman.2024.01.028 | DOI Listing |
Cureus
November 2024
Internal Medicine - Medicina 2, Unidade Local de Saúde do Alto Minho - Hospital Conde de Bertiandos, Ponte de Lima, PRT.
Effective communication is crucial in multidisciplinary teams (MDTs) within palliative care, where patient needs can be complex and multifaceted. This article examines the significance of communication in promoting collaborative, patient-centered care while addressing challenges such as professional jargon, hierarchical barriers, and the emotional strain associated with end-of-life care. Leadership plays a vital role in creating an environment of open dialogue, reducing hierarchical dynamics, facilitating conflict resolution, and supporting the emotional well-being of team members.
View Article and Find Full Text PDFCureus
November 2024
Department of Traditional Medicine, Toho University, Tokyo, JPN.
Fibromyalgia (FM) is a common chronic pain with no established treatment. Acupuncture is an expected treatment for FM though a diagnosis of FM tends to be delayed, and the advantage is still unclear in early-phase intervention with acupuncture treatment for FM. A 51-year-old woman with panic disorder presented with a four-month history of whole-body pain and was diagnosed with FM.
View Article and Find Full Text PDFJ Family Med Prim Care
November 2024
Global Institute of Public Health, Ananthapuri Hospitals and Research Institutes, Trivandrum, Kerala, India.
Dichotomies with respect to medical orientations and public health have been common in the past and even in the present probably orchestrated by the traditional versus modern medical concepts that became eternal arena for disquiet in the healing world of many countries. In public health, the so-called technology tradition was especially dominant which assumed the power of technology and the paternalistic 'managerial mode' regarding disease control programs. Such a 'managerial perversion' has demolished the positivity of primary health care as well as the social determinants framework.
View Article and Find Full Text PDFLancet Digit Health
January 2025
Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA. Electronic address:
Background: Palliative spine radiation therapy is prone to treatment at the wrong anatomic level. We developed a fully automated deep learning-based spine-targeting quality assurance system (DL-SpiQA) for detecting treatment at the wrong anatomic level. DL-SpiQA was evaluated based on retrospective testing of spine radiation therapy treatments and prospective clinical deployment.
View Article and Find Full Text PDFGan To Kagaku Ryoho
December 2024
Dept. of Palliative and Supportive Care, Institute of Medicine, University of Tsukuba.
Advance care planning(ACP)was officially incorporated into Japan's healthcare system in 2018 with the revision of the "Guidelines for the Decision-Making Process in End-of-Life Care"by the Ministry of Health, Labor and Welfare. This revision mandated that the government designated cancer hospitals and comprehensive community care wards establish systems for implementing ACP. Consequently, the implementation and promotion of ACP have become significant issues in the healthcare field.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!