Subscribe
The following lists palliative care research primarily conducted by Australian research groups. The list is based on application of the CareSearch search filter for palliative care to identify articles held within the PubMed database and corresponding to the strongest evidence. Articles have been selected based on relevance and new articles are added on a weekly basis.
Whilst not an exhaustive list, the aim is to keep the community informed by providing a snapshot of recent research findings and planned studies in the Australian setting.
Disler APR, Pascoe DA, Chen DXE, Lawson E, Cahyadi M, Paalendra A, Hickson DH, Wright PJ, Phillips B, Subramaniam DS, Glenister DK, Philip PJ, Donesky PD, Smallwood APN.
Abstract
Introduction/aim: Despite clear benefit from palliative care in end-stage chronic diseases, access is often limited, and rural access largely undescribed. This study sought to determine if a palliative approach is provided to people with chronic disease in their terminal hospital admission.
Methods: Multisite, retrospective medical record audit, of decedents with a primary diagnosis of chronic lung, heart or renal failure, or multimorbidity of these conditions over 2019.
Results: Of 241 decedents, across five clinical sites, 143 (59.3%) were men, with mean age 80.47 years (SD 11.509), and diagnoses of chronic lung (n=56, 23.2%), heart (n=56, 23.2%), renal (n=24, 10.0%) or multimorbidity disease (n=105, 43.6%), and had 2.88 (3.04SD) admissions within 12 months. Outpatient chronic disease care was evident (n=171, 73.7%), however, contact with a private physician (n=91, 37.8%), chronic disease program (n=61, 25.3%), or specialist nurse (n=17, 7.1%) were less apparent. "Not-for-resuscitation" orders were common (n=139, 57.7%), however, advance care planning (n=71, 29.5%), preferred place of death (n=18, 7.9%), and spiritual support (n=18, 7.5%) were rarely documented. Referral to and input from palliative services were low (n=74, 30.7% and n=49, 20.3%), as was review of non-essential medications or blood tests (n=86, 35.7%, and n=78, 32.4%). Opioids were prescribed in 45.2% (n=109). Hospital site and diagnosis were significantly associated with outpatient care and palliative approach (p<0.001).
Conclusions: End-of-life planning and specialist palliative care involvement occurred infrequently for people with chronic disease who died in rural hospitals. Targeted strategies are necessary to improve care for these prevalent and high needs rural populations.
Copyright © 2024. Published by Elsevier Inc.
Worrell S, Hemer SR.
This paper explores the experiences of people who blog about their own terminal illness and dying through the lens of anticipatory grief. Anticipatory grief is a concept which is frequently applied to those people who will be bereaved by death, rather than those who are themselves dying. Ethnographic content analysis of terminal illness blogs of two Australian women clearly narrate experiences of loss and grief which can be understood through the frame of anticipatory grief. Yet they also document positive experiences of growth and connection which can be conceptualized as resilience rather than a demonstration of denial of death.
Haupt LM, Haywood A, Sutherland HG, Yu C, Albury CL, Pharasi A, Zunk M, George R, Griffiths LR, Good P, Hardy J.
Cancer pain is the most feared symptom at end of life. Methadone has advantages over other opioids but is associated with significant variability in clinical response, making dosing challenging in practice. OPRM1 is the most studied pharmacogene associated with the pharmacodynamics of opioids, however reports on the association of the A118G polymorphism on opioid dose requirements are conflicting, with no reports including methadone as the primary intervention. This association study on OPRM1 A118G and response to methadone for pain management, includes a review of this genetic factor's role in inter-patient variability. Fifty-four adult patients with advanced cancer were recruited in a prospective, multi-centre, open label dose individualization study. Patient characteristics were not shown to influence methadone response, and no significant associations were observed for methadone dose or pain score. The findings of our review of association studies for OPRM1 A118G in advanced cancer pain demonstrate the importance of taking ancestry into account. While our sample size was small, our results were consistent with European populations, but in contrast to studies in Chinese patients, where carriers of the A118G polymorphism were associated with higher opioid dose requirements. Pharmacogenetic studies in palliative care are challenging, continued contribution will support future genotype-based drug dosing guidelines.
© 2024. The Author(s).
Last updated 30 April 2024