A longitudinal study of pain in hospice and pre-hospice patients

Owens, Michael R.; Simmons, B Brent; Gibson, Pamela; Weeks, Dorothy

doi:10.1177/104990910101800211

Cited by 11 publications

(12 citation statements)

References 21 publications

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“…The prevalence of pain is high in all medical departments, varying from 40% to 90% according to different studies [1][2][3][4][5][6][7][8][9]. The management of pain in hospitalized patients remains a top priority for public hospital policy.…”

Section: Introductionmentioning

confidence: 99%

Determinants of patient satisfaction regarding pain care

Bourdillon¹,

Montcel²,

Collin³

et al. 2012

Revue d'Épidémiologie et de Santé Publique

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Section: Introductionmentioning

confidence: 99%

Determinants of patient satisfaction regarding pain care

Bourdillon¹,

Montcel²,

Collin³

et al. 2012

Revue d'Épidémiologie et de Santé Publique

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“…Prior studies of distressing symptoms at the end of life have focused on specific subgroups, such as patients with cancer, 17 have lacked data on hospice, 18 have not had access to detailed longitudinal data prior to hospice, 19 or have focused on only a single symptom such as pain. 20 In an earlier study, 10 we used a longitudinal cohort design to study symptom burden in the last year of life. To our knowledge, comparable longitudinal data do not exist for patients before and after admission to hospice.…”

mentioning

confidence: 99%

Restricting Symptoms Before and After Admission to Hospice

Cheraghlou

Gahbauer

Stabenau

et al. 2016

The American Journal of Medicine

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Background Prior work has shown that symptoms leading to restrictions in daily activities are common at the end of life. Hospice is a Medicare benefit designed to alleviate distressing symptoms in the last 6 months of life. The effect of hospice on the burden of such symptoms is uncertain. Methods From an ongoing cohort study of 754 community-dwelling older persons, aged 70 years or older, we evaluated 241 participants who were admitted to hospice from March 1998 to December 2013. A set of 15 physical and psychological symptoms leading to restricted activity (i.e. cut down on usual activities or spend at least ½ day in bed) were ascertained during monthly telephone interviews in the year before and three months after hospice admission. Results The prevalence and mean number of restricting symptoms increased progressively until about 2 months prior to hospice admission, before increasing precipitously to a peak around the time of hospice admission. After the start of hospice, both the prevalence and the mean number of restricting symptoms dropped markedly. For several symptoms deemed most amenable to hospice treatment, including depression and anxiety, the prevalence dropped to levels comparable to or lower than those observed 12 months before the start of hospice. The trends observed in symptom prevalence and mean number of symptoms before and after hospice did not differ appreciably according to hospice admission diagnosis or sex. The median duration of hospice (before death) was only 15 days. Conclusion The burden of restricting symptoms increases progressively several months before the start of hospice, peaks around the time of hospice admission, and decreases substantially after the start of hospice. These results, coupled with the short duration of hospice, suggest that earlier referral to hospice may help to alleviate the burden of distressing symptoms at the end-of-life.

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“…2 Studies that have observed patients longitudinally have focused on select clinical populations, such as seriously ill, hospitalized patients, 3 patients with cancer, 4 or those in hospice. 5 Relatively little is known, however, about the evolution of symptom occurrence in the final months of life among a diverse group of older persons. This information could be used to help guide efforts to improve end-of-life care.…”

mentioning

confidence: 99%