Interventions and symptom relief in hospital palliative cancer care: results from a prospective longitudinal study

Thronæs, Morten; Løhre, Erik Torbjørn; Kvikstad, Anne; Brenne, Elisabeth; Norvaag, Robin; Aalberg, Kathrine Otelie; Moen, Martine Kjølberg; Jakobsen, Gunnhild; Klepstad, Pål; Solberg, Arne; Solheim, Tora Skeidsvoll

doi:10.1007/s00520-021-06248-z

Cited by 8 publications

(22 citation statements)

References 39 publications

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“…Eight studies were conducted on adult patients. One study investigated the prevalence of IV rehydration in patients with incurable cancer [ 34 ]; two studies investigated patients with fever and other signs of dengue [ 35 , 36 ]; one study investigated patients admitted to the cholera isolation ward [ 37 ]; one study investigated patients who had single substance ingestion of modafinil [ 38 ]; one study investigated patients with diarrhoea [ 39 ]; one study investigated patients with hypercalcemia [ 40 ]; and one study investigated patients with postural tachycardia syndrome [ 41 ].…”

Section: Resultsmentioning

confidence: 99%

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The Prevalence and Indications of Intravenous Rehydration Therapy in Hospital Settings: A Systematic Review

et al. 2022

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(1) Objective: We performed a systematic review to explore the prevalence of intravenous (IV) rehydration therapy in hospital settings, and we assessed it by patient groups and populations. (2) Methods: A systematic review of major databases and grey literature was undertaken from inception to 28 March 2022. Studies reporting prevalence of IV rehydration therapy in a hospital setting were identified. The data were synthesised in a narrative approach. (3) Results: Overall, 29 papers met the inclusion criteria. The prevalence of IV rehydration therapy in paediatric patients ranged from 4.5% (hospitalised with diarrhoea and dehydration) to 100% (admitted to the emergency department with mild to moderate dehydration caused by viral gastroenteritis), and in adults this ranged from 1.5% (had single substance ingestion of modafinil) to 100% (hospitalised with hypercalcemia). The most common indication for IV rehydration therapy in paediatric patients was dehydration due to fluid loss from the gastrointestinal tract. Other causes included malnutrition, neuromuscular disease, bronchiolitis, and influenza. In adults, indications for IV rehydration therapy were much more diverse: fever, diarrhoea, drug intoxication, hypercalcemia, cancer, and postural tachycardia syndrome; (4) Conclusions: This systematic review showed that IV rehydration therapy in paediatric patients is often used to treat dehydration and diarrhoea, while in adults it has a broader spectrum of use. While IV rehydration therapy is important in correcting fluid problems and electrolyte status, the maintenance fluid prescribing practices vary considerably, and guidelines are scarce.

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Section: Resultsmentioning

confidence: 99%

“…The prevalence was 51%. One study [ 34 ] reported the prevalence of IV rehydration in patients with incurable cancer. The prevalence was 45%.…”

Section: Resultsmentioning

confidence: 99%

The Prevalence and Indications of Intravenous Rehydration Therapy in Hospital Settings: A Systematic Review

et al. 2022

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“…The current paper is a retrospective secondary analysis of a previously published study on the delivery of palliative care [ 19 ]. In the present analysis, we identified all acute hospitalizations of patients with a clinically-based diagnosis of infection who received intravenous antibiotics at admission.…”

Section: Methodsmentioning

confidence: 99%

“…The design of the data collection is described elsewhere [ 19 ]. The patients reported symptom scores on the 11-point numeric rating scale (NRS 0-10) [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

“…The infection was considered as serious if in need of intravenous antibiotics. Reviews of the medical records identified antibiotic treatment and duration, suspected sources of infection, physiological variables as assessed by the national early warning score (NEWS) [ 24 ], clinical chemistry tests (C-reactive protein (CRP), leucocytes and neutrophiles), blood and other cultures, hospital length of stay (LOS), and survival [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

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Antibiotic Therapy in Integrated Oncology and Palliative Cancer Care: An Observational Study

Moen

Løhre

Jakobsen

et al. 2022

Cancers

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Decision-making for antibiotic therapy in palliative cancer care implies avoiding futile interventions and to identify patients who benefit from treatment. We evaluated patient-reported outcome-measures (PROMs), physiological findings, and survival in palliative cancer care patients hospitalized with an infection. All acute admissions during one year, directly to a University Hospital unit that provided integrated services, were included. Serious infection was defined as a need to start intravenous antibiotics. PROMs, clinical and paraclinical variables, and survival were obtained. Sixty-two of 257 patients received intravenous antibiotic treatment. PROMs were generally similar in the infection group and the non-infection group, both in respect to intensities at admission and improvements during the stay. There were more physiological and paraclinical deviations at admission in patients in the infection group. These deviations improved during the stay. Survival was not poorer in the infection group compared to the non-infection group. Patients in integrated cancer care were as likely to be put on intravenous antibiotics but had longer survival. In integrated oncology and palliative cancer services, patients with an infection had similar outcomes as those without an infection. This argues that the use of intravenous antibiotics is appropriate in many patients admitted to palliative care.

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Pharmacological treatment of cancer pain and opioid induced nausea and vomiting: online survey and comparison with current guidelines

Gaertner,

Boehlke,

Kreye

et al. 2024

Support Care Cancer

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Purpose We assumed that in Palliative Care, even in common clinical situations, the choice of drugs differs substantially between physicians. Therefore, we assessed the practice of pharmaceutical treatment choices of physicians for cancer pain and opioid-induced nausea and vomiting (OINV) and the rationale for their choices. Methods An online survey was conducted with physicians covering the following domains: i) Cancer pain therapy: non-opioids in addition to opioids: choice of drug ii) prevention of OINV: choice of drug and mode of application. Current guidelines concerning cancer pain therapy and prevention of OINV were compared. Results Two-hundred-forty European physicians responded to our survey. i) Use of non-opioids in addition to opioids for the treatment of cancer pain: Only 1.3% (n = 3) of respondents never used an additional non-opioid. Others mostly used: dipyrone/metamizole (49.2%, n = 118), paracetamol/acetaminophen (34.2%, n = 82), ibuprofen / other NSAIDs (11.3%, n = 27), specific Cox2-inhibitors (2.1%, n = 5), Aspirin (0.4%, n = 1), no answer (2.9%, n = 7). ii) Antiemetics to prevent OINV: The drugs of choice were metoclopramide (58.3%, n = 140), haloperidol (26.3%, n = 63), 5-HT3 antagonists (9.6%, n = 23), antihistamines (1.3%, n = 3) and other (2.9%, n = 7); no answer (1.7%, n = 4). Most respondents prescribed the substances on-demand (59.6%, n = 143) while others (36.3%, n = 87) provided them as around the clock medication. Over both domains, most physicians answered that their choices were not based on solid evidence from randomized controlled trials (RCTs). Guidelines were inconsistent regarding if and what non-opioid to use for cancer pain and recommend anti-dopaminergic drugs for prevention or treatment of OINV. Conclusions Physician’s practice in palliative care for the treatment of cancer pain and OINV differed substantially. Respondents expressed the lack of high-quality evidence- based information from RCTs. We call for evidence from methodologically high-quality RCTs to be available to inform physicians about the benefits and harms of pharmacological treatments for common symptoms in palliative care.

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Interventions and symptom relief in hospital palliative cancer care: results from a prospective longitudinal study

Cited by 8 publications

References 39 publications

The Prevalence and Indications of Intravenous Rehydration Therapy in Hospital Settings: A Systematic Review

The Prevalence and Indications of Intravenous Rehydration Therapy in Hospital Settings: A Systematic Review

Antibiotic Therapy in Integrated Oncology and Palliative Cancer Care: An Observational Study

Pharmacological treatment of cancer pain and opioid induced nausea and vomiting: online survey and comparison with current guidelines

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