Primary Thromboprophylaxis in Individuals without Cancer Admitted to a Geriatric Palliative Care Unit

Gurau, A.J.; Berall, Anna; Karuza, Jurgis; Perri, Giulia

doi:10.1111/jgs.15197

Cited by 2 publications

(2 citation statements)

References 11 publications

(43 reference statements)

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“…This highlights the problem at hand; lack of awareness concerning the fact that nursing home residents cannot simply be compared to hospitalized patients in general. In two other studies, 14,15 questionnaires were sent out to geriatricians to survey the rate and duration of thromboprophylaxis in long‐term care patients, while two additional studies evaluated thromboprophylaxis prescription in hospice inpatients 16,17 . Unfortunately, none of these studies addressed the safety and efficacy of thromboprophylaxis Nevertheless, all these studies highlight the fact that thromboprophylaxis is deemed important in clinical practice even though evidence supporting its use is lacking.…”

Section: References Population (Sample Size) Study Type/design Age (Y...mentioning

confidence: 99%

“…In two other studies, 14,15 questionnaires were sent out to geriatricians to survey the rate and duration of thromboprophylaxis in long-term care patients, while two additional studies evaluated thromboprophylaxis prescription in hospice inpatients. 16,17 Unfortunately, none of these studies addressed the safety and efficacy of thromboprophylaxis Nevertheless, all these studies highlight the fact that thromboprophylaxis is deemed important in clinical practice even though evidence supporting its use is lacking. One prospective study in older post-acute care patients did address the efficacy of thromboprophylaxis as well as the lack of an applicable guideline in this specific population of hospitalized older patients.…”

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confidence: 99%

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A known unknown? Pharmacological prevention of venous thromboembolism in nursing home residents

Brüggemann

Alnima

Brouns

et al. 2021

J American Geriatrics Society

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Section: References Population (Sample Size) Study Type/design Age (Y...mentioning

confidence: 99%

mentioning

confidence: 99%

A known unknown? Pharmacological prevention of venous thromboembolism in nursing home residents

Brüggemann

Alnima

Brouns

et al. 2021

J American Geriatrics Society

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Duration of palliative care before death in international routine practice: a systematic review and meta-analysis

Jordan

Allsop

ElMokhallalati

et al. 2020

BMC Med

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Background Early provision of palliative care, at least 3–4 months before death, can improve patient quality of life and reduce burdensome treatments and financial costs. However, there is wide variation in the duration of palliative care received before death reported across the research literature. This study aims to determine the duration of time from initiation of palliative care to death for adults receiving palliative care across the international literature. Methods We conducted a systematic review and meta-analysis that was registered with PROSPERO (CRD42018094718). Six databases were searched for articles published between Jan 1, 2013, and Dec 31, 2018: MEDLINE, Embase, CINAHL, Global Health, Web of Science and The Cochrane Library, as well undertaking citation list searches. Following PRISMA guidelines, articles were screened using inclusion (any study design reporting duration from initiation to death in adults palliative care services) and exclusion (paediatric/non-English language studies, trials influencing the timing of palliative care) criteria. Quality appraisal was completed using Hawker’s criteria and the main outcome was the duration of palliative care (median/mean days from initiation to death). Results One hundred sixty-nine studies from 23 countries were included, involving 11,996,479 patients. Prior to death, the median duration from initiation of palliative care to death was 18.9 days (IQR 0.1), weighted by the number of participants. Significant differences between duration were found by disease type (15 days for cancer vs 6 days for non-cancer conditions), service type (19 days for specialist palliative care unit, 20 days for community/home care, and 6 days for general hospital ward) and development index of countries (18.91 days for very high development vs 34 days for all other levels of development). Forty-three per cent of studies were rated as ‘good’ quality. Limitations include a preponderance of data from high-income countries, with unclear implications for low- and middle-income countries. Conclusions Duration of palliative care is much shorter than the 3–4 months of input by a multidisciplinary team necessary in order for the full benefits of palliative care to be realised. Furthermore, the findings highlight inequity in access across patient, service and country characteristics. We welcome more consistent terminology and methodology in the assessment of duration of palliative care from all countries, alongside increased reporting from less-developed settings, to inform benchmarking, service evaluation and quality improvement.

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Primary Thromboprophylaxis in Individuals without Cancer Admitted to a Geriatric Palliative Care Unit

Abstract: VTE prophylaxis rates were similar in participants with and without cancer on a geriatric PCU. The rate was not significantly less for nonambulatory participants. Further research would help to better guide VTE prophylaxis decisions and minimize suffering at the end of life.

Cited by 2 publications

References 11 publications

A known unknown? Pharmacological prevention of venous thromboembolism in nursing home residents

A known unknown? Pharmacological prevention of venous thromboembolism in nursing home residents

Duration of palliative care before death in international routine practice: a systematic review and meta-analysis

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