Role of Early Palliative Care Interventions in Hematological Malignancies and Bone Marrow Transplant Patients: Barriers and Potential Solutions

Ruiz, Marco; Reynolds, Patrick; Marranzini, Regina; Khan, Alina; Ketterer, J.; Brahim, Amanda

doi:10.1177/1049909118772849

Cited by 20 publications

(21 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pain, nausea, anorexia, and constipation had comparable prevalences in both groups [5,6,7]. Some studies also suggest that psychological, spiritual, and emotional concerns may not be properly and comprehensively addressed and quality of life may be decreased in patients with HM [8]. …”

Section: Problems and Needs Of Patients With Advanced Hematological Mmentioning

confidence: 99%

“…Most hematological treatments either have curative intent or aim to prolong survival for many years or decades, but treatment outcomes have often dual potential for rapid clinical decline and ultimate improvement [8,9]. Therefore, prolongation of life usually represents the primary treatment focus during the main time of hematological treatment - even in patients with potentially life-threating illness due to refractory disease or complications.…”

Section: Problems and Needs Of Patients With Advanced Hematological Mmentioning

confidence: 99%

“…Patients with HM represent a heterogeneous group including patients with both very aggressive as well as rather smoldering diseases, resulting in very different disease trajectories and survival prognosis [8,9]. Most hematological treatments either have curative intent or aim to prolong survival for many years or decades, but treatment outcomes have often dual potential for rapid clinical decline and ultimate improvement [8,9].…”

Section: Problems and Needs Of Patients With Advanced Hematological Mmentioning

confidence: 99%

See 2 more Smart Citations

Palliative Care in Patients with Hematological Malignancies

Oechsle¹

2018

Oncol Res Treat

View full text Add to dashboard Cite

Patients with hematologic malignancies (HM) nowadays rarely receive palliative or hospice care, and studies on potential effects of integrated palliative care are rare. This narrative review provides a comprehensive overview on their current end-of-life care, first data on integrated specialist palliative care (SPC) and potential barriers. Symptom burden and distress in patients with HM seem to be comparable to other cancer patients, but their performance status and specific symptoms are even worse. Prolongation of life usually remains the main focus until the last days or weeks of life. Their chance to die in hospital is twice as high, but their chance to receive specialist palliative or hospice care is only half of that of other cancer patients. Prospective studies indicate a high acceptability and positive effects of integrated SPC, e.g. clarification of treatment goals, stabilization of quality of life, decreased depression, anxiety, symptom burden, and post-traumatic stress disorders. Interdisciplinary cooperation, timely discussions about SPC referral, and indicators to ‘flag' patients in need for SPC are important, but they are largely missing. In conclusion, further studies have to evaluate factors identifying patients with HM in need for SPC. Further models of early integrated palliative care should be evaluated in prospective studies and established in daily clinical practice.

show abstract

Section: Problems and Needs Of Patients With Advanced Hematological Mmentioning

confidence: 99%

Section: Problems and Needs Of Patients With Advanced Hematological Mmentioning

confidence: 99%

Section: Problems and Needs Of Patients With Advanced Hematological Mmentioning

confidence: 99%

See 1 more Smart Citation

Palliative Care in Patients with Hematological Malignancies

Oechsle¹

2018

Oncol Res Treat

View full text Add to dashboard Cite

show abstract

“…The study also showed that patients admitted for stem cell transplants endorsed an increase in post-transplant depression from 15.6% at baseline to 37.8% eight days post-treatment [17]. In addition, it has been reported that BMT patients usually receive the most intensive treatments during their last 30 days of life [24]. Therefore, there is even more need for early PC interventions in these populations.…”

Section: Reviewmentioning

confidence: 79%

Revisiting Early Palliative Care for Patients With Hematologic Malignancies and Bone Marrow Transplant: Why the Delay?

Sánchez¹,

Armesto²,

Chavez³

et al. 2020

Cureus

Self Cite

View full text Add to dashboard Cite

Palliative care has been defined as specialized care for patients facing serious illnesses. Despite advancements in the field and studies documenting the effectiveness of early palliative care (PC) interventions in seriously ill patients, the fields of hematologic malignancies and bone marrow transplant still lag behind of a comprehensive framework for early and effective interventions. The aim of this literature review is to analyze and discuss the possible barriers to care and delayed referrals for hematologic malignancies and bone marrow transplant patients. Using the EBSCO and PubMed databases, articles regarding PC among patients with hematologic malignancies and bone marrow transplant were analyzed. There are three main domains with its respective barriers in PC: physicians, patients and caregivers, and the healthcare system. Issues that were identified included the lack of knowledge and misconceptions about PC among physicians, patients, and caregivers, delayed referral of patients with hematologic malignancies, unrealistic treatment expectations, lack of communication between specialties, difficulties with appointment availability, geographical distance between clinics, and lack of insurance coverage for PC services. We suggest possible alternatives including obligatory continuing medical education (CME) credits, loan forgiveness, rotations during residency and fellowship training, use of informational videos and pamphlets to educate patients and caregivers, obligatory early consults despite prognosis, an algorithm to evaluate patient's needs, creating a platform within electronic medical records (EMR) systems shared by specialties, and having PC service in every cancer center. Findings suggest a need for further studies aimed towards implementing solutions to increase the early referral of patients with hematologic malignancies and bone marrow transplantation (BMT) to palliative care.

show abstract

“…Nausea and vomiting are expected side effects of AHSCT and significantly impair patient quality of life (Ruiz et al., 2018). Transplant centres usually have scalable protocols to manage transplant‐associated gastrointestinal adverse events.…”

Section: Discussionmentioning

confidence: 99%

Nursing interventions in autologous stem cell transplantation for autoimmune diseases

Nilsen

Santos

Leopoldo

et al. 2020

Journal of Advanced Nursing

View full text Add to dashboard Cite

Aims To identify clinical symptoms and nursing interventions for stem cell therapy in autoimmune diseases. Design This is a retrospective, cross‐sectional study. Methods This study was undertaken with patients diagnosed with type 1 diabetes or multiple sclerosis, undergoing autologous haematopoietic stem cell transplantation from January 2004 ‐ December 2018. Data were registered in a questionnaire, taken during the conditioning regimen comprising cyclophosphamide and rabbit anti‐thymocyte globulin. Descriptive statistics and Fisher's exact test were used for data analysis. Results There were 68 and 23 patients in the multiple sclerosis and type 1 diabetes groups respectively. Skin rash, nausea, vomiting and fever were more frequent and diverse in the type 1 diabetes group. Steroids were used as prophylaxis for anti‐thymocyte globulin‐associated allergic reactions in 97% of multiple sclerosis patients. Most of the identified symptoms and nursing interventions were more associated with one or other disease group (p < .05) and were more frequent in the type 1 diabetes group. Conclusion Patients with autoimmune diseases who underwent stem cell therapy present differences in their repertoire of adverse events and require disease‐specific nursing actions. Impact Our results may enable nurses to establish transplant and disease‐specific guidelines to improve prevention and management of adverse events and therefore optimize patient care and therapeutic success.

show abstract

Role of Early Palliative Care Interventions in Hematological Malignancies and Bone Marrow Transplant Patients: Barriers and Potential Solutions

Cited by 20 publications

References 34 publications

Palliative Care in Patients with Hematological Malignancies

Palliative Care in Patients with Hematological Malignancies

Revisiting Early Palliative Care for Patients With Hematologic Malignancies and Bone Marrow Transplant: Why the Delay?

Nursing interventions in autologous stem cell transplantation for autoimmune diseases

Contact Info

Product

Resources

About