Traitement prophylactique de la maladie thromboembolique veineuse en soins palliatifs

Duverger, Catherine; Tardy, Bernard; Richard, Anne; Célarier, Thomas; Bayle, S.; Cambou, Marie; Perrot, Jean; Cathébras, P.; Gonthier, R.; Etienne, Fédération de Soins Palliatifs de Saint

doi:10.1016/j.lpm.2008.11.021

Cited by 5 publications

(1 citation statement)

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“…This leads to this heterogeneity of medical practices according to the different clinical situations, whatever the medical specialty. This phenomenon was notably exposed in a 2009 study that looked at the differences in medical practices concerning the continuation (or not) of the prophylactic treatment of venous thromboembolic disease in palliative patients [ 26 ]. The absence of strictly documented recommendations leads to the rather random management of patients, depending on the practitioner.…”

Section: Discussionmentioning

confidence: 99%

Impact of Medical Specialties on Diagnostic and Therapeutic Management of Elderly Cancer Patients

et al. 2023

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The management (diagnostic and therapeutic) of cancer in the geriatric population involves a number of complex difficulties. The aim of this study was to assess the impact of a medical specialty on the diagnostic and therapeutic management of elderly cancer patients. Four clinical scenarios of cancer in the geriatric population, with a dedicated survey to gather information regarding each clinical case’s diagnostic and therapeutic approaches, as well as the different criteria influencing physicians’ therapeutic decisions, were exposed to geriatricians, oncologists, and radiotherapists in Saint-Etienne. The surveys were filled out by 13 geriatricians, 11 oncologists, and 7 radiotherapists. There was a homogeneity of responses regarding the confirmation of cancer diagnostics in the elderly. There were strong disparities (inter- and intra-specialties) for several clinical situations regarding the therapeutic management of cancer. There were significant disparities in terms of surgical management, the implementation of a chemotherapy protocol, and the adaptation of the chemotherapy dosage. Contrary to oncologists, who primarily consider the G8 and the Karnofsky score, geriatric autonomy scores and frailty with cognitive assessment were the key factors determining diagnostic/therapeutic therapy for geriatricians. These results raise important ethical questions, requiring specific studies in geriatric populations to provide the homogenous management of elderly patients with cancer.

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Section: Discussionmentioning

confidence: 99%