OBJECTIVE: To identify, from the patient’s perspective, the major opportunities for improving BMS-754807 EOL care for patients hospitalized because of advanced HF.
METHODS: A cross-sectional survey of patient perspectives regarding EOL care was administered via interview of 106 hospitalized patients who bad advanced HF in five tertiary care centres across Canada. The Study compared which aspects of EOL care patients rated as ‘extremely important’ and their level of satisfaction with these aspects of EOL care to identify key opportunities for improvement of care.
RESULTS: The greatest opportunities for improvement in EOL care were reducing the emotional and physical burden on family, having an adequate plan of care following
discharge, effective symptom relief and opportunities for honest communication. The three most important issues ranked by patients were avoidance of life support if there was no hope for a meaningful recovery, communication of information by the doctor and avoidance Of burden for the family.
CONCLUSIONS: Advanced care planning that seamlessly bridges hospital and borne Must be standard care for patients who have advanced HE Components Must include coordination of care, caregiver
support, comprehensive symptom management, and effective communication regarding HF and EOL issues.”
“Objectives This study aimed to describe national utilization of psychotropic medications by adult cancer survivors in the USA and to estimate the extra use of psychotropic medications that is attributable to cancer survivorship.
Methods Prescription HDAC inhibitor selleck chemicals llc data for 20012006 from the Medical Expenditure Panel Survey (MEPS) were linked to the data identifying cancer survivors from the National Health Interview Survey, the MEPS sampling frame. The sample was limited
to adults 25 years of age and older. Propensity score matching was used to estimate the effects of cancer survivorship on utilization of psychotropic medications by comparing cancer survivors and other adults in MEPS. Utilization was measured as any use during a calendar year and the number of prescriptions purchased (including refills). Analyses were stratified by gender and age, distinguishing adults younger than 65 years from those 65 years and older.
Results Nineteen percent of cancer survivors under age 65 years and 16% of survivors age 65 years and older used psychotropic medications. Sixteen percent of younger survivors used antidepressants, 7% used antianxiety medications. For older survivors, utilization rates for these two drug types were 11% and 7%, respectively. The increase in any use attributable to cancer amounted to 45 percentage points for younger survivors (p<0.05) and 23 percentage points for older survivors (p<0.05), depending on gender.
Conclusion Increased use of psychotropic medications by cancer survivors, compared with other adults, suggests that survivorship presents ongoing psychological challenges. Copyright (c) 2011 John Wiley & Sons, Ltd.