Update in hospital palliative care

J Hosp Med. 2013 Dec;8(12):715-20. doi: 10.1002/jhm.2110. Epub 2013 Nov 8.

Abstract

Background: Seriously ill patients frequently receive care in hospitals, and palliative care is a core competency for hospitalists. We aimed to summarize and critique recent research that has the potential to impact the clinical practice of palliative care in the hospital.

Methods: We reviewed articles published between January 2012 and May 2013, identified through a hand-search of leading journals and PubMed. The authors collectively selected 9 articles based on their scientific rigor and relevance to hospital practice. We review their findings, strengths, and limitations and make recommendations for practice.

Results: Key findings include: indwelling pleural catheters and talc pleurodesis provide similar relief of dyspnea in patients with malignant pleural effusions; oxygen many not be needed to prevent dyspnea in many dying patients; docusate may not be needed in addition to sennosides to treat opioid-induced constipation; atropine is no more effective than placebo in treating respiratory rattles in dying patients; many older adult survivors of in-hospital cardiopulmonary resuscitation (CPR) are alive up to 1 year after discharge; observing CPR may decrease family post-traumatic stress; surrogates of intensive care unit patients often interpret prognostic information optimistically; many patients with metastatic cancer feel that chemotherapy may cure their disease; viewing a goals-of-care video may decrease preference for CPR in patients being admitted to skilled nursing facilities.

Conclusions: Recent research provides important insights into the effectiveness of medications and interventions for symptom management, outcomes of CPR for patients and families, and Journal of Hospital Medicine 2013;8:715-720. © 2013 Society of Hospital Medicine.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiopulmonary Resuscitation / mortality
  • Cardiopulmonary Resuscitation / trends
  • Critical Illness / mortality*
  • Critical Illness / therapy*
  • Hospitalization* / trends
  • Humans
  • Palliative Care / methods*
  • Palliative Care / trends
  • Randomized Controlled Trials as Topic / methods
  • Randomized Controlled Trials as Topic / trends