Palliative care and neurology
Identifieur interne : 000B90 ( Pmc/Curation ); précédent : 000B89; suivant : 000B91Palliative care and neurology
Auteurs : Isabel Boersma ; Janis Miyasaki ; Jean Kutner ; Benzi KlugerSource :
- Neurology [ 0028-3878 ] ; 2014.
Abstract
Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research.
Url:
DOI: 10.1212/WNL.0000000000000674
PubMed: 24991027
PubMed Central: 4142002
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Palliative care and neurology</title><author><name sortKey="Boersma, Isabel" sort="Boersma, Isabel" uniqKey="Boersma I" first="Isabel" last="Boersma">Isabel Boersma</name></author><author><name sortKey="Miyasaki, Janis" sort="Miyasaki, Janis" uniqKey="Miyasaki J" first="Janis" last="Miyasaki">Janis Miyasaki</name></author><author><name sortKey="Kutner, Jean" sort="Kutner, Jean" uniqKey="Kutner J" first="Jean" last="Kutner">Jean Kutner</name></author><author><name sortKey="Kluger, Benzi" sort="Kluger, Benzi" uniqKey="Kluger B" first="Benzi" last="Kluger">Benzi Kluger</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24991027</idno><idno type="pmc">4142002</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142002</idno><idno type="RBID">PMC:4142002</idno><idno type="doi">10.1212/WNL.0000000000000674</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000B90</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000B90</idno><idno type="wicri:Area/Pmc/Curation">000B90</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000B90</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Palliative care and neurology</title><author><name sortKey="Boersma, Isabel" sort="Boersma, Isabel" uniqKey="Boersma I" first="Isabel" last="Boersma">Isabel Boersma</name></author><author><name sortKey="Miyasaki, Janis" sort="Miyasaki, Janis" uniqKey="Miyasaki J" first="Janis" last="Miyasaki">Janis Miyasaki</name></author><author><name sortKey="Kutner, Jean" sort="Kutner, Jean" uniqKey="Kutner J" first="Jean" last="Kutner">Jean Kutner</name></author><author><name sortKey="Kluger, Benzi" sort="Kluger, Benzi" uniqKey="Kluger B" first="Benzi" last="Kluger">Benzi Kluger</name></author></analytic><series><title level="j">Neurology</title><idno type="ISSN">0028-3878</idno><idno type="eISSN">1526-632X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research.</p></div></front></TEI><pmc article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Neurology</journal-id><journal-id journal-id-type="iso-abbrev">Neurology</journal-id><journal-id journal-id-type="hwp">neurology</journal-id><journal-id journal-id-type="publisher-id">neur</journal-id><journal-id journal-id-type="pmc">neurology</journal-id><journal-id journal-id-type="publisher-id">NEUROLOGY</journal-id><journal-title-group><journal-title>Neurology</journal-title></journal-title-group><issn pub-type="ppub">0028-3878</issn><issn pub-type="epub">1526-632X</issn><publisher><publisher-name>Lippincott Williams & Wilkins</publisher-name><publisher-loc>Hagerstown, MD</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24991027</article-id><article-id pub-id-type="pmc">4142002</article-id><article-id pub-id-type="publisher-id">NEUROLOGY2014575266</article-id><article-id pub-id-type="doi">10.1212/WNL.0000000000000674</article-id><article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>14</subject><subject>17</subject><subject>89</subject></subj-group><subj-group subj-group-type="heading"><subject>Views & Reviews</subject></subj-group></article-categories><title-group><article-title>Palliative care and neurology</article-title><subtitle>Time for a paradigm shift</subtitle></title-group><contrib-group><contrib contrib-type="author"><name><surname>Boersma</surname><given-names>Isabel</given-names></name><degrees>MS</degrees><author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Gifts:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Editorial Boards:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Patents:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Publishing Royalties:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Employment, Commercial Entity:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Consultancies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Speakers' Bureaus:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Other Activities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Commercial Entities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Government Entities:</title><list-item><p>(1) National Institutes of Health, 1 K07 Ag030337-01A2, Professional Research Assistant, 10 months</p></list-item></list></p><p><list list-type="order"><title>Research Support, Academic Entities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Foundations and Societies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Legal Proceedings:</title><list-item><p>NONE</p></list-item></list></p></author-comment></contrib><contrib contrib-type="author"><name><surname>Miyasaki</surname><given-names>Janis</given-names></name><degrees>MEd, FRCPC, MD</degrees><author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Gifts:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title><list-item><p>Teva honoraria and funding for travel Merz funding for travel</p></list-item></list></p><p><list list-type="order"><title>Editorial Boards:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Patents:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Publishing Royalties:</title><list-item><p>Up to Date - Psychogenic Movement Disorders</p></list-item></list></p><p><list list-type="order"><title>Employment, Commercial Entity:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Consultancies:</title><list-item><p>Merz consultant</p></list-item></list></p><p><list list-type="order"><title>Speakers' Bureaus:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Other Activities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Commercial Entities:</title><list-item><p>Teva - research grant for rasagiline</p></list-item></list></p><p><list list-type="order"><title>Research Support, Government Entities:</title><list-item><p>National Institutes of Health - Independent Medical Monitor 2008-Present Ontario Drug Benefits 2000 to 2013 - consultant</p></list-item></list></p><p><list list-type="order"><title>Research Support, Academic Entities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Foundations and Societies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Legal Proceedings:</title><list-item><p>NONE</p></list-item></list></p></author-comment></contrib><contrib contrib-type="author"><name><surname>Kutner</surname><given-names>Jean</given-names></name><degrees>MD, MSPH</degrees><author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Gifts:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title><list-item><p>1) Informed Medical Decisions Foundation (non-profit entity) - travel reimbursement to twice yearly Medical Editor meetings 2) American Academy for Hospice and Palliative Medicine (non-profit entity) - travel reimbursement to twice yearly Board meetings and Annual Assembly.</p></list-item></list></p><p><list list-type="order"><title>Editorial Boards:</title><list-item><p>Journal of Pain and Symptom Management, editorial advisory board (2011- present)</p></list-item></list></p><p><list list-type="order"><title>Patents:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Publishing Royalties:</title><list-item><p>Pocket Practice Guidelines in Primary Care. McGraw Hill. Published 2009, most recent royalties 2014.</p></list-item></list></p><p><list list-type="order"><title>Employment, Commercial Entity:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Consultancies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Speakers' Bureaus:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Other Activities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Commercial Entities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Government Entities:</title><list-item><p>NIH/NHLBI (1R01HL102084-01A1) ï¿ ½An Intervention to Improve ICD Deactivation Conversationsï¿ ½ $3,341,593 (total award, subcontract only for 2.5% FTE Kutner) Co-Investigator (PI=Goldstein) Award Dates: 02/07/11 ï¿ ½ 01/31/16 Agency for Healthcare Research and Quality (1P01HS021138- 01) ï¿ ½Center for Research in Implementation Science and Prevention (CRISP)ï¿ ½ $4,446,826 (total award) Collaborative Scientific Lead (PI=Kempe) Award Dates: 09/30/11 ï¿ ½ 09/29/14 NIH/NCI (P30CA046934) Cancer Center Support Grant $2,317,973 Staff Investigator (PI = Theodorescu) Award Dates: 02/01/12-01/31/18 NIH/NCI (R01CA172050) ï¿ ½Strategies to Improve Kaposiï¿ ½s Sarcoma Outcomes in Zimbabweï¿ ½ $965,000 Investigator (PI = Campbell) Award Dates: 7/9/2012 - 6/30/2015 American Cancer Society Research Scholar Grant ï¿ ½Prognosis Communication and Race in Advanced Cancer Careï¿ ½. $1,320,000 Consultant (PI=Gramling) Award Dates: 2013 - 2017 Agency for Healthcare Research and Quality (AHRQ) ï¿ ½Implementing Best Practice in Palliative Careï¿ ½ $2,499,967 (total award) $663,028 (subcontract only) Co-Principal Investigator (multiple PI with Abernethy) Award Dates: 10/1/13 ï¿ ½ 9/30/18 National Institute of Nursing Research (1U24NR014637-01) Refinement and expansion of the Palliative Care Research Cooperative Group $9,770,372 (total award) $2,348,017 (subcontract only) Co-Principal Investigator (multiple PI with Abernethy) Award Dates: 9/28/13 ï¿ ½ 6/30/18</p></list-item></list></p><p><list list-type="order"><title>Research Support, Academic Entities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Foundations and Societies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Legal Proceedings:</title><list-item><p>NONE</p></list-item></list></p></author-comment></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Kluger</surname><given-names>Benzi</given-names></name><degrees>MD, MS</degrees><author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Gifts:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title><list-item><p>1) TEVA Pharmaceuticals - Speaker Honoraria 2) Parkinson's Association of the Rockies - Speaker Honoraria 3) National Parkinson's Foundation - Speaker Honoraria</p></list-item></list></p><p><list list-type="order"><title>Editorial Boards:</title><list-item><p>1) Frontiers in Movement Disorders, Editorial Board, 2011-present</p></list-item></list></p><p><list list-type="order"><title>Patents:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Publishing Royalties:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Employment, Commercial Entity:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Consultancies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Speakers' Bureaus:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Other Activities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Commercial Entities:</title><list-item><p>1) Teva Pharmaceuticals</p></list-item></list></p><p><list list-type="order"><title>Research Support, Government Entities:</title><list-item><p>1)US Army Research Laboratory and US Army Research Office, PI, W911NF1010192, 2010-2013 2) National Institutes of Health, PI, 5 KL2RR025779-03, 2010-2013 3) NIH/NINDS, PI, 1 K02 NS080885-01A1, 2013-2018 4) Veterans Affairs Medical Center CRICC Program, PI, 2013-2014</p></list-item></list></p><p><list list-type="order"><title>Research Support, Academic Entities:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Research Support, Foundations and Societies:</title><list-item><p>1) Michael J Fox Foundation 2) University of Colorado Hospital Clinical Effectiveness and Patient Safety Program 3) NIH, project PI, 1 K07 AG030337-01A2</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title><list-item><p>NONE</p></list-item></list></p><p><list list-type="order"><title>Legal Proceedings:</title><list-item><p>NONE</p></list-item></list></p></author-comment></contrib><aff>From the Departments of Neurology and Psychiatry (I.B., B.K.) and Internal Medicine (J.K.), University of Colorado Anschutz Medical Campus, Aurora; and Department of Neurology (J.M.), University of Alberta, Edmonton, Canada.</aff></contrib-group><author-notes><corresp>Correspondence to Dr. Kluger: <email>benzi.kluger@ucdenver.edu</email></corresp><fn fn-type="financial-disclosure"><p>Go to <ext-link ext-link-type="uri" xlink:href="http://neurology.org/">Neurology.org</ext-link> for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.</p></fn></author-notes><pub-date pub-type="ppub"><day>5</day><month>8</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>5</day><month>8</month><year>2015</year></pub-date><pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
<volume>83</volume><issue>6</issue><fpage>561</fpage><lpage>567</lpage><history><date date-type="received"><day>31</day><month>1</month><year>2014</year></date><date date-type="accepted"><day>27</day><month>4</month><year>2014</year></date></history><permissions><copyright-statement>© 2014 American Academy of Neurology</copyright-statement><copyright-year>2014</copyright-year><copyright-holder>American Academy of Neurology</copyright-holder></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="NEUROLOGY2014575266.pdf"></self-uri><abstract><p>Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research.</p></abstract><custom-meta-group><custom-meta><meta-name>special-property</meta-name><meta-value>podcast</meta-value></custom-meta><custom-meta><meta-name>cme</meta-name><meta-value>yes</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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