Spilsbury, K. Annals of Emergency Medicine. Published online: 3 February 2017
Historically, palliative care evolved to meet the end-of-life needs of cancer patients. It has since become apparent that it benefits noncancer terminal conditions such as renal failure, heart failure, chronic obstructive pulmonary disease, and liver failure, although access to and quality of palliative care for these conditions could be improved. In Australia, there has been evidence of this improved access to palliative care in noncancer conditions during the last 10 years.
The objective of this study was to describe patterns of use of EDs by people in their last year of life and how this varied when they received community-based palliative care. We also investigated whether any patient health, social, and demographic factors modified the rates of ED visits while patients were receiving community-based palliative care.
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Cooper, E. et al. (2016) Emergency Medicine Journal 33:919-920
Objectives & Background: Emergency departments (EDs) receive a variety of patients: those with unexpected injuries or trauma, chronic disease exacerbation or progression and existing advanced disease or terminal illness. Thus expectations of attendees can vary greatly. However the primary focus of EDs is acute management.The provision of tailored palliative care (PC), that meets the unique needs of people with advanced disease, is often difficult in the ED. The main objective of this qualitative synthesis was to increase understanding of the ED experience of people with advanced disease, their relatives and healthcare professionals.
Conclusion: This synthesis has provided a greater breadth of insight to enable recurring themes regarding the potential conflicts between emergency care and PC to be identified with a view to overcoming the challenges faced. Significantly recognising the need for educating ED physicians in the scope and components of PC, improving interdisciplinary working and enabling better understanding of patients and carers about their likely disease progression and the opportunities open to them. Further research should focus on the best ways to provide such education, the specific reasons for shortfalls in communication and how these could be overcome.
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