Barry Ashpole Media Watch (#474)

Barry Ashpole Media Watch

The latest issue of Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada) can now be downloaded here. More reports can be found at IPCRC.NET

Articles from Asia Pacific Region

New Zealand – Palliative care set for big budgeted increase

NEW ZEALAND | Radio New Zealand (Wellington) – 4 August 2016 – The government announced more money for hospices in the May budget which would be used to fund the new positions. There was $52 million allocated directly to hospices over four years as general funding, with $24 million to be spent on new services that improve palliative care. It will fund 40 confirmed positions at 15 hospices, with nine hospices still working on proposals expected to see a further 20 positions. http://goo.gl/uFIW6x

Australia – Normalising and planning for death in residential care: Findings from a qualitative focus group study of a specialist palliative care intervention

BMJ SUPPORTIVE & PALLIATIVE CARE | Online – 3 August 2016 – Improving access to palliative care (PC) for older adults living in residential care is recognised internationally as a pressing clinical need. The integration of specialist PC in residential care for older adults, however, is not yet standard practice. The intervention led to: 1) Normalising death and dying in these settings; 2) Timely access to a PC specialist who was able to prescribe anticipatory medications aiding symptom management and unnecessary hos- pitalisations; and, 3) Better decision-making and planned care for residents, which meant that staff and relatives were better informed about, and prepared for, the resident’s likely trajectory. The intervention normalised death and dying and also underlined the important role that specialists play in providing staff education, timely access to medicines, and advance care planning. The findings from this study, and the growing wealth of evidence integrating specialist PC in residential care for older adults, indicate a number of priorities for care providers, academics and policymakers. http://goo.gl/66QdPV

Australia – What is the evidence for conducting palliative care family meetings? A systematic review

PALLIATIVE MEDICINE | Online – 4 August 2016 – Structured family meeting procedures and guidelines suggest that these forums enhance family-patient-team communication in the palliative care inpatient set- ting. However, the vulnerability of palliative patients and the resources required to implement family meet- ings in accordance with recommended guidelines make better understanding about the effectiveness of this type of intervention an important priority. Of the 5,051 articles identified, 13 met the inclusion criteria: 10 quantitative and 3 qualitative studies. There was low-level evidence to support family meetings. Only two quantitative pre- and post-studies used a validated palliative care family outcome measure with both studies reporting significant results post-family meetings. Four other quantitative studies reported signifi- cant results using non-validated measures. Despite the existence of consensus-based family meeting guidelines, there is a paucity of evidence to support family meetings in the inpatient palliative care setting. http://goo.gl/2DMlN3

Article highlighted to be of particular interest:

Doctors’ reports about palliative systemic treatment: A medical record study

Palliative Medicine | Online – 4 August 2016 – Medical records provide insight into the decision-making process about palliative systemic treatment. The content and detail of doctors’ notes, however, widely varies especially concerning their palliative systemic treatment considerations. Registries that aim to measure the quality of (end-of-life) care must be aware of this outcome. About 75% of all notes [of the 147 patients studied] reported doctors’ considerations to start/continue palliative systemic treatment, including information about the prognosis (47%), possible survival gain (22%), patients’ wish for palliative systemic treatment (33%), impact on quality of life (8%), and patient’s age (3%). Co-morbidity (82%), smoking status (78%) and drinking behaviour (63%) were more often documented than patients’ performance status (16%). Conversations with the patient/family about palliative systemic treatment were reported in 49% of all notes. Response measurements and dose adaptations were documented in 75% and 71% of patients who received palliative systemic treatment respectively. Future research should further explore how medical records can best assist in evaluating the quality of the decision-making process in the patient’s final stage of life. http://goo.gl/YaVS4k