PS01 (E) Massive open online courses (MOOCs) to improve education in palliative care PS02 (A) innovative models of palliative home care. PS09 (G) Revealing the current state of palliative care for persons with persistent mental illness in three high-income countries PS10 (B) (Potential) Pitfalls in palliative care pharmacotherapy.
Abstracts from the 17th World Congress of the EAPC 2021
PS01 (E) Massive Open Online Courses (MOOCs) to Enhance Education in Palliative Care
PS02 (A) Innovative Models of Home Palliative Care
PS03 (B) Improving Care for People Unable to Self- report: The Role of Person-Centred Proxy-Reported
Objectives: To develop and pilot test a data extraction matrix for routine care documentation and test its feasibility for validating IPOS Dem. Conclusion: The extraction matrix is a reliable tool to use information from routine care documentation for psychometric validation of the IPOS-Dem.
PS04 (B) Management of Fatigue in Advanced Cancer - Psychological, Physical And Pharmacological
Development of an extraction matrix based on IPOS-Dem and patient charts, medication and structured assessments, with a mixed inductive and deductive approach. Interrater reliability of the final version of the extraction matrix on a random subsample, tested with Cohens' Kappa.
PS05 (F) Economics of Palliative Care: New Approaches to Understand and Demonstrate Effects
Nursing home staff administered IPOS-Dem and collected demographic and clinical data at baseline and at 10–14 days. The extraction matrix has 13 topic areas and 94 items, covering symptoms, symptom burden, actions taken and free text.
PS06 (A) “There is an app for that” — Leveraging Technology to Advance Palliative Care to Patients
PS06 (A) “There's an app for that” — Leveraging technology to improve palliative care for patients. Palliative care clinicians and researchers are beginning to take advantage of VR to improve the patient experience of illness.
PS07 (A) Peer Support in Palliative Care: How to Leverage its Potential?
As VR technology rapidly evolves into deeper levels of immersive experience and affordable technological hardware, including smartphones, palliative care stakeholders are increasingly encouraged to use these new non-pharmacological interventions. Conclusion: Evolving VR technology offers opportunities to explore new non-pharmacological strategies to improve health-related quality of life in advanced diseases.
PS08 (M) Expanding Palliative Care Beyond Health Care Services: Lessons Learned From International
Conclusion: Just as knowledge alone is not sufficient to bring about individual behavioral change, knowledge of effectiveness and cost-effectiveness is not sufficient to bring about systemic change. PS09 (G) Revealing the current state of palliative care for persons with persistent mental illness in.
PS09 (G) Revealing the Current State of Palliative Care for Persons with Persistent Mental Illness in
PS10 (B) (Potential)Pitfalls in Palliative Care Pharmacotherapy
Unlike most medications currently prescribed in palliative care, many cannabis medicines have not undergone the usual regulatory processes before coming to market as medicines. This presentation will discuss the various issues and challenges healthcare professionals face when considering cannabis medicines in the palliative care setting.
PS11 (D) Developing an Evidence Base to Support Advance Care Planning in Dementia
Engaging in Advance Care Planning Conversations: Lessons Learned from People with Dementia and Their Family. We aimed to identify the unique views and preferences of people with dementia and their family regarding ACP, both in a professional and family context.
PS12 (B) Treatment Decision-Making: Communicating, Informing and Supporting Patient Choice
Joining the JPND-funded mySupport study provided an opportunity for structured implementation and evaluation of advance care planning with relatives of nursing home residents with dementia. Methods: Review of reviews, focus groups and interviews with people with early-onset and late-onset dementia and their families in Belgium and the European Working Group on People with Dementia, the official reference group supported by Alzheimer Europe.
PS13 (C) Children and Young People: The Hidden Carers
Aim: Patients with advanced cancer need information about their treatment goals, possible treatment options and possible side effects. In this presentation, van Vliet will address these challenges and focus on how information can help and harm patients when providing information about treatment goals, options and side effects in advanced cancer.
PS14 (E) Rebalancing Death and Dying: The Lancet Commission on the Value of Death
It is therefore crucial that the children of adult patients are identified by healthcare staff so that appropriate support can be provided to them. Overtreatment of the rich and inadequate or missing care of the poor is a paradox and a failure of global health and solidarity.
PS15 (Q) Researcher Award Session
The Commission recognizes that rebalancing death and dying will depend on changes across "death systems", the many interrelated social, cultural, economic, religious and political factors that determine how death, dying and dying are understood, experienced and managed. Our recommendations outline the next steps we will encourage politicians, health and social services, civil society and society to take.
PS16 (B) Opioids for Chronic Breathlessness - Practical Evidence-Based Prescribing
Methods: This talk will provide an overview of studies investigating the safety of opioids for chronic respiratory distress. Conclusion: Low-dose opioids for chronic breathlessness appear to be safe for patients with chronic lung diseases.
PS17 (D) Exploring New Dimensions in Dementia Palliative Care: Making Research Work in Practice
There is no evidence of significant or clinically relevant adverse respiratory effects of opioids in chronic dyspnea. Conclusion: Regular, low-dose extended-release morphine can safely and effectively reduce the worst dyspnea in many people with chronic dyspnea.
PS18 (F) Ethical Decision Making at the End-Of-Life
This presentation will explore our understanding of autonomy in end-of-life care decisions. Relying on a revised view of autonomy, we will identify primary directions towards improving care decisions at the end of life.
PS19 (B) Sedation at the End-Of-Life Outside Specialist Palliative Care – International
More research is needed to demonstrate how to systematically develop these ethical skills and whether they impact quality of care and quality of life. We will recognize the traditional focus of autonomy as individual freedom and self-determination, moving toward the view that autonomy must be contextualized to fit the lived situation.
PS20 (C) Strategies to Improve the Psychosocial Well-Being of Family Carers: How International
The protocol included 7 sequential steps focusing on clarification of the medical and social situation, communication with all involved care providers and with the resident and/or relatives, the organization of care, the actual performance of continuous sedation and support for relatives and care. providers during and after the procedure.
Paediatric Palliative Care - Transitioning Children with Palliative Care Needs Between Settings and Phases
Of the 100 children enrolled in SPPCT during the study period, 45 children died (58% from cancer). Extubation at home should include 3 phases: before extubation, around the time of extubation and after extubation.
Plenary sessions
In the first decade of the 20th century, there was an increase in opioid-associated deaths associated with increased opioid prescribing. Opioid-associated deaths have now risen to 90,000 in the US in 2020 (exacerbated by the COVID epidemic).
P 2 Plenary
While poor treatment of cancer pain is a current reality for nearly 90% of the world's population, it was a common situation even in high-income countries up until the latter half of the 20th century. Palliative care advocates must be adequately informed about the true nature of the US situation to ensure that it does not detract from improved and appropriate opioid access worldwide.
P 3 Plenary
Most of the world, especially low- and middle-income countries, continues to face a crisis of poor opioid access for pain relief, both acute and chronic, for cancer pain and to address palliative care needs. In the latter half of 2021, the CDC is reevaluating these pain guidelines, given significant misinterpretation of the 2016 evidence along with misapplication to patients with cancer and other palliative care who are exempt from those recommendations.
P 4 Plenary
PDC use reduces total direct medical costs in the last month of life by €1,025 per capita. More intensive use of PDC reduced the likelihood of one-day care, specialist contact, home care and palliative home care in the past month, but had no influence on the total direct medical costs.
P 5 Plenary
Higher costs were found associated with GP contact and use of a palliative care unit (€1,570), while lower costs were associated with intensive care and emergency room admissions, contacts with specialists, medication and outpatient services. The associated lower direct medical costs, coupled with previous findings of significant benefits and satisfaction of PDC users, suggest that this model is worthy of government support.
P 6 Plenary
Cohort described by sex, age at death, deprivation, comorbidity (standard prescription index) and time to death from when need for palliative care was recorded. Poisson regression plots for the last year of life by group showed that people with dementia remained on simple analgesics with increasing opioid prescriptions 1 week before death.
Free Communication sessions
Measuring and Managing Symptoms
System effects included the increased interest in receiving care in the community and the lack of interest in palliative care units. Background/purpose: Early palliative care improves the quality of life for patients with advanced cancer, but is not possible or necessary for all patients.
Advance Care Planning and Cardio-Pulmonary Resuscitation
Objective: To evaluate the experience of timing of ACP conversations among patients with advanced cancer, and its potential impact. Conclusion: Adequate timing of the initiation of ACP conversations improved the acceptance and effectiveness of ACP.
Innovation and New Technologies
Key factors that influenced eHealth implementation most relate to the Inner Setting construct of the CFIR, which relates to requirements for implementation in the care home. A new conceptual model of the key factors was developed, and translated into practical recommendations to guide implementation in care homes.
Symptoms and Sedation
Guidelines for reducing, processing, and reporting missing data in palliative care studies, co-produced using a multi-stakeholder nominal group technique. Objective: To develop guidelines on how best to (i) reduce, (ii) treat, and (iii) report missing data in palliative care clinical trials.
Palliative Care and COVID - Session 1
Experiences, challenges and possible solutions of generalist palliative care in an inpatient setting during the SARS-CoV2 pandemic. Providing general palliative care during a pandemic requires drawing on the experiences of staff.
Compassionate Communities and Civic Responsibilities
Background: Compassionate Cities (CC) are community-based public health interventions that focus on community responsibility in palliative care. Key areas of clinical practice enabling optimal palliative care in acute hospitals: A mixed methods study.
Models of Care
Specialized palliative care teams and characteristics related to the referral rate: a national cross-sectional study among hospitals in the Netherlands. Emergency medical services” OR “pre-hospital care” (OR “prehospital care”) OR “paramedics” from the MeSH keywords: Palliative care/organization.
Psychological Symptoms and Communication
Background: Specialized palliative care teams (SPCTs) in hospitals have positive effects on quality of life and satisfaction with care for patients with advanced disease. This study demonstrates the value of robust consultation with patients and staff in developing acceptable online interventions for use in palliative care.
Older & Frail People
Perspectives of older people living with mild dementia on eating and drinking problems in the later stages of dementia: A qualitative study. Background: Eating and drinking problems can occur at any point in the progression of dementia, especially in the later stages and at the end of life.
Education and Workforce
Aim: To explore the experiences of health professionals providing palliative and end-of-life care to people living in socially disadvantaged areas. This summary reports on a subset of findings relating to participants' experiences of providing palliative and end-of-life care in socially disadvantaged areas.
Dementia and Care Homes
Patterns of unplanned hospital admissions among people with dementia: from diagnosis to end of life. Development of a benchmarking tool for evaluating the quality of end-of-life care in care homes.
Palliative Care Identification and Impact
Objectives: The aim of this study was to develop a tool to assess the quality of end-of-life care services in a nursing home. Methods: The study was part of the intervention project "Optimal care at the end of life" (OPAL).
Advancing Advance Care Planning
It is unclear how physicians and parents address EOL in advance care planning (ACP). Objective: To understand how pediatricians conceptualize advance care planning when caring for children with life-limiting conditions.
Families and Carers
The influence of extended family on supportive relationships between patients and family caregivers in palliative care requires much attention. Results: According to focus group participants, the toolkit provided a practical guide, increased awareness of the importance of bereavement support and increased feelings of competence.
Sharing Learning from across the Globe
Providing quality palliative care is not a high priority on the care organization's agenda. Topics included: the uncertainty of the future, the determination to live life to the fullest, and the meaning of life.
Palliative Care and COVID - Session 2
Conclusion / Discussion: In the short term, the COVID-19 pandemic does not have a significant impact on the well-being of victims' relatives. Purpose: To explore the experiences of bereaved relatives with visiting restrictions of dying patients during the COVID-19 pandemic.
A Posters Innovation and New Technologies
Background: Provision of ambulatory palliative care services is difficult in the COVID-19 pandemic due to resource limitations. Decision trees to support the use of palliative care guidelines in daily practice – Results of interviews and a focus group.
B Posters Pain and Symptom Management
Aim: To examine differences in the treatment of malignant ascites in the context of palliative care. Conclusion: Health care providers have identified the most important issues in the palliative care of patients with pruritus.
C Posters Informal and Formal Caregivers
Family caregiver crises in the home palliative care setting: How palliative care staff and hospice support families. Discussion: Symptoms of burnout are quite prevalent among healthcare professionals providing palliative care in the Netherlands.
D Posters Older People
Background: Integrated short-term palliative care models have been advocated for frail and multimorbid older adults in the community. Patients admitted to a palliative care unit (PCU) with dementia may be on a cholinesterase inhibitor (CHEIS).
E Posters Education and Advocacy
Palliative care is one of the priorities in the development of integrated, human-centered health services. Background: In Finland, the development of palliative education has been one of the national priorities.
F Posters Ethics, Policy and Law
Objectives: The study aims to translate and culturally validate the GWG in the Italian environment. Objectives: To explore palliative care doctors' experiences of sedation as an alternative to assisted suicide in the French-speaking part of Switzerland.
G Posters Disadvantaged Populations
Objective: To investigate the relationship between ethnicity, deprivation and timing of palliative care referral for patients with COVID-19. Facilitators and barriers to access and utilization of palliative care among non-Western migrants: A systematic review.
H Posters Psychological, Social and Spiritual Care
Results: Of the 1386 patients included in the analysis, high distress was reported during their first DTPL. To explore the experiences and views of palliative healthcare professionals of assessing needs in their first encounters with patients in palliative care.
I Posters Paediatric Palliative Care
Complex chronic conditions in children: Hospital use in the last year of life and the involvement of pediatric palliative care. In the shadow of illness': Perspectives of parental caregivers of children in palliative care.
J Posters Public Health and Epidemiology
Is early palliative care associated with reduced healthcare costs of end-of-life care in patients with advanced cancer. End of life and mortality for the elderly in France: Are existing palliative care resources sufficient.
K Posters Policy, including International Developments
The World Health Organization (WHO) endorsement of palliative care has helped spread 'palliative care' as an end-of-life care strategy to health systems worldwide. In addition, 'palliative care' has been included as a priority and basic requirement of the Universal Health Coverage agenda.
L Posters Development and Organization of Services
Predictors of death at home for palliative care patients receiving the Nurse-led End of Life (PEACH) program. Purpose: To demonstrate the importance of including palliative care professionals in multidisciplinary cancer care team meetings.
M Posters Primary and Integrated Care
An online international comparison of palliative care identification in primary care using a surprise question. Methods: The study is part of the Junior Research Group "Primary Palliative Care in General Practice" (ALLPRAX).
N Posters Communication
Methods: This study is an ethnographic exploration of palliative care professionals' interactions in their daily work. Method: A prospective study was conducted among patients with advanced cancer receiving palliative care in an outpatient setting.