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Symptoms and medication management in the end of life phase of high-grade glioma patients

(2014) JOURNAL OF NEURO-ONCOLOGY. 120(3). p.589-595
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Abstract
During the end of life (EOL) phase of high-grade glioma (HGG) patients, care is primarily aimed at reducing symptom burden while maintaining quality of life as long as possible. In this study, we evaluated the prevalence of symptoms and medication management in HGG patients during the EOL phase. We analyzed disease-specific symptoms, general EOL symptoms, symptom frequency, and medication use at 3 months and 1 week before death in a cohort of 178 HGG patients, based on questionnaires completed by physicians responsible for EOL care. In addition, information on patient's perceived quality of care (QOC) was derived from 87 questionnaires completed by patient's relatives. Somnolence, focal neurological deficits and cognitive disturbances were the most prevalent symptoms during the EOL phase. Overall, disease-specific symptoms occurred more often than general EOL symptoms at both 3 months and 1 week before death. Somnolence and/or dysphagia were present in 81 % of patients whose medication was withdrawn and 96 % of patients in whom antiepileptic drugs (AEDs) were withdrawn. One week before death, 65.9 % of patients with high symptom frequency experienced good QOC, compared to 87.5 % of patients with low symptom frequency (p = 0.032). Disease-specific symptoms are the main concern in EOL care for HGG patients. Somnolence and dysphagia may hamper the regular oral administration of drugs, and particularly AEDs, during the EOL phase. High symptom frequency at 1 week before death negatively affects patient's perceived QOC.
Keywords
Palliative care, Signs and symptoms, End of life care, Brain tumor, Glioma, Medication therapy management, Antiepileptic drugs, PRIMARY BRAIN-TUMORS, QUALITY-OF-LIFE, CANCER-PATIENTS, PALLIATIVE CARE, LUNG-CANCER, PREVALENCE, ADULTS, INTENSITY, DRUGS

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MLA
Koekkoek, JAF, L Dirven, EM Sizoo, et al. “Symptoms and Medication Management in the End of Life Phase of High-grade Glioma Patients.” JOURNAL OF NEURO-ONCOLOGY 120.3 (2014): 589–595. Print.
APA
Koekkoek, J., Dirven, L., Sizoo, E., Pasman, H., Heimans, J., Postma, T., Deliens, L., et al. (2014). Symptoms and medication management in the end of life phase of high-grade glioma patients. JOURNAL OF NEURO-ONCOLOGY, 120(3), 589–595.
Chicago author-date
Koekkoek, JAF, L Dirven, EM Sizoo, HRW Pasman, JJ Heimans, TJ Postma, Luc Deliens, et al. 2014. “Symptoms and Medication Management in the End of Life Phase of High-grade Glioma Patients.” Journal of Neuro-oncology 120 (3): 589–595.
Chicago author-date (all authors)
Koekkoek, JAF, L Dirven, EM Sizoo, HRW Pasman, JJ Heimans, TJ Postma, Luc Deliens, R Grant, S McNamara, G Stockhammer, E Medicus, MJB Taphoorn, and JC Reijneveld. 2014. “Symptoms and Medication Management in the End of Life Phase of High-grade Glioma Patients.” Journal of Neuro-oncology 120 (3): 589–595.
Vancouver
1.
Koekkoek J, Dirven L, Sizoo E, Pasman H, Heimans J, Postma T, et al. Symptoms and medication management in the end of life phase of high-grade glioma patients. JOURNAL OF NEURO-ONCOLOGY. 2014;120(3):589–95.
IEEE
[1]
J. Koekkoek et al., “Symptoms and medication management in the end of life phase of high-grade glioma patients,” JOURNAL OF NEURO-ONCOLOGY, vol. 120, no. 3, pp. 589–595, 2014.
@article{5803553,
  abstract     = {During the end of life (EOL) phase of high-grade glioma (HGG) patients, care is primarily aimed at reducing symptom burden while maintaining quality of life as long as possible. In this study, we evaluated the prevalence of symptoms and medication management in HGG patients during the EOL phase. We analyzed disease-specific symptoms, general EOL symptoms, symptom frequency, and medication use at 3 months and 1 week before death in a cohort of 178 HGG patients, based on questionnaires completed by physicians responsible for EOL care. In addition, information on patient's perceived quality of care (QOC) was derived from 87 questionnaires completed by patient's relatives. Somnolence, focal neurological deficits and cognitive disturbances were the most prevalent symptoms during the EOL phase. Overall, disease-specific symptoms occurred more often than general EOL symptoms at both 3 months and 1 week before death. Somnolence and/or dysphagia were present in 81 % of patients whose medication was withdrawn and 96 % of patients in whom antiepileptic drugs (AEDs) were withdrawn. One week before death, 65.9 % of patients with high symptom frequency experienced good QOC, compared to 87.5 % of patients with low symptom frequency (p = 0.032). Disease-specific symptoms are the main concern in EOL care for HGG patients. Somnolence and dysphagia may hamper the regular oral administration of drugs, and particularly AEDs, during the EOL phase. High symptom frequency at 1 week before death negatively affects patient's perceived QOC.},
  author       = {Koekkoek, JAF and Dirven, L and Sizoo, EM and Pasman, HRW and Heimans, JJ and Postma, TJ and Deliens, Luc and Grant, R and McNamara, S and Stockhammer, G and Medicus, E and Taphoorn, MJB and Reijneveld, JC},
  issn         = {0167-594X},
  journal      = {JOURNAL OF NEURO-ONCOLOGY},
  keywords     = {Palliative care,Signs and symptoms,End of life care,Brain tumor,Glioma,Medication therapy management,Antiepileptic drugs,PRIMARY BRAIN-TUMORS,QUALITY-OF-LIFE,CANCER-PATIENTS,PALLIATIVE CARE,LUNG-CANCER,PREVALENCE,ADULTS,INTENSITY,DRUGS},
  language     = {eng},
  number       = {3},
  pages        = {589--595},
  title        = {Symptoms and medication management in the end of life phase of high-grade glioma patients},
  url          = {http://dx.doi.org/10.1007/s11060-014-1591-2},
  volume       = {120},
  year         = {2014},
}

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