Palliative Medicine

Questions discussed in this category

How do you titrate opioids for pain and breathlessness in patients with a DNR/DNI code status, but who otherwise still wish to pursue life-prolonging treatments?

2 Answers available

How do you counsel patients struggling to decide if they wish to pursue an invasive diagnostic procedure to confirm a severe illness with poor prognosis and/or limited treatment options?

1 Answer available

What is your approach to counseling severely frail older adults regarding their planning for invasive life-sustaining therapy?

2 Answers available

How do you determine whether to continue anti-dementia medications (such as cholinesterase inhibitors) for patients with dementia when enrolling in hospice?

3 Answers available

What are the most common pain regimens that you use in cancer care?

Can you explain the rationale behind your choices? Are there certain patient factors or logistical barriers which influence your approach?

1 Answer available

How do you consider and approach transition to hospice in a patient with HFrEF who does not appear to tolerate GDMT?

3 Answers available

How do you counsel patients/families whose goals of care are clearly aligned with a comfort-focused, end-of-life approach, but who are hesitant to formally enroll in hospice?

4 Answers available

What is your approach to determining eligibility for hospice in persons with Alzheimer's disease?

1 Answer available

How do you counsel patients who are concerned that discontinuation of certain chronic medications may actually perpetuate suffering at the end of life?

Do you ever continue medications such as rate-control agents for tachyarrhythmias, anticoagulation for blood clots, immunosuppression to prevent trans...

1 Answer available

How do you decide whether to include a basal rate when initiating a PCA?

How do you subsequently titrate it?

2 Answers available

What is your stepwise approach to treating constipation in a patient with symptoms such as abdominal pain, nausea, decreased appetite, etc?

What do you start initially, and how do you go about escalating the regimen if constipation persists?

2 Answers available

At what point should you consider deactivating ICDs or implanted pacemakers in patients nearing the end of life but not imminently dying?

Should we consider this as a unique point during goal of care discussions, separate from code status, comfort measures only, etc.?

1 Answer available

When do you recommend starting a continuous opioid infusion for symptom control at the end of life?

1 Answer available

How do you counsel patients with ALS on the benefits of enteral nutrition?

E.g., PEG tube placement.

3 Answers available

How early do you involve palliative care in the management of a CKD Stage 5 patient who does not wish to pursue renal replacement therapy?

1 Answer available

How do you approach and manage anorexia and appetite loss in people with advanced cancer?

How do you counsel patients and caregivers? Do you prescribe medications (''appetite stimulants'') with the goal to improve appetite even if they do n...

4 Answers available

Papers discussed in this category

The New England journal of medicine, 2016-07-14

Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting.

Practical radiation oncology, 2021 Sep-Oct

Medical Marijuana for Cancer: Perspective From a Radiation Oncologist Credentialed to Certify in Pennsylvania.

Palliative medicine, 2022 Mar 31

Efficacy of medicinal cannabis for appetite-related symptoms in people with cancer: A systematic review.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023 Mar 28

Randomized Double-Blind Placebo-Controlled Study of Olanzapine for Chemotherapy-Related Anorexia in Patients With Locally Advanced or Metastatic Gastric, Hepatopancreaticobiliary, and Lung Cancer.

Lancet (London, England), 2014-06-14

Hypercaloric enteral nutrition in patients with amyotrophic lateral sclerosis: a randomised, double-blind, placebo-controlled phase 2 trial.

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2018-02

A Systematic Review of Practice Guidelines and Recommendations for Discontinuation of Cholinesterase Inhibitors in Dementia.

JAMA internal medicine, 2025 May 01

Continued Use of Cholinesterase Inhibitors and Memantine in Hospice.

Alzheimer's & dementia (New York, N. Y.), 2022 Jan 31

CCCDTD5 recommendations on the deprescribing of cognitive enhancers in dementia.

The Medical journal of Australia, 2019 Feb 16

Deprescribing cholinesterase inhibitors and memantine in dementia: guideline summary.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2002-11

Discussion of the do-not-resuscitate order: a pilot study of perceptions of patients with refractory cancer.

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