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姑息治疗与帕金森病:会议总结及临床研究建议

Palliative care and Parkinson's disease: Meeting summary and recommendations for clinical research.

作者信息

Kluger Benzi M, Fox Siobhán, Timmons Suzanne, Katz Maya, Galifianakis Nicholas B, Subramanian Indu, Carter Julie H, Johnson Miriam J, Richfield Edward W, Bekelman David, Kutner Jean S, Miyasaki Janis

机构信息

Department of Neurology, University of Colorado School of Medicine, Anschutz Medical Campus, 12631 E 17th Ave, Mail Stop B185, Aurora, CO 80045, USA.

Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, The Bungalow, Block 13, St. Finbarr's Hospital, Douglas Road, Cork, Republic of Ireland.

出版信息

Parkinsonism Relat Disord. 2017 Apr;37:19-26. doi: 10.1016/j.parkreldis.2017.01.008. Epub 2017 Jan 11.

Abstract

INTRODUCTION

Palliative care is an approach to caring for patients and families affected by serious illnesses that focuses on the relief of suffering through the management of medical symptoms, psychosocial issues, advance care planning and spiritual wellbeing. Over the past decade there has been an emerging clinical and research interest in the application of palliative care approaches to Parkinson's disease (PD) and outpatient palliative care services are now offered by several movement disorders centers.

METHODS

An International Working Group Meeting on PD and Palliative Care supported by the Parkinson's Disease Foundation was held in October 2015 to review the current state of the evidence and to make recommendations for clinical research and practice.

RESULTS

Topics included: 1) Defining palliative care for PD; 2) Lessons from palliative care for heart failure and other chronic illnesses; 3) Patient and caregiver Needs; 4) Needs assessment tools; 5) Intervention strategies; 6) Predicting prognosis and hospice referrals; 7) Choice of appropriate outcome measures; 8) Implementation, dissemination and education research; and 9) Need for research collaborations. We provide an overview of these discussions, summarize current evidence and practices, highlight gaps in our knowledge and make recommendations for future research.

CONCLUSIONS

Palliative Care for PD is a rapidly growing area which holds great promise for improving outcomes for PD patients and their caregivers. While clinical research in this area can build from lessons learned in other diseases, there is a need for observational, methodological and interventional research to address the unique needs of PD patients and caregivers.

摘要

引言

姑息治疗是一种针对受严重疾病影响的患者及其家庭的护理方法,它通过管理医疗症状、心理社会问题、预先护理计划和精神健康来减轻痛苦。在过去十年中,将姑息治疗方法应用于帕金森病(PD)的临床和研究兴趣不断涌现,现在一些运动障碍中心提供门诊姑息治疗服务。

方法

2015年10月,在帕金森病基金会的支持下,召开了一次关于帕金森病与姑息治疗的国际工作组会议,以审查现有证据状况,并为临床研究和实践提出建议。

结果

讨论的主题包括:1)定义帕金森病的姑息治疗;2)心力衰竭和其他慢性病姑息治疗的经验教训;3)患者和照护者的需求;4)需求评估工具;5)干预策略;6)预测预后和临终关怀转诊;7)选择合适的结局指标;8)实施、传播和教育研究;9)研究合作的必要性。我们概述了这些讨论内容,总结了当前的证据和实践,突出了我们知识上的差距,并为未来研究提出建议。

结论

帕金森病的姑息治疗是一个快速发展的领域,有望改善帕金森病患者及其照护者的结局。虽然该领域的临床研究可以借鉴其他疾病的经验教训,但仍需要进行观察性、方法学和干预性研究,以满足帕金森病患者及其照护者的独特需求。

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