Textbook of Palliative Medicine This page intentionally left blank Textbook of Palliative Medicine Edited by Eduardo Bruera MD Professor and Chair, Department of Palliative Care and Rehabilitation Medicine, U.T. MD Anderson Cancer Center, Houston, Texas, USA Irene J HigginsonBMed Sci BMBS FFPHM PhD FRCP Professor and Head of Department, Department of Palliative Care, Policy and Rehabilitation, King’s College London, UK; Scientific Director, The Cicely Saunders Foundation, UK Carla Ripamonti MD Head, Day-Hospital and Outpatient Clinic of Pain Therapy and Palliative Care, Rehabilitation and Palliative Care Operative Unit, National Cancer Institute, Milan, Italy Charles F von Gunten MD PhD Director, Center for Palliative Studies, San Diego Hospice and Palliative Care, San Diego, California, USA Hodder Arnold www.hoddereducation.com First published in Great Britain in 2006 by Hodder Arnold, an imprint of Hodder Education, part of the Hachette Livre UK, 338 Euston Road, London NW1 3BH http://www.hoddereducation.com Distributed in the United States of America by Oxford University Press Inc., 198 Madison Avenue, New York, NY10016 Oxford is a registered trademark of Oxford University Press ©2006 Edward Arnold (Publishers) Ltd All rights reserved. Apart from any use permitted under UK copyright law, this publication may only be reproduced, stored or transmitted, in any form, or by any means with prior permission in writing of the publishers or in the case of reprographic production in accordance with the terms of licences issued by the Copyright Licensing Agency. In the United Kingdom such licences are issued by the Copyright licensing Agency: Saffron House, 6-10 Kirby Street, London EC1N 8TS. Hachette Livre UK’s policy is to use papers that are natural, renewable and recyclable products and made from wood grown in sustainable forests.The logging and manufacturing processes are expected to conform to the environmental regulations of the country of origin. Whilst the advice and information in this book are believed to be true and accurate at the date of going to press, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. In particular, (but without limiting the generality of the preceding disclaimer) every effort has been made to check drug dosages; however it is still possible that errors have been missed. Furthermore, dosage schedules are constantly being revised and new side-effects recognized. For these reasons the reader is strongly urged to consult the drug companies’ printed instructions before administering any of the drugs recommended in this book. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress ISBN: 978 0 340 810 187 2 3 4 5 6 7 8 9 10 Commissioning Editor: Sarah Burrows Project Editor: Naomi Wilkinson Production Controller: Joanna Walker Cover Design: Georgina Hewitt Typeset in 10/12 pts Minion by Charon Tec Ltd (A Macmillan Company), Chennai, India www.charontec.com Printed and bound in the UK by MPG Books What do you think about this book? Or any other Hodder Arnold title? Please send your comments to www.hoddereducation.com To Ed, Sofia and Sebastian EB To Kathleen and Leslie Higginson IH To Andrea, Francesca, Maria, Felice, Dario, Maddalena, and Fausto Ripamonti CR Dedicated to the staff and benefactors of San Diego Hospice and Palliative Care for pursuing the mission of the academic hospice CVG This page intentionally left blank Contents Contributors xiii Dedication to Cicely Saunders xxv Preface xxvii List of abbreviations xxix Reference annotation and evidence scores xxxiii Part 1 The development of palliative medicine 1 1 The development of palliative medicine in the UK and Ireland 3 David Clark 2 The development of palliative medicine in Europe 12 Franco de Conno, Heidi Blumhuber, Javier Rocafort 3A The development of palliative care in Canada 22 Neil MacDonald 3B The development of palliative medicine in the USA 29 True Ryndes,Charles F von Gunten 4 The development of palliative medicine in Latin America 36 Roberto Wenk 5 The development of palliative medicine in Africa 42 Anne Merriman 6 The development of palliative medicine in Australia/New Zealand 49 J Norelle Lickiss 7 The development of palliative medicine in Asia 58 Rosalie Shaw 8 Palliative care versus palliative medicine 64 Eduardo Bruera,Ellen A Pace 9 Palliative care as a public heath issue 68 Joseph F O’Neill, R Cameron Wolf 10 The future of palliative medicine 77 Charles F von Gunten, Irene J Higginson Part 2 Bioethics 83 11 Principles of bioethics in palliative care 85 Paulina Taboada 12 Ethics in the practice of palliative care 92 James A Tulsky 13 Dignity in palliative care 100 Susan E McClement,Harvey M Chochinov viii Contents Part 3 The problems and challenges of global reach 109 14 Transcultural palliative care 111 Carl Johan Fürst,Solvig Ekblad 15 Palliative care: global situation and initiatives 117 Liliana De Lima Part 4 Education 127 16 Undergraduate education 129 Doreen Oneschuk 17 Graduate education 136 Ilora G Finlay,Simon I R Noble 18 Changing the norms of palliative care practice by changing the norms of education 146 Linda Emanuel 19 Public education 153 Sharon Baxter,Romayne Gallagher Part 5 Research and audit 161 20 Challenges of research in palliative medicine 163 Irene J Higginson 21 The patient population: who are the subjects in palliative medicine research? 171 Jennifer Kapo,David Casarett 22 Study designs in palliative medicine 178 Massimo Costantini 23 Outcomes measurement in palliative care research 185 Joan M Teno 24 Ethics in palliative care research 192 Jonathan Koffman,Fliss Murtagh 25 Practical tips for successful research in palliative care 202 Eduardo Bruera,Ellen A Pace 26 Audit and quality improvement in palliative care research 208 Hsien-Yeang Seow,Sarah Myers,Joanne Lynn Part 6 Organization and governance 215 27 Standards of care 217 Frank D Ferris 28 The adoption of palliative care. The engineering of organizational change 231 Winford E Holland 29 Cost avoidance and other financial outcomes for palliative care programs 238 J Brian Cassel,Thomas J Smith 30 Organization and support of the interdisciplinary team 245 Karen Macmillan,Bette Emery,Louise Kashuba 31 Population-based needs assessment for patient and family care 251 Irene J Higginson,Charles F von Gunten 32 The palliative care consult team 259 Alexie Cintron,Diane E Meier 33 Models of palliative care delivery 266 Badi El Osta,Eduardo Bruera 34 Palliative home care 277 Roberto Wenk Contents ix 35 Day hospitals 285 Bruno Gagnon 36 Inpatient hospices 294 Jeremy Keen 37 The palliative care unit 301 Sharon Watanabe,Karen Macmillan 38 Combined care models 309 Frederick J Meyers,Anthony F Jerant Part 7 Overview of assessment 317 39 Multidimensional assessment in palliative care 319 Ernesto Vignaroli,Eduardo Bruera 40 Tools for pain and symptom assessment in palliative care 333 Victor T Chang 41 Quality of life assessment in palliative care 349 S Robin Cohen Part 8 Pain 357 42 Pathophysiology of chronic pain 359 Sebastiano Mercadante 43 Causes and mechanisms of pain in palliative care patients 367 Suresh K Reddy 44 Opioid analgesics 380 Per Sjøgren,Jørgen Eriksen 45 Assessment and management of opioid side effects 390 Catherine Sweeney,Cathryn Bogan 46 Adjuvant analgesic drugs 402 David Lussier,Russell K Portenoy 47 Alternative routes for systemic opioid delivery 415 Carla Ripamonti,Mauro Bianchi 48 Epidural and intrathecal analgesia and neurosurgical techniques in the palliative setting 431 Phillip C Phan,Madhuri Are,Samuel J Hassenbusch III,Allen W Burton 49 Topical administration of analgesics 450 Andreas Kopf,Steffen Schmidt,Christoph Stein 50 Pain and opioids in children 458 Richard D W Hain,Mary Devins, Angela Miser 51 Pain in older people 467 Wendy M Stein 52 Neuropathic pain 482 Marco Lacerenza,Fabio Formaglio,Lia Teloni,Paolo Marchettini 53 Bone pain 493 Yoko Tarumi 54 Episodic pain 505 Shirley H Bush 55 Somatization and pain expression 512 Marilu P Berry,Diane M Novy 56 Pain in patients with alcohol and drug dependence 517 Steven D Passik,Kenneth L Kirsh
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