- Title
- The population burden of chronic symptoms that substantially predate the diagnosis of a life-limiting illness
- Creator
- Currow, David C.; Clark, Katherine; Kamal, Arif; Collier, Aileen; Agar, Meera R.; Lovell, Melanie R.; Phillips, Jane L.; Ritchie, Christine
- Relation
- Journal of Palliative Medicine Vol. 18, Issue 6, p. 480-485
- Publisher Link
- http://dx.doi.org/10.1089/jpm.2014.0444
- Publisher
- Mary Ann Liebert
- Resource Type
- journal article
- Date
- 2015
- Description
- Many people in our communities live with symptoms for years or decades, something of relevance to hospice/palliative care clinicians and researchers. The proportion of people in the community at large who have a chronic symptom is likely to approximate the proportion of people referred to hospice/palliative care services with that same chronic symptom that pre-dates their life-limiting illness. Such patients may have different responsiveness to, and expectations from, symptomatic therapies, thus requiring more advanced approaches to symptom control. For researchers evaluating the impact of hospice/palliative care services, failing to account for people with long-term refractory symptoms pre-dating their life-limiting illness may systematically underestimate services' benefits. Observational symptom prevalence studies reported in hospice/palliative care to date have not accounted for people with long-term refractory symptoms, potentially systematically overestimating symptoms attributed to life-limiting illnesses. Cross-sectional community prevalence rates of key chronic refractory symptoms largely unrelated to their life-limiting illness reflect the likely prevalence on referral to hospice/palliative care: fatigue (up to 35%); pain (12%–31%); pain with neuropathic characteristics (9%); constipation (2%–29%); dyspnea (4%–9%); cognitive impairment (>10% of people >65 years old; >30% of people >85 years old); anxiety (4%); and depression (lifetime incidence 2%–15%; one year prevalence 3%). Prospective research is needed to establish (1) the prevalence and severity of chronic symptoms that pre-date the diagnosis of a life-limiting illness in people referred to hospice/palliative care services, comparing this to whole-of-population estimates; and (2) whether this group is disproportionately represented in people with refractory symptoms.
- Subject
- chronic symptoms; palliative care; life-limiting illness
- Identifier
- http://hdl.handle.net/1959.13/1338916
- Identifier
- uon:28133
- Identifier
- ISSN:1096-6218
- Language
- eng
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