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Record W2099913013 · doi:10.1089/jpm.2009.0048

The Palliative Medication Kit: An Effective Way of Extending Care in the Home for Patients Nearing Death

2009· article· en· W2099913013 on OpenAlexaff
Suzanne M. Wowchuk, E. Adriana Wilson, Lori Embleton, Marcelo Garcia, Mike Harlos, Harvey Max Chochinov

Bibliographic record

VenueJournal of Palliative Medicine · 2009
Typearticle
Languageen
FieldMedicine
TopicPalliative Care and End-of-Life Issues
Canadian institutionsCancerCare ManitobaDalhousie University
Fundersnot available
KeywordsMedicinePalliative careTerminally illPlace of deathIntervention (counseling)PopulationNursing homesEmergency medicineFamily medicineNursing

Abstract

fetched live from OpenAlex

OBJECTIVE: Palliative medication kits for home use were developed in order to extend the period of time terminally ill patients might be cared for in their homes. DESIGN: Kits containing medications that could be used when the oral route was lost, targeting common symptoms that result in hospital admissions, were placed in homes of terminally ill patients. SETTING: Regional health authority, urban setting, community-based palliative care. POPULATION: Patients receiving care in the community, anticipated to die within the next 2 weeks and wishing to be cared for at home as long as possible. INTERVENTION: Kits were used when patients were experiencing symptom escalation or crisis, and the drugs to manage these were otherwise not available. Community palliative care nurses recommended when to open the kit and received verbal orders from the supervising palliative care physician for the medications to be administered. MAIN OUTCOME MEASURES: Number of kits placed and opened and the prevalence of home death in those instances; the number of kits placed and not opened and the prevalence of home death in those instances. RESULTS: From 2002-2007, a total of 293 kits were placed in patients' homes and used. Two hundred fifty-eight patients (88%) died at home, compared to 24% who died outside of an acute care setting across the entire program (chi(2) = 579.71; p < 0.0001). In 2006-2007, 73 kits were placed but not used. Forty-four patients (60%) died at home, compared to a program home death rate of 27% (chi(2) = 60.70; p < 0.0001). CONCLUSIONS: Palliative medication kits are a simple and effective way of anticipating and addressing comfort and symptom control for dying patients being cared for in the community. These kits can avert institutional crisis admissions, extend the period of time patients can be cared for in their homes and may increase the likelihood of a home death.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.004
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.200
Threshold uncertainty score0.521

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.004
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.080
GPT teacher head0.436
Teacher spread0.356 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations48
Published2009
Admission routes1
Has abstractyes

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