Palliative care and end-of-life care for polypathological patients

Rev Clin Esp (Barc). 2017 Dec;217(9):543-552. doi: 10.1016/j.rce.2017.08.005. Epub 2017 Oct 10.
[Article in English, Spanish]

Abstract

Patients with advanced chronic diseases receive fragmented care, which entails high resource consumption and a poor quality of life. Uncertainty in the prognosis and scarce investigation into the importance of symptomatic control in this patient group hinders a proper therapeutic approach. Palliative care teams optimise the use of resources through comprehensive patient care, the optimization of the patient's environment, communication, the preparation of early care plans and the creation of coordinated healthcare circuits, which improve the quality of the patient's care in advanced stages of the disease. In the end-of-life phase, the therapeutic approach is focused on symptomatic control, selecting treatments according to the cause, comorbidities and the patient's wishes. To control refractory symptoms, palliative sedation is considered an indispensable option.

Keywords: Advanced chronic disease; Atención paliativa; End of life; Enfermedad crónica avanzada; Final de vida; Palliative care.