000			05159cam a2200169 4500
001			NMDX6997
008			120401t2015 xxu||||| |||| 00| 0 eng d
100			_aSampson, Elizabeth L
240			_aBMJ Supportive & Palliative Care
245			_aEuropean palliative care guidelines: how well do they meet the needs of people with impaired cognition?
260			_c2015
500			_aNMUH Staff Publications
500			_a5
520			_a<h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">OBJECTIVE:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">Numbers of people dying with cognitive impairment (intellectual disability (ID), dementia or delirium) are increasing. We aimed to examine a range of <span class="highlight">European</span> national <span class="highlight">palliative care</span> <span class="highlight">guidelines</span> to determine if, and how well, pain detection and management for people dying with impaired cognition are covered.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">METHODS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">Questionnaires were sent to 14 country representatives of the <span class="highlight">European</span> Pain and Impaired Cognition (PAIC) network who identified key national <span class="highlight">palliative care</span> <span class="highlight">guidelines</span>. Data was collected on <span class="highlight">guideline</span> content: inclusion of advice on pain management, whether cognitively impaired populations were mentioned, assessment tools and management strategies recommended. Quality of <span class="highlight">guideline</span> development was assessed with the Appraisal of <span class="highlight">Guidelines</span> Research and Evaluation (AGREE) instrument.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">RESULTS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">11 countries identified <span class="highlight">palliative care</span> <span class="highlight">guidelines</span>, 10 of which mentioned pain management in general. Of these, seven mentioned cognitive impairment (3 dementia, 2 ID and 4 delirium). Half of <span class="highlight">guidelines</span> recommended the use of pain tools for people with cognitive impairment; recommended tools were not all validated for the target populations. <span class="highlight">Guidelines</span> from the UK, the Netherlands and Finland included most information on pain management and detection in impaired cognition. <span class="highlight">Guidelines</span> from Iceland, Norway and Spain scored most highly on AGREE rating in terms of developmental quality.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">CONCLUSIONS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;"><span class="highlight">European</span> national <span class="highlight">palliative care</span> <span class="highlight">guidelines</span> may not meet the needs of the growing population of people dying with cognitive impairment. New <span class="highlight">guidelines</span> should consider suggesting the use of observational pain tools for people with cognitive impairment. Better recognition of their needs in <span class="highlight">palliative care</span> <span class="highlight">guidelines</span> may drive improvements in <span class="highlight">care</span>.</span></p>
856			_uhttps://www.ncbi.nlm.nih.gov/pubmed/25869811
856			_uhttp://ferriman.wufoo.com/forms/journal-article-request/
999			_c76013 _d76013