Specialist Palliative Care Centre Research Articles

Blood pressure evaluation and review of antihypertensive medication in patients with life limiting illness.

Background Patients with life limiting illness commonly have multiple co-morbidities that require the use of complex, costly pharmacotherapy. One such example is using medications to treat hypertension in life limiting illness. Objective To: (1) assess the prevalence of previously documented hypertension and associated blood pressure in a cohort of patients with life limiting illness; and, (2) assess the appropriateness of antihypertensive medication in this patient group. Method This was a single centre study at a tertiary, specialist palliative care centre in Northern England. Electronic medical notes were reviewed and data were extracted. Antihypertensive medication was assessed for appropriateness using a conceptual framework. Results A total number of 54 patients were included in the study. Twenty six (48.1%) had previously documented hypertension: the mean blood pressure of which was 122/65mmHg (SD 17.0/10.5), while for the normotensive patients it was 122/73mmHg (SD 21.0/11.6). Of the 26 patients using antihypertensive medication, 25 were assessed as using the medication inappropriately. Conclusions The blood pressure for patients with previously documented hypertension who access specialist palliative care day services is commonly below the NICE target threshold. The majority of these patients are prescribed antihypertensive medications inappropriately.

P127 Hospice respite: Moving forwards not backwards

Anecdotal evidence suggested that respite provision at an independent hospice was dominated by patients with neurological or non cancer diagnoses and that a small number of patients had a disproportionately...

A study of a training scheme for Macmillan nurses in Northern Ireland

To evaluate a one year training scheme for Macmillan Nurses. The role of the clinical nurse specialist has evolved and expanded greatly over the past few years so that it now encompasses components far beyond the traditional nursing remit of direct clinical practice. While several studies have looked at the barriers and facilitators to this process for clinical nurse specialists in particular, none has looked at the benefits of a structured training scheme which involves both a theoretical and clinical component. Tape recorded, semi-structured interviews were undertaken with a purposive sample of trainees who undertook the scheme, their practice-based facilitators and another person(s) involved in the trainee's support. Tapes were transcribed verbatim and each transcript anonymized to prevent identification of participants. Data were analysed thematically using the main headings of expectations, experience and impact and the structured prompts from the aide-memoir within these headings. Results showed that the majority of respondents felt the scheme had been successful with one of the main achievements being that trainees were perceived to be adequately prepared to take on the role of a CNS on completion of the scheme. While the Role Development Programme was thought to provide a good academic structure for the scheme some participants thought that more theory on symptom control and communication skills and a placement in a specialist palliative care centre should also be included. The Macmillan Trainee Scheme has succeeded in its objectives to facilitate the transition from generalist to specialist nursing. It should be extended to include an induction and consolidation period and more theoretical input on communication skills and symptom control. With these improvements, the scheme could be used as a standard model for training specialist practitioners and a means to address the current issues of workforce planning.