Frank Ferris - Academia.edu (original) (raw)

Papers by Frank Ferris

Springer eBooks, 2017

The use of aggressive treatments in patients with advanced cervical cancer at the end of life is ... more The use of aggressive treatments in patients with advanced cervical cancer at the end of life is frequent. Different studies have suggested no appreciable difference in survival between patients treated aggressively versus those that received palliative care, the term is frequently misconstrued as synonymous with end-of-life. Palliative care is focused on the relief of suffering, in all of its dimensions, throughout the course of a patient’s illness. A provisional clinical opinion released by the American Society of Clinical Oncology recommends the use of palliative care alongside standard oncologic therapy for patients newly diagnosed with metastatic cancer, according with the patients’ needs. The purpose of the chapter is to highlight the importance of palliative care (PC) as an integral part of the care of CaCu patients. A better understanding of PC would help the oncologist to identify potentially eligible patients for PC; researchers to standardize the design for future trials and administrators promote the implementation of PC programs and allocate proper resources.

CRC Press eBooks, Jan 30, 2009

Journal of Pain and Symptom Management, Feb 1, 2018

Context. Since the year 2000, Mongolia has established the foundation measures for a national pal... more Context. Since the year 2000, Mongolia has established the foundation measures for a national palliative care program and has made several significant achievements. Methods. Systematic reviews and observational studies on palliative care development in Mongolia have taken place over the past 16 years. Results. Mongolia began palliative care development in 2000 with the creation of the Mongolian Palliative Care Society and the Palliative Care Department. Palliative care is included in the Mongolia's Health Law, Health Insurance Law, Social Welfare Law, National Cancer Control Program, and the National Program for Non-Communicable Diseases, and has approved Palliative Care Standards and Pain Management Guidelines. Palliative care education is included in the undergraduate and postgraduate curriculum in all medical universities. Six hospice units in Ulaanbaatar have 50 beds; each of the nine districts and all 21 provinces have up to four to five palliative beds, and there are 36 palliative care units, for a total 190 beds for three million people. In 2014, a pediatric palliative care inpatient unit was established with five beds. Essential drugs for palliative care have been available in Mongolia since 2015. The pharmaceutical company IVCO produces morphine, codeine, pethidine, and oxycodone in Ulaanbaatar. Conclusion. Mongolia has made real progress in integrating palliative care into the health system.

Palliative & Supportive Care, May 23, 2008

Major depression is prevalent, difficult to assess, underrecognized, and undertreated in hospice ... more Major depression is prevalent, difficult to assess, underrecognized, and undertreated in hospice settings. Furthermore, it is associated with significant morbidity and mortality. A retrospective chart review of 2716 patients receiving hospice care was conducted in order to determine the baseline rate of recognition of depression in patients with advanced, life-threatening illnesses by frontline hospice clinicians. Documentation of "depression" as either a diagnosis or problem was used as an estimate of how often these disorders were considered significant issues by the treating interdisciplinary team. Of the patients receiving home/long-term care, 10.8% (234/2168) had depression documented as a diagnosis or significant problem. The presence of recognized depression in this setting was associated with significant differences in gender, marital status, and terminal diagnoses. Total length of hospice care was also significantly longer. Of patients receiving inpatient care, 13.7% (75/548) had depression documented as a diagnosis or significant problem. Recognized depression in this setting was associated with significant differences in marital status, length of inpatient stay, and total time in hospice care. If documentation is representative of the care that the interdisciplinary teams provide, depression of any kind appears to be underrecognized in this population. In fact, it is on the low end of prevalence estimates in the literature. Improved depression assessment is needed in order to minimize the impact of depression on patients living with advanced, life-threatening illnesses.

Journal of Pain and Symptom Management, Aug 1, 2002

BMJ Supportive & Palliative Care, 2019

ObjectivesTo determine whether specific external signs of emotional distress (ESED) can be an ind... more ObjectivesTo determine whether specific external signs of emotional distress (ESED) can be an indirect measure of emotional distress in caregivers.MethodsA cross-sectional multicentre design was used. 148 primary caregivers of advanced cancer patients attended in four Spanish palliative care units participated in this study. The emotional distress of caregivers was measured using both the Emotional Distress of Caregivers Scale and a psychological interview. Health professionals collected data using a standard clinical interview process after a brief training period.ResultsMore than half the caregivers (60%) presented with emotional distress. A positive correlation (r=0.566) was found between the intensity of ESED and emotional distress per se. Caregivers who presented emotional distress showed more ESED than those that did not (p<0.01). The study found significant differences for the categories ‘visible signs of sadness, fear, crying, feeling overwhelmed’ (p<0.001), ‘difficult...

Journal of Clinical Epidemiology, 1991

We conducted a retrospective, non-randomized, cost-minimization study, from the perspective of th... more We conducted a retrospective, non-randomized, cost-minimization study, from the perspective of the Ministry of Health, to compare the cost of managing cancer patients who required narcotic infusions, in hospital and at home. Our medical costs averaged 369.72perinpatientdayand369.72 per inpatient day and 369.72perinpatientdayand150.24 per outpatient day (saving 219.48perdiem,1988Canadiandollars),whilenarcoticcostswerethesameforanygivenpatientinbothsettings.Sensitivityanalysisshowedthatnoreasonablechangesinthequantityandcostofservicesreducedoursavingsbymorethan50219.48 per diem, 1988 Canadian dollars), while narcotic costs were the same for any given patient in both settings. Sensitivity analysis showed that no reasonable changes in the quantity and cost of services reduced our savings by more than 50%. During incremental analysis, savings increased as more outpatient days were managed by our centre, from 219.48perdiem,1988Canadiandollars),whilenarcoticcostswerethesameforanygivenpatientinbothsettings.Sensitivityanalysisshowedthatnoreasonablechangesinthequantityandcostofservicesreducedoursavingsbymorethan500.00 for 318 days, to more than $500,000 for over 2000 days per annum. As this program has been extremely cost effective and preferred by our patients, other hospitals and central funding agencies might consider establishing a regional outpatient narcotic infusion program to reduce their costs. Ambulatory care Costs and cost analysis Drug infusion systems Home care services Hydromorphone Morphine Narcotics Palliative treatment Parenteral infusions Terminal care

JCO Global Oncology

PURPOSE Palliative care in Sarawak is mainly provided by health care professionals with limited f... more PURPOSE Palliative care in Sarawak is mainly provided by health care professionals with limited formal training in palliative care. Therefore, in 2020, collaborative work between Sarawak General Hospital, University Malaysia Sarawak, and ASCO began. This study reports on the outcome of this collaboration. METHODS The collaboration was initiated with the first ASCO Palliative Care e-course, Train the Trainer program, International Development and Education Award—Palliative Care and translation of ASCO Palliative Care Interdisciplinary Curriculum resources. RESULTS This collaboration has resulted in the change of practice of palliative care among the oncology team of Sarawak General Hospital. CONCLUSION It encourages more timely palliative care referrals to ensure that patients with complex physical, psychosocial, and spiritual needs have the necessary input and support from the palliative care team throughout the course of patients’ illnesses.

Oxford University Press eBooks, 2010

... to palliative care: 4.11 The contribution of the stoma nurse specialist to palliative care: J... more ... to palliative care: 4.11 The contribution of the stoma nurse specialist to palliative care: Jane Ellen Barr [Summary] [Browse Figures]. 4.12 The contribution of clinical psychology to palliative care: 4.12 The contribution of clinical psychology to palliative care: Fiona Cathcart [Summary ...

Clinical Cardiology, 2000

Drugs, 2020

Pain is associated with emotional and physical suffering that severely impacts quality of life. M... more Pain is associated with emotional and physical suffering that severely impacts quality of life. Many guidelines for the treatment of moderate to severe cancer pain indicate the use of opioids. For a small proportion of the global population, opioids are readily accessible, but are consequently also subject to risk of overuse and misuse. On the other hand, many regions provide limited access to licensed opioid therapeutics and patients struggle for better pain management. The use of prescription opioids for treatment of severe cancer and acute pain is well established, but opioid use in chronic non-cancer pain is controversial and not supported by the literature. The opioid crisis and the increasing overdose fatalities in some countries have resulted in a resurgence of opiophobia in these countries, but even worse, amplified opiophobia in countries with lower opioid consumption. In this narrative review, we highlight how the opioid crisis of overuse in some countries can negatively impact appropriate access to opioids elsewhere. The availability of opioids for clinical and recreational use differs between countries worldwide-this is an important factor in determining the occurrence of a 'crisis of recreational use of opioids' or a 'crisis of under-prescription of opioids' for pain management.

Canadian oncology nursing journal = Revue canadienne de nursing oncologique, 2004

Journal of Palliative Care, 1990

Morphine and hydromorphone infusions of 6 or more (average 25.75) days in duration were used with... more Morphine and hydromorphone infusions of 6 or more (average 25.75) days in duration were used with increasing frequency (up to 7%) by our oncology inpatients. Eighty-six percent of the 135 inpatients we reviewed realized good pain control with dose rates up to 700 morphine-equivalent (ME) mg/h. Local toxicity occurred on only 10 occasions. Systemic side effects secondary to the infusion were reported 75 times and were generally readily reversed. Myoclonus was seen in 11% of our patients at dose rates as low as 60–90 ME mg/h. Adjuvant therapies were not used as frequently as might be warranted. We believe that narcotic infusions, particularly subcutaneous ones, are safe and effective. Further prospective trials are needed to clarify how they should be combined with other therapies to control cancer pain that is poorly responsive to narcotics, and to better understand the etiology and management of serious side effects.

Surgical Oncology Clinics of North America, 2001

Nursing times

This article is an abstract from a new guide, Principles of Best Practice: Minimising Pain at Wou... more This article is an abstract from a new guide, Principles of Best Practice: Minimising Pain at Wound Dressing-Related Procedures. It is an educational initiative of the World Union of Wound Healing Societies (WUWHS). The guide has been inspired by two seminal documents: the European Wound Management Association's position document, Pain at Wound Dressing Changes (EWMA, 2002), and Practical Treatment of Wound Pain and Trauma: A Patient-centred Approach (Reddy et al, 2003). As an international educational initiative, the WUWHS document is aimed at anyone involved in dressing-related procedures anywhere in the world. This article summarises the section on best practice in the assessment of wound pain.

Journal of Palliative Medicine, 2004