Pain Management and Palliative Pharmacology

This book provides a practical, evidence-based overview of the supportive care of patients with urological failure, focusing on chronic symptoms such as chronic prostatitis. It begins by looking at quality of life measurements, self-help strategies, the role of the interdisciplinary team, and psychological and social support. It then moves on to clinical chapters which cover issues such as patients who present with hematuria, urinary retention, urinary incontinence, neurological disease affecting the urinary tract, chronic prostatitis, and infertility; ending with a chapter on supportive care for the urology patient and family in the future. The book places a special emphasis on symptomatic interventions, particularly in the setting where the course of the illness cannot be modified.

Heart failure occurs in almost epidemic proportions, placing a huge burden on both the healthcare system, and sufferers and their families. The care of this group of patients has evolved significantly over recent years as our knowledge and understanding of the pathophysiology of heart failure has developed. This book provides an evidence-based overview of heart failure aetiology, its management, and the supportive care required by patients throughout the course of their disease. It also integrates the complexities of heart failure care, bridging knowledge bases from cardiology and cardiothoracic surgery, general medicine and palliative care. It reviews essential information about the epidemiology and pathophysiology of heart failure, and evidence-based medical, device, surgical, and interdisciplinary management. It addresses the evaluation and management of quality of life, common symptoms and problems associated with heart failure, and the holistic approach to supportive care throughout the course of the illness through to the end of life. Prognostication, communication, and ethical decision making are outlined in detail. By applying the principles of palliative medicine, it is possible to offer a supportive care approach that synthesizes the experience of both the heart failure specialist and the palliative care physician, and offers the best possible quality of care to this group of patients.

Respiratory symptoms such as breathlessness and cough are common in patients with advancing and incurable disease. For example, cancer, chronic cardiac and pulmonary disease, progressive neuromuscular disorders and degenerative disorders all give rise to varying degrees of respiratory distress, which adversely affects the patient's quality of life. In recent years, there has been significant growth in the palliation of respiratory symptoms, leading to practical ways of giving relief in hospices, hospitals, and at home. This book includes non-malignant respiratory diseases, such as tuberculosis in AIDS patients and cystic fibrosis, and focuses on aetiology and diagnosis and management, emphasising symptoms, quality of life, and psychosocial support. Its underlying theme is the application of modern research-based knowledge, in a humane way, for patients with advancing disease.

There is increasing recognition of the burden of venous thromboembolism (VTE) in patients with advanced incurable disease and the clinical, ethical, and philosophical challenges they may pose. With a growing elderly population and oncological therapies helping patients live longer with malignant disease, VTE is likely to be an ongoing problem. Whilst presentation, diagnosis, and treatment of VTE in general medicine are well established, its management within the palliative care setting is less clear-cut. Clinical presentation is often masked by other palliative symptoms, and symptoms can be consistent with those of other conditions; diagnosis is therefore underappreciated, and the condition can be difficult to manage. Bringing together international contributions from the field of VTE and palliative care, this book explores the increasing challenges faced by healthcare professionals when managing VTE in advanced disease. Topics such as the epidemiology and pathogenesis of the condition are discussed. It appraises the current evidence informing the prevention, diagnosis, and treatment of VTE, with particular emphasis on its application to patients with incurable malignancy and non-malignant disease. Chapters are illustrated with key learning points and, where appropriate, case studies are presented to illustrate the decision-making processes that may occur when balancing the evidence with its impact on patient quality of life.