Palliative Care

Specialist palliative care access low in kidney disease and linked to lower utilization in malignant cases

In a Finnish retrospective cohort of adults dying in 2019, SPC access was 9.1% for non-malignant and 27.6% for malignant kidney disease. Among patients with malignant kidney disease, SPC users died at home more often (10.6% vs 5.9%) and had fewer ED contacts (19.7% vs 32.9%). SPC access was also associated with fewer hospitalizations and fewer readmissions in malignant disease. There was no measurable benefit of SPC access for patients with non-malignant kidney disease in this dataset. 1

Reiki and Therapeutic Touch: very limited, heterogeneous evidence in palliative settings

This systematic review included nine studies (N = 415) of Reiki and Therapeutic Touch in palliative care populations. Some studies reported improvements in pain, anxiety, fatigue, sleep, and emotional well-being, but findings were inconsistent. Risk of bias was present and overall certainty was judged very low, with limited adverse-event reporting. These therapies may offer perceived relaxation or comfort but are not practice-changing yet. 2

Swiss physicians divided on antibiotics for aspiration pneumonia in frail older patients

In a randomized survey of 195 Swiss physicians, 22.1% would prescribe antibiotics for aspiration pneumonia in frail, palliative patients. Most respondents (77.9%) believed antibiotics did not improve comfort, while 76.4% thought withholding could shorten life. Physicians were more likely to prescribe for patients with better functional status and varied by linguistic region. Authors highlight clinical uncertainty and recommend decision-support and inclusive conversations with families and teams. 3