Palliative and end-of-life care in the global response to multidrug-resistant tuberculosis
Palliative and end-of-life care in the global response to multidrug-resistant tuberculosis
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DOI：
10.1016/s1473-3099(12)70084-1
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发表时间：
2012-08-01
影响因子：
56.3
通讯作者：
Jaramillo, Ernesto
中科院分区：
文献类型：
--
作者：
Harding, Richard;Foley, Kathleen M.;Jaramillo, Ernesto
耐多药结核病（MDR）治疗成本高，治疗困难，对结核病控制构成全球威胁。患者的高疾病和治疗负担、低治愈率和高死亡率给患者、家庭和护理人员带来痛苦。尽管有改善治疗结果的指导，但很少关注患者和家庭的姑息治疗，如身体，心理，社会和精神方面的困难。召开了一次国际专家研讨会，以阐明耐多药结核病患者的适当姑息治疗反应。应更新几项政策，以确保姑息治疗和临终关怀与治疗同时到位，如果治愈，则治愈，否则直到生命结束。已经开发了许多服务，包括综合姑息治疗（即从现有的结核病治疗中提供）。我们建议可以使用姑息治疗中的现有专业知识，这将改善对包括家庭在内的护理环境中患者的呼吸困难、恶病质和咯血等问题的管理，并提高控制方案的性能。
Multidrug-resistant (MDR) tuberculosis is costly, difficult to treat, and poses a global threat to tuberculosis control. The high burden of disease and treatment for patients, poor cure rates, and high mortality bring distress to patients, families, and caregivers. Despite guidance to improve treatment outcomes, little attention has been paid to palliative care of patients and families, such as for physical, psychosocial, social, and spiritual difficulties. An international expert symposium was convened to articulate an appropriate palliative care response for people with MDR tuberculosis. Several policies should be updated to ensure that palliative and end-of-life care is in place alongside treatment should cure be achieved, and to the end of life if not. Many services have been developed that exemplify integrated palliative care (ie, provided from within existing tuberculosis care). We recommend that existing expertise within palliative care can be used, which will improve management of problems such as dyspnoea, cachexia, and haemoptysis for patients across care settings, including at home, and enhance performance of control programmes.