Clearing Confusion in Palliative Care: Antipsychotics for Delirium and Goals of Care Interventions


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It’s palliative care week on The Rounds Table! Kieran and Ariel guide listeners through two noteworthy new studies: interventions to clarify goals of care for individuals with advanced dementia; and a randomized trial of treatment for delirium in palliative care.

Goals of care discussions are critical in ensuring treatments are aligned with patients expressed wishes. But, they can be difficult discussions to have. Ariel takes listeners through a study which examined the effectiveness of a goals of care video decision aid on end of life communication between nursing home residents, their families, and the healthcare team.

Up to 40% of patients have delirium on admission to a palliative care unit. Antipsychotics are routinely used to treat the distressing symptoms of delirium in a palliative care setting, but their use for this indication has not been investigated in a placebo controlled trial – until now! Tune in as Kieran guides listeners through a ground breaking new study: should clinicians exercise sober second thought before reaching for their prescription pads?

Last, but definitely not least, the Good Stuff segment. When should peanuts be introduced into the paediatric diet? Ariel gives listeners the latest recommendations! Kieran then ties up the conversation on palliative care through discussing how to care for the increasing comorbidity and complexity seen in elderly patients.

Like what you hear? Rate us on iTunes! Chat with us on Twitter @roundstable and tweet at Kieran directly @kieranlquinn.

The Papers

1. Goals of Care: http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2587643

2. PC Delirium: http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2588810

3. Ariel’s article on GOC for dialysis patients: http://cjk.sagepub.com/content/3/2054358116678207.abstract

Good Stuff

1. “Go Nuts!”: http://www.aappublications.org/news/2017/01/05/PeanutAllergy010517

2. Intensity costs: http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2594282

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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