Journal of Pain & Palliative Care Pharmacotherapy最新文献_第8页

Dehydration in the Dying Process: An Integrative Systematic Review of Physiological Mechanisms and Clinical Implications. 死亡过程中的脱水：生理机制和临床意义的综合系统综述。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2026-04-11 DOI: 10.1080/15360288.2026.2655782

Juan Esteban Correa-Morales, Nidia Mantilla-Manosalva, María Fernanda Iriarte-Aristizábal, Angie Nathalia Hernández-Rico, Santiago Guadarrama, Maria Alejandra Umbacia, Leah Ward, Rebecca Gagne-Henderson

{"title":"Dehydration in the Dying Process: An Integrative Systematic Review of Physiological Mechanisms and Clinical Implications.","authors":"Juan Esteban Correa-Morales, Nidia Mantilla-Manosalva, María Fernanda Iriarte-Aristizábal, Angie Nathalia Hernández-Rico, Santiago Guadarrama, Maria Alejandra Umbacia, Leah Ward, Rebecca Gagne-Henderson","doi":"10.1080/15360288.2026.2655782","DOIUrl":"10.1080/15360288.2026.2655782","url":null,"abstract":"Dehydration is a common finding in patients with life-limiting illnesses at the end of life. Clinicians often face uncertainty when deciding on the use of artificial hydration, particularly given concerns about thirst, delirium, and respiratory secretions. Despite its clinical relevance, the underlying physiology of terminal dehydration has been insufficiently explored. We conducted an integrative systematic review of studies addressing dehydration in patients with advanced disease at the end of life. Six databases were searched up to March 2025. Eligible studies included physiological or clinical analyses of dehydration in terminally ill populations. Seven studies met inclusion criteria. Evidence suggests that terminal dehydration often reflects a regulated, adaptive process rather than a simple fluid deficit. Laboratory findings showed stable electrolytes and activation of the renin-angiotensin-aldosterone system, with minimal association between biochemical changes and thirst. Bioelectrical impedance indicated progressive intracellular dehydration consistent with catabolic decline. Clinically, higher hydration volumes correlated with increased risk of respiratory secretions, edema, and agitation, while reduced hydration was associated with improved comfort and fewer secretion-related complications. Terminal dehydration appears to be an adaptive physiological response in dying patients, with limited evidence of symptomatic benefit from artificial hydration and potential for harm.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"271-281"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Targeting Complementary Pain Pathways: The Rationale for Combining Carbamazepine and Gabapentin in Neuropathic Pain. 靶向互补疼痛通路：卡马西平和加巴喷丁联合治疗神经性疼痛的基本原理。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2026-01-22 DOI: 10.1080/15360288.2026.2619588

Marina Ayres Delgado, Ítala Ferreira de Jesus, Larissa Caroline Barbosa

引用次数: 0

Perioperative Anesthetic Management in Cancer Patients Receiving Strong Opioids: A Retrospective Study from a Single Center with Palliative Care Team Involvement. 接受强阿片类药物治疗的癌症患者围手术期麻醉管理：一项有姑息治疗团队参与的单中心回顾性研究

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2026-03-12 DOI: 10.1080/15360288.2026.2638375

Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Shuri Yoshino, Hiromasa Kawakami, Hitoshi Sato, Takahisa Goto

{"title":"Perioperative Anesthetic Management in Cancer Patients Receiving Strong Opioids: A Retrospective Study from a Single Center with Palliative Care Team Involvement.","authors":"Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Shuri Yoshino, Hiromasa Kawakami, Hitoshi Sato, Takahisa Goto","doi":"10.1080/15360288.2026.2638375","DOIUrl":"10.1080/15360288.2026.2638375","url":null,"abstract":"There are no clinical guidelines for the perioperative management of cancer pain among opioid users, and a lack of literature exists concerning this topic. This study aimed to retrospectively investigate the actual perioperative management of patients with cancer who received general anesthesia while using strong opioids. We conducted a chart review of the perioperative management of patients with cancer who received general anesthesia while using strong opioids. The primary outcome was the number of additional administration of analgesics during the first 24 h after surgery, except for PCA (patient-controlled analgesia). The secondary outcome was the prevalence of cases of poor pain control after surgery, which was defined in this study as \"patients who received additional administration of analgesics more than four times (excluding PCA) within the first 24 h after surgery.\" Fifty-two patients were included in this analysis. The primary outcome was one per day (interquartile range, 0-4). By contrast, the secondary outcome was 17.3%. Preoperative pelvic visceral pain (cancer pain) was the most common; it was associated with poor pain control. In this area, it is important to evaluate cancer and non-cancer pain accurately and provide appropriate analgesia after surgery.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"237-247"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Clinical Application of Suzetrigine. 苏泽三嗪的临床应用。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2026-02-14 DOI: 10.1080/15360288.2026.2624502

Shanhui Yuan, Hui Ji, Yuntao Lu, Ziyue Zhang, Hui Tang

{"title":"The Clinical Application of Suzetrigine.","authors":"Shanhui Yuan, Hui Ji, Yuntao Lu, Ziyue Zhang, Hui Tang","doi":"10.1080/15360288.2026.2624502","DOIUrl":"10.1080/15360288.2026.2624502","url":null,"abstract":"Acute pain affects patient's health and quality of life. Suzetrigine is a new highly selective Nav1.8 inhibitor for the treatment of moderate to severe acute pain in adults. This article aims to summarize the existing clinical results of suzetrigine to evaluate its mechanism of action, pharmacokinetics, pharmacodynamics, efficacy, and safety. Using the keywords \"suzetrigine OR VX-548 OR SUZ\" AND \"Acute Pain OR Pain, Acute,\" clinical trial results were searched on PubMed, Web of Science, Vertex Pharmaceuticals (suzetrigine's R&D company) Inc., and ClinicalTrials.gov. Suzetrigine is a CYP3A inducer; caution should be exercised when combining it with CYP3A substrates. Dosage adjustment is required for patients with hepatic or renal impairment. In four phase II and III trials for patients with bunionectomy and abdominoplasty surgery, suzetrigine demonstrated superior pain relief within 48 h compared to placebo (p < 0.05) and a lower incidence of adverse reactions compared with hydrocodone bitartrate/acetaminophen. As a new type of analgesic, the clinical studies of suzetrigine in other types of pain and special populations, as well as whether there are gender metabolic differences, are still unknown. Thus, current research on suzetrigine is worth further exploration.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"311-320"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Pharmacist-Led Risk Mitigation Strategies for Veterans Prescribed Concurrent Benzodiazepine and Opioid Medications with or Without a Stimulant. 药剂师主导的风险缓解策略对退伍军人服用或不服用兴奋剂的苯二氮卓类药物和阿片类药物的影响

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2026-03-02 DOI: 10.1080/15360288.2026.2638371

Lauren Shiplett, Stephen Gruver, Jennifer Dress

{"title":"Impact of Pharmacist-Led Risk Mitigation Strategies for Veterans Prescribed Concurrent Benzodiazepine and Opioid Medications with or Without a Stimulant.","authors":"Lauren Shiplett, Stephen Gruver, Jennifer Dress","doi":"10.1080/15360288.2026.2638371","DOIUrl":"10.1080/15360288.2026.2638371","url":null,"abstract":"Introduction: Concurrent use of benzodiazepines (BZDs) and opioids increases the risk of overdose by 3-4 times compared to opioids alone. In 2016, boxed warnings and medication guides were added to these medications to highlight the risks of sedation, respiratory depression, coma, and death. Stimulants oppose the central nervous system effects of these agents; thus masking sedation and can lead to potential unintentional overdose. With this knowledge, the objective of this study was to enhance risk mitigation interventions in patients prescribed BZD and opioids with or without stimulants.Methods: This single-center, prospective quality-improvement study evaluated patient engagement in pharmacist-led comprehensive medication management (CMM) to reduce risks associated with concurrent BZD and opioid use (+/- stimulants). The secondary outcome assessed the willingness of patients to initiate tapers. Patients were identified utilizing the Psychotropic Drug Safety Initiative Dashboard (PDSI) from December 17, 2024 to February 4, 2025, and contacted for CMM via phone calls.Results: Among 43 patients, 95% (n = 41) agreed to pharmacist-led CMM. Naloxone was ordered for 70% (n = 30) of patients. Additionally, 4 patients agreed to meet with a clinical pharmacy practitioner to discuss tapering.Conclusion: Pharmacist-led CMM and tailored education effectively encourage patient engagement and openness to medication tapers. Continued efforts are needed to reduce concurrent prescribing of BZDs and opioids.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"217-222"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of Diarrhea Incidence Following Initial Naldemedine Administration in Patients Receiving Strong Opioids: A Retrospective Cohort Study. 服用强阿片类药物患者初始服用纳地美定后腹泻发生率的比较：一项回顾性队列研究。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2026-03-26 DOI: 10.1080/15360288.2026.2649362

Masashi Toyoda, Yoshihiko Okano, Takeo Yasu, Mikio Shirota

{"title":"Comparison of Diarrhea Incidence Following Initial Naldemedine Administration in Patients Receiving Strong Opioids: A Retrospective Cohort Study.","authors":"Masashi Toyoda, Yoshihiko Okano, Takeo Yasu, Mikio Shirota","doi":"10.1080/15360288.2026.2649362","DOIUrl":"10.1080/15360288.2026.2649362","url":null,"abstract":"Naldemedine is commonly prescribed for opioid-induced constipation but can cause diarrhea. Diarrhea incidence following naldemedine initiation may vary across background opioids. We conducted a single-center retrospective cohort study of hospitalized adults with cancer who initiated naldemedine while receiving strong opioids between November 2021 and December 2024 to quantify diarrhea incidence within 7 days of naldemedine initiation by opioid type (graded according to the Common Terminology Criteria for Adverse Events version 5.0) and explore the associated factors. Covariates included demographics, Eastern Cooperative Oncology Group performance status, oral morphine equivalents, and selected concomitant medications and clinical factors. Univariate logistic regression was used to explore associations with diarrhea. Thirty-nine patients were included (morphine, 1; oxycodone, 27; fentanyl, 5; hydromorphone, 6). Overall, 33% (13/39) developed diarrhea, all of which were mild (grades 1-2). Diarrhea incidence varied by opioid type: morphine (0%, 0/1), oxycodone (26%, 7/27), fentanyl (80%, 4/5), and hydromorphone (33%, 2/6). Exploratory analyses suggested that fentanyl use and female sex were associated with diarrhea incidence, although estimates were imprecise. Early post-naldemedine diarrhea incidence was common but uniformly mild, with a higher incidence among fentanyl recipients, but these hypothesis-generating findings require validation in larger prospective studies.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"248-254"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enhancing Perioperative Prescription Opioid Risk Mitigation Through Pharmacist Intervention. 通过药师干预加强围手术期处方阿片类药物风险降低。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2026-01-28 DOI: 10.1080/15360288.2026.2613840

Cheyenne Barrier, Lindsay Wells, Jennifer Meyer Reid

{"title":"Enhancing Perioperative Prescription Opioid Risk Mitigation Through Pharmacist Intervention.","authors":"Cheyenne Barrier, Lindsay Wells, Jennifer Meyer Reid","doi":"10.1080/15360288.2026.2613840","DOIUrl":"10.1080/15360288.2026.2613840","url":null,"abstract":"Prescription opioid risk mitigation is paramount to patient and community safety. Postoperative pain management prescriptions can lead to excess opioids in the home with many patients being unaware of proper disposal. The purpose of this initiative was to evaluate pharmacist impact on opioid safety outcomes in perioperative surgical pain management patients. Select patients scheduled to undergo total knee arthroplasty or total hip arthroplasty at a single Veterans Affairs Health Care System were contacted perioperatively by a clinical pharmacist to provide education on pain management and prescription opioid risk mitigation. Outcomes measured included patient interest in a naloxone prescription and medication disposal envelopes, level of pain control, quantity of opioids used, method of disposal or planned disposal of remaining opioids, and patient satisfaction. Twenty-seven patients were included in the initiative. Twenty patients (74%) expressed interest in a naloxone prescription and 13 patients (48%) expressed interest in a medication disposal envelope. During the postsurgery assessment, 20 patients reported having excess opioid tablets. Of those, 4 patients (20%) reported proper disposal of excess opioids, and 16 patients (80%) had not yet disposed of their excess opioids. Pharmacist involvement in perioperative pain management could promote prescription opioid risk mitigation through targeted education and the proffering of tools such as naloxone and medication disposal options.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"388-394"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low-Dose Ketamine Infusions for Postoperative Analgesia in Patients on Chronic Opioids Therapy in General Inpatient Units: safety Signals and Monitoring Needs in a Retrospective Cohort. 低剂量氯胺酮输注用于普通住院单位慢性阿片类药物治疗患者的术后镇痛：回顾性队列的安全信号和监测需求

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2026-02-18 DOI: 10.1080/15360288.2026.2624496

David Carrasco Guariento, Amir Dadashian, Maggie Xiao, Christopher Brown, Binu Jose Jacob, Debashish Chowdhury, Naveed Siddiqui

{"title":"Low-Dose Ketamine Infusions for Postoperative Analgesia in Patients on Chronic Opioids Therapy in General Inpatient Units: safety Signals and Monitoring Needs in a Retrospective Cohort.","authors":"David Carrasco Guariento, Amir Dadashian, Maggie Xiao, Christopher Brown, Binu Jose Jacob, Debashish Chowdhury, Naveed Siddiqui","doi":"10.1080/15360288.2026.2624496","DOIUrl":"10.1080/15360288.2026.2624496","url":null,"abstract":"Patients with chronic pain often have difficult postoperative pain and high opioid needs. Ketamine is a useful adjuvant, but uncertainty about monitoring requirements limits utility. To evaluate incidence and severity of ketamine-related adverse effects under a low-resource monitoring protocol on general inpatient units, we conducted a retrospective chart review at a tertiary center including adults with chronic pain on long-term opioids who received postoperative ketamine infusions (0.1-0.3 mg/kg/h). Monitoring included vital signs, sedation, and mental status at predefined intervals. Data included demographics, surgery type, ketamine doses, preoperative opioid use, and adverse effects (hallucinations, nightmares, nystagmus/diplopia, hypersalivation, seizures), classified as mild (no pharmacologic/escalation) or severe (intervention or higher-acuity transfer). Eighty-nine patients were included (abdominoperineal 53.9%, orthopedic 42.7%). Mean 0-24 h and 24-48 h administered ketamine doses were 249.2 ± 167.5 mg and 235.6 ± 293.2 mg. No severe adverse effects occurred. Mild effects were reported in 9.0% (hallucinations 7.9%; nystagmus/diplopia 1.1%); all resolved with dose reduction or discontinuation; no patient required pharmacologic treatment or higher-level monitoring. Ketamine dosing, surgery type, age, sex, and preoperative opioid use were not associated with hallucinations. These findings support resource-conscious general inpatient units' protocols, while prospective studies should refine patient selection, dosing, and monitoring frequency.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"207-216"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Strategic Integration of EMR Tools in a Pharmacist-Led Palliative Care Pilot Program to Improve Workflow Efficiency. 在药剂师主导的姑息治疗试点项目中战略性整合电子病历工具以提高工作流程效率。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2025-12-19 DOI: 10.1080/15360288.2025.2606250

Elizabeth Stroeh, Brianna Jansma Vant Hul, Karly Blaalid

{"title":"Strategic Integration of EMR Tools in a Pharmacist-Led Palliative Care Pilot Program to Improve Workflow Efficiency.","authors":"Elizabeth Stroeh, Brianna Jansma Vant Hul, Karly Blaalid","doi":"10.1080/15360288.2025.2606250","DOIUrl":"10.1080/15360288.2025.2606250","url":null,"abstract":"Previous studies have shown that pharmacist involvement in inpatient palliative care programs is associated with lower daily cost expenditures and fewer patients with subsequent hospitalizations or urgent care visits. The objective of this study was to determine the impact of a new inpatient pain and palliative pharmacy service line staffed by a first year pharmacist resident. In this prospective, single center pilot study, a PGY1 pharmacy resident reviewed pain medications for hospitalized patients from February 3, 2025 through February 28, 2025, and joined with the interdisciplinary palliative care team attending daily huddle. The pharmacist resident reviewed 571 patients and made 79 interventions during the pilot duration (average 4.3 interventions per day). Most common intervention types included discontinuation of a medication, adding an adjunct medication, or dose adjustment. This study found that a dedicated pain and palliative care pharmacist resident integrated within the interdisciplinary palliative care team can make diverse interventions and recommendations to optimize pain and symptom management for hospitalized patients. Depending on the size of the medical center, the scope of such a position may need to be expanded to justify a full FTE pain and palliative pharmacist position.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"380-387"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early Palliative Care Integration in End-Stage Liver Disease: A Narrative Review of Clinical Strategies for Symptom Control and Quality of Life. 晚期肝病的早期姑息治疗整合：症状控制和生活质量的临床策略综述

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-06-01 Epub Date: 2026-01-12 DOI: 10.1080/15360288.2026.2613837

Daniela Sarria-Gómez, Cristhian Camilo Martínez Torres, Diana Estrada-Bermúdez, Liliana Saavedra

{"title":"Early Palliative Care Integration in End-Stage Liver Disease: A Narrative Review of Clinical Strategies for Symptom Control and Quality of Life.","authors":"Daniela Sarria-Gómez, Cristhian Camilo Martínez Torres, Diana Estrada-Bermúdez, Liliana Saavedra","doi":"10.1080/15360288.2026.2613837","DOIUrl":"10.1080/15360288.2026.2613837","url":null,"abstract":"End-stage liver disease (ESLD) is associated with a high symptom burden, poor prognosis, and limited access to curative disease. Despite growing evidence supporting the role of palliative care (PC), its integration into the routine management of ESLD remains limited and inconsistent. To synthesize the current evidence on the role of palliative care in ESLD, emphasizing its impact on quality of life and including strategies for symptom control and effective clinical integration. A narrative review with a systematic approach was conducted. PubMed, Scopus, Embase, and SciELO were searched for English- and Spanish-language studies published between 2015 and 2025. Studies were selected based on methodological rigor and relevance to PC interventions in ESLD. Key barriers to PC implementation include misconceptions about its use being limited to terminal phases, lack of referral criteria, and insufficient coordination between specialties. Evidence shows that early PC involvement improves symptom control (pain, dyspnea, pruritus, encephalopathy), decreases avoidable hospitalizations, and facilitates shared decision-making. Early and structured integration of palliative care into ESLD management is essential. Health systems should prioritize interdisciplinary care models, establish clear referral criteria, and promote a care approach focused on patient well-being, autonomy, and dignity.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"294-310"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0