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The purpose is to investigate how palliative teams collaborate interprofessionally with professionals/patients from different occupations in hospital departments and municipal health care services. Background: Previous research has argued that interprofessional teams support the continuity of care, research-based decision-making, advanced care planning, and high-quality care for palliative patients. Method: Qualitative methodology with four focus group interviews was utilized in four hospitals in central Norway, and there were 26 informants: nine doctors, eight nurses, three physiotherapists, two social workers, two priests and two occupational therapists. Results: The informants described factors that were perceived as either facilitators or barriers in interprofessional collaboration with hospitals andmunicipalities. Together with employees fromhospitals andmunicipalities, the informants could develop amore comprehensive view of the patient's holistic needs. Discussion: The informants highlighted that patients were followed up by the team. They described their mission to contribute as raising the competence level in other professions and care services. Different professionals with palliative skills could facilitate both health professionals and patients. The physiotherapy profession was especially useful because it emphasized the rehabilitation factor. This study found that patients were referred to the team late in the disease process. Conclusion: Palliative teams want to collaborate with other health institutions, so the palliative patients receive comprehensive, holistic and coordinated care. There is different availability and varieties of palliative care in municipalities. These differences can be a challenge in interprofessional coordinated and holistic health care services. [ABSTRACT FROM AUTHOR]

Objective. To examine drug treatment in nursing home patients at the end of life, and identify predictors of palliative drug therapy. Design. A historical cohort study. Setting. Three urban nursing homes in Norway. Subjects. All patients admitted from January 2008 and deceased before February 2013. Main outcome measures. Drug prescriptions, diagnoses, and demographic data were collected from electronic patient records. Palliative end-of-life drug treatment was defined on the basis of indication, drug, and formulation. Results. 524 patients were included, median (range) age at death 86 (19-104) years, 59% women. On the day of death, 99.4% of the study population had active prescriptions; 74.2% had palliative drugs either alone (26.9%) or concomitantly with curative/preventive drugs (47.3%). Palliative drugs were associated with nursing home, length of stay > 16 months (AOR 2.10, 95% CI 1.12-3.94), age (1.03, 1.005-1.05), and a diagnosis of cancer (2.12, 1.19-3.76). Most initiations of palliative drugs and withdrawals of curative/preventive drugs took place on the day of death. Conclusion. Palliative drug therapy and drug therapy changes are common for nursing home patients on the last day of life. Improvements in end-of-life care in nursing homes imply addressing prognostication and earlier response to palliative needs. [ABSTRACT FROM AUTHOR]

Abstract: Background: A high opioid consumption for cancer related and acute pain may indicate adequate pain treatment. Analysis of a national, compulsory and complete database of all dispensed prescription drugs in Norway (NorPD) may reveal important epidemiological data on prescription pattern of opioids. This study investigated the prevalence of opioid dispensions in 2004–2007 and explored patterns of use. Methods: All pharmacies in Norway submit data electronically to NorPD on all dispensed prescriptions. All prescriptions to any individual are identified by a unique pseudonym. All persons who were dispensed opioids from 2004 to 2007 are included in the study. Cancer patients are identified by a reimbursement code. Non-cancer pain indications are inferred from pattern of prescriptions. Results: 470,638 Norwegians were dispensed opioids in 2007, corresponding to 9.7% of the population (13.0% of adults). Only 13,220 persons (2.8% of all patients) received opioids for cancer pain, accounting for 10% of all dispensed opioids measured in defined daily doses (DDDs). Among persons with non-cancer pain 77% received only one dispension per year or less than 50 DDDs/year. Fifteen percent received from 50 to 200 DDDs/year. Only 13,846 (4%) received >400 DDDs/year and are likely to be daily users for chronic non-cancer pain. From 2004 to 2007 a 9 % increase was observed in the number of persons receiving opioids and the number of dispensions, whereas opioid types, doses, and indications appeared stable. Interpretation: From these prescription patterns it can be concluded that the majority of patients received opioids for acute, non-cancer pain. [Copyright &y& Elsevier]