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19 results on '"De La Rosa, Allison"'

2. Neuroleptic strategies for terminal agitation in patients with cancer and delirium at an acute palliative care unit: a single-centre, double-blind, parallel-group, randomised trial

Author

Hui, David, De La Rosa, Allison, Wilson, Annie, Nguyen, Thuc, Wu, Jimin, Delgado-Guay, Marvin, Azhar, Ahsan, Arthur, Joseph, Epner, Daniel, Haider, Ali, De La Cruz, Maxine, Heung, Yvonne, Tanco, Kimberson, Dalal, Shalini, Reddy, Akhila, Williams, Janet, Amin, Sapna, Armstrong, Terri S, Breitbart, William, and Bruera, Eduardo

Published
2020
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4. A National Survey of Palliative Care Team Compositions

Author

Chen, Joseph, primary, de la Rosa, Allison, additional, Lai, Dejian, additional, De La Cruz, Maxine, additional, Zhukovsky, Donna, additional, Revere, Lee, additional, Lairson, David, additional, Wermuth, Paige, additional, and Hui, David, additional

Published
2021
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6. The impact of a web-based prognostic intervention on physicians’ prognostic confidence.

Author

Hui, David, primary, De La Rosa, Allison, additional, Shelal, Zeena, additional, Maxwell, John P, additional, Hosain, Monawar, additional, De La Cruz, Maxine Grace Jaucian, additional, Vidal, Marieberta, additional, Reddy, Akhila Sunkepally, additional, Azhar, Ahsan, additional, Dev, Rony, additional, Tanco, Kimberson Cochien, additional, Wong, Angelique, additional, Heung, Yvonne, additional, Delgado Guay, Marvin, additional, Zhukovsky, Donna S., additional, Arthur, Joseph Anthony, additional, Reddy, Suresh, additional, Yennu, Sriram, additional, and Bruera, Eduardo, additional

Published
2021
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10. Neuroleptic Rotation for Terminal Agitation in Patients with Cancer and Delirium at an Acute Palliative Care Unit: A Single-Centre, Parallel-Group, Double-Blind, Randomised Clinical Trial

Author

Hui, David, De La Rosa, Allison, Wilson, Annie, Nguyen, Thuc, Wu, Jimin, Delgado-Guay, Marvin, Azhar, Ahsan, Arthur, Joseph, Epner, Daniel, Haider, Ali, De La Cruz, Maxine, Heung, Yvonne, Tanco, Kimberson, Dalal, Shalini, Reddy, Akhila, Williams, Janet, Amin, Sapna, Armstrong, Terri S., Breitbart, William, and Bruera, Eduardo

Subjects
Article
Abstract

BACKGROUND: The role of neuroleptics for terminal agitated delirium is controversial. We assessed the effect of 3 neuroleptic strategies on refractory agitation in cancer patients with terminal delirium. METHODS: In this single-centre, double-blind, parallel group randomised trial, patients with advanced cancer, age≥18, admitted to a Palliative Care unit with refractory agitation despite low dose haloperidol were randomised to haloperidol dose escalation 2 mg intravenously every 4 hours; neuroleptic rotation with chlorpromazine 25 mg intravenously every 4 hours; or combined haloperidol 1 mg and chlorpromazine 12.5 mg intravenously every 4 hours until death or discharge. Rescue doses identical to the scheduled doses were administered at inception then hourly as needed. Permuted block randomization (block size=six, 1:1:1) was conducted, stratified by baseline Richmond Agitation Sedation Scale (RASS) scores. Research staff, clinicians, patients and caregivers were blinded. The primary outcome was change in RASS from time 0 to 24 hours. Comparisons among group was conducted with modified intention-to-treat analysis. This completed study is registered with Clinicaltrials.gov, NCT03021486. FINDINGS: Between 7/5/2017 and 7/1/2019, 68 patients were enrolled and 45 received the blinded study interventions (escalation n=15, rotation n=16, combination n=14). RASS decreased significantly within 30 minutes and remained low at 24 hours in the escalation group (number analyzed, mean RASS change between 0 and 24 h [95%CI]: n=10, −3·6 [−5,−2·2]), rotation group (n=11, −3·3 [−4·4,−2·2]) and combination group (n=10, −3.0 [−4·6,−1·4]), with no difference among groups (P=0·71). The most common serious toxicity was hypotension (escalation n=6 [40%], rotation n=5 [31%], combination n=3 [21%]); there were no treatment-related deaths. INTERPRETATION: Our data provided preliminary evidence that the 3 strategies of neuroleptics may reduce agitation in patients with terminal agitation. These findings should be put in context of the single-centre design, small sample size and lack of a placebo-only group. FUNDING: National Institute of Nursing Research

Published
2020

11. A National Survey of Palliative Care Team Compositions.

Author

Chen, Joseph, de la Rosa, Allison, Lai, Dejian, De La Cruz, Maxine, Zhukovsky, Donna, Revere, Lee, Lairson, David, Wermuth, Paige, and Hui, David

Subjects
PALLIATIVE treatment, CANCER, HEALTH care teams, CROSS-sectional method, SURVEYS
Abstract

Objective: It is unclear how well palliative care teams are staffed at US cancer centers. Our primary objective was to compare the composition of palliative care teams between National Cancer Institute (NCI)-designated cancer centers and non-NCI-designated cancer centers in 2018. We also assessed changes in team composition between 2009 and 2018. Methods: This national survey examined the team composition in palliative care programs at all 61 NCI-designated cancer centers and in a random sample of 60 of 1252 non-NCI-designated cancer centers in 2018. Responses were compared to those from our 2009 survey. The primary outcome was the presence of an interprofessional team defined as a palliative care physician, nurse, and psychosocial member. Secondary outcomes were the size and number of individual disciplines. Results: In 2018, 52/61 (85%) of NCI-designated and 27/38 (71%) non-NCI-designated cancer centers in the primary outcome comparison responded to the survey. NCI-designated cancer centers were more likely to have interprofessional teams than non-NCI-designated cancer centers (92% vs 67%; P =.009). Non-NCI-designated cancer centers were more likely to have nurse-led teams (14.8% vs 0.0%; P =.01). The median number of disciplines did not differ between groups (NCI, 6.0; non-NCI, 5.0; P =.08). Between 2009 and 2018, NCI-designated and non-NCI-designated cancer centers saw increased proportions of centers with interprofessional teams (NCI, 64.9% vs 92.0%, P <.001; non-NCI, 40.0% vs 66.7%; P =.047). Conclusion: NCI-designated cancer centers were more likely to report having an interprofessional palliative care team than non-NCI-designated cancer centers. Growth has been limited over the past decade, particularly at non-NCI-designated cancer centers. [ABSTRACT FROM AUTHOR]

Published
2022
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14. Neuroleptic rotation for refractory agitation in cancer patients with delirium in the acute palliative care unit: A double-blind randomized clinical trial.

Author

Hui, David, primary, De La Rosa, Allison, additional, Wilson, Annie, additional, Nguyen, Thuc, additional, Wu, Jimin, additional, Delgado Guay, Marvin, additional, Azhar, Ahsan, additional, Arthur, Joseph Anthony, additional, Epner, Daniel E., additional, Haider, Ali, additional, De La Cruz, Maxine Grace Jaucian, additional, Heung, Yvonne, additional, Tanco, Kimberson Cochien, additional, Dalal, Shalini, additional, Armstrong, Terri, additional, Breitbart, William, additional, and Bruera, Eduardo, additional

Published
2020
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