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Introduction. Polypharmacy and potentially inappropriate prescribing at the end of life are a major problem in health care, due to both the risks of adverse effects and the lack of short-term benefit associated with some drugs. This study aims to assess the prevalence of polypharmacy and potentially inappropriate prescribing in terminally ill patients and to identify associated risk factors.
Objective: Assess the prevalence of polypharmacy and inappropriate prescription, as well as determine the factors associated with it.
Material and methods. This retrospective cross-sectional study reviewed the clinical and treatment records of all patients who died under the care of the Home Hospitalization Unit from November 2019 to March 2020. We have analyzed sociodemographic characteristics, comorbidities and active medication both at 12 months and the month before death.
Results. The study included 136 patients. Twelve months before dying, 71.9% (n=98) were polymedicated: 52.2% (n=71) of the total sample had 5 to 10 active prescriptions; 18.3% (n=25), 11 to 15 prescriptions; and 1.4% (n=2), more than 15. Just 27.9% (n=38) of the patients were taking fewer than 5 drugs. In the month preceding death, 66% (n=90) of the patients were polymedicated; prescriptions included lipid-lowering drugs (16.1%), antiplatelets (24.2%), oral antidiabetics (17.6%), proton pump inhibitors (53.6%), and vitamin D (22%). Furthermore, oral antidiabetics have an OR of 11.67 for patients with polypharmacy and vitamin D an OR of 5.54
Conclusions: The results of this study show that a high percentage of patients maintain preventive treatments in their last days of life, drugs with little benefit in such a short term, where we should prioritize measures that optimize quality of life. The clinical consequences of our findings indicate that it is crucial to reconsider the administration of these medications in patients with palliative needs

Background: Malignant intestinal obstruction is a common oncological complication; it limits survival and affects the quality of life of patients. Surgical management options are often more effective than medical strategies but carry a higher complication rate. Recent consensus proposes percutaneous decompressive gastrostomy as an alternative for refractory symptoms to medical management.
Patients/Methods: A retrospective observational case series study was conducted on patients with malignant intestinal obstruction who underwent decompressive gastrostomy with palliative intent, treated between the years 2015 and 2022 at the National Cancer Institute in Bogotá, Colombia. Patients were identified through the Universal Procedure Point Code registered in medical records and extracted from the oncology center's database. For patients meeting inclusion criteria, sociodemographic, oncological, and clinical variables were documented by two investigators based on the medical records.
Results: A total of 426 medical records were reviewed, revealing 3 patients diagnosed with malignant intestinal obstruction who underwent palliative surgical management with decompressive gastrostomy. The patients ranged in age from 27 to 43 years, all underwent open surgical procedures, and on average received palliative care assessment on the eleventh day after admission. They required an average dose of 73 mg of equivalent doses of morphine per day, stayed hospitalized for a mean of 23 days, and succumbed approximately 14 days after the procedure.
Conclusion: Malignant bowel obstruction is a complex pathology with a high symptomatic burden. Decompressive gastrostomy is a rarely used procedure in the global south that could be useful if performed promptly, percutaneously, in patients who want to be treated at home or whose symptoms are refractory to medical management

Patients with Advanced Congestive Heart Failure (ACHF) depending on their complexity may be eligible for specialized Palliative Care (PC) treatment. The profile of cardiology patients admitted to a Medium Stay Palliative Care Unit (MSPCU) is described in comparison to patients with other non-oncological and oncological pathologies.

Palliativecare attempts to provide a scientific and humane response to the needs of the sick at the end of life. The death of a human being is an intense and shocking experience, constituting a focus of suffering for patients and relatives as well as for health care personnel. Relatives are often encouraged to engage in some creative activity to express their grief. The development of literary works, including fiction and comics, also prove to be a useful way of coping with and exposing many aspects of grief. The aim of the present work is to carry out an analysis of the resources and characteristics of comics dealing with Palliative Care. To this end, a critical reading has been carried out both of publications by experts in Graphic Medicine and of various comics that are widely recognised by critics and readers. The study of Graphic Medicine allows us to have a greater connection with the circumstances of the patient and the people in charge of their care, helping us to accept life until the end of it. The development of these works also constitutes a useful tool for the management of grief, the strengthening of empathy and the visualisation of the disease process.

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INTRODUCTION
Palliative radiotherapy during the final month of life has demonstrated little benefit regarding quality of life, survival, and symptom control. Factors related to survival can help healthcare providers decide if and how to start radiotherapy in patients at the end of life.

OBJECTIVES
This study aims to describe overuse of palliative radiotherapy at the end of life, and to analyse factors associated with survival and poor quality of life in these patients.

MATERIAL AND METHODS
A retrospective analysis of patients referred for radiotherapy during 2022 who died during the same year. Variables included in the analysis were 30-day mortality after finishing radiotherapy, different treatment schedules, and potential factors associated with survival and quality of life.

RESULTS
116 patients were included; 49 (42%) died 30 days within starting radiotherapy. 97 (83.6%) completed treatment. The most frequent indication for radiotherapy was bone metastasis (42%). The most frequent treatment schedule was 5 sessions (45%). Only 3 patients with bone metastases received only one dose (6%). Factors associated with mortality included the presence of liver metastases, low serum albumin levels, and the use of opioids. 28% of patients who started radiotherapy spent more than a third of their last month of life in hospital. 31% of patients were not referred to a palliative care specialist.

CONCLUSIONS
High rates of radiotherapy during the last month of life were described. Few single-dose schedules were observed. Liver metastases, low serum albumin levels, opioid use and interrupted (incomplete) radiotherapy were associated with shorter survival. Hyperfractionated and interrupted radiotherapy were associated with prolonged hospital admissions during the last month of life. A multidisciplinary approach including palliative care improves the choice of radiotherapy and length of hospital stays, improving quality of life.

Nutrition is an essential point in paediatric palliative care (PPC) to cover physiological, social and psychological requirements. The aim of the study is to determine the specific nutritional conditions of these patients and to identify if there is a diagnostic group with a higher risk of malnutrition. An observational study was carried out, collecting anthropometric, clinical and nutritional variables of patients under follow-up by the PPC team in a tertiary hospital. Twenty-five patients were included, 52% male, with a mean age of 7.6 years and a disease time of 4.3 years. The most frequent diagnosis was cerebral palsy (5/25). Malnutrition was detected in 60%, 20% severe. A lower weight and height Z-score was observed in patients with neurological disease, although it was not statistically significant. Malnutrition is a frequent diagnosis among patients who require PPC, so they could benefit from an early detection, intervention and individualized nutritional monitoring.

Introduction: Research in Palliative Care (PC) is insufficient. It is essential to generate more research to 1) improve the quality of care, care and results, 2) take better care of professionals, 3) meet ethical requirements and 4) follow the recommendations of various organizations. To this end, this work makes a diagnosis of the research published in PC in Andalusia.

Methodology: Bibliometric analysis of the production of scientific articles and authorship characteristics for the period 2012-2021. The inclusion criteria are publications in Spanish or English in peer-reviewed journals and in which at least one of the authors is assigned to an institution located in Andalusia. 55 articles were obtained, on which a frequency analysis and an analysis of co-authorship networks were carried out.

Results: Regarding methodologies used, 49.1% use a qualitative approach and 45.5% use a quantitative approach. In terms of themes, those dedicated to cultural and social aspects (23,6%) and ethical-legal aspects (23,6%) stand out, followed by clinical and organizational aspects (20%). The largest production occurs in Granada, and in the period 2016-2018. PC articles have been published in 33 journals, 63% of them international, and those in the field of Nursing stand out. The total number of authors is 167, 58.8% being women. Only a third of the authors have published more than one article and only 6% have published more than 5. Of those who publish the most, the majority work in academic institutions. The structure of co-authorship networks is loosely connected with many independent subgroups, in which healthcare professionals occupy peripheral positions.

Conclusions: It seems necessary to promote research among healthcare professionals. Alliances with academic professionals can be strengthened, and generate alliances that result in an improvement and an increase in research on PC in Andalusia. Leadership must be strengthened.