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Reader response: Inpatients with neurologic disease referred for palliative care consultation

  • Birgit Basedow-Rajwich, Neurologist, Palliative Care, Marianne Strauß Klinik, Behandlungszentrum Kempfenhausen, Berg, Germany
  • Ingo Kleiter, Neurologist, Marianne Strauß Klinik, Behandlungszentrum Kempfenhausen, Berg, Germany
Submitted June 04, 2019

Taylor et al. addressed an important point in palliative care for patients with neurologic diseases.1 They discussed that needs and characteristics of patients with acute and chronic neurologic illness, which were not separated in their study, may be different and concluded that targeted approaches may best address the needs of distinct patient populations. We support this view and want to draw attention to recent advances in in the palliative care of patients with severe multiple sclerosis.² Compared to end-stage cancer and non-neurologic non-cancer disease, multiple sclerosis patients with Expanded Disability Status Scale > or equal to 8.0 and no immune modifying drugs treated by a neuro-palliative concept showed a significantly lower in-house death rate.³ Our focus was on relieving patients’ suffering and support for caregivers’ needs, with advanced care planning to avoid unwanted intensive care and death in the hospital. Impact of palliative care on symptom burden was not dependent of underlying diagnosis.

Our data support the point of view that “palliative care has a broader scope, may be helpful at any point along an illness trajectory, and is useful for patients with noncancer diagnoses, including neurologic illness.”4 Symptom-relief is appropriate not only at the end of life but during decades of progressive neurologic illness and suffering.

Disclosure

The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.

References

  1. Taylor BL, O’Riordan DL, Pantila SZ, Creutzfeldt CJ. Inpatients with neurologic disease referred for palliative care consultation. Neurology 2019; 92:e1975–e1981.
  2. Köpke S, Giordano A, Veronese S, et al. Patient and caregiver involvement in the formulation of guideline questions: findings from the European Academy of Neurology guideline on palliative care of people with severe multiple sclerosis. Eur J Neurol 2019;26:41–50.
  3. Basedow-Rajwich B, Montag T, Duckert A, et al. Mobile Palliative Care Consultation Service (PCCS): Overview of Hospice and Palliative Care Evaluation (HOPE) Data on In-Patients With End-Stage Cancer, Multiple Sclerosis, and Noncancer, Nonneurological Disease From 4 PCCS Centers in Germany in 2013. Palliat Care 2018;11:1178224218785139.
  4. Kluger BM, Bernat JL. Palliative care and inpatient neurology: Where to next? Neurology 2019;92:784–785.

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Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

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