ABSTRACT
Respiratory symptoms are common in patients living with serious illness, both in cancer and nonmalignant conditions. Common symptoms include dyspnea (breathlessness), cough, malignant pleural effusions, airway secretions, and hemoptysis. Basic management of respiratory symptoms is within the scope of primary palliative care. There are pharmacologic and nonpharmacologic approaches to treating respiratory symptoms. This article provides clinicians with treatment approaches to these burdensome symptoms.
Subject(s)
Cough/therapy , Critical Illness/therapy , Dyspnea/therapy , Hemoptysis/therapy , Pleural Effusion, Malignant/drug therapy , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/adverse effects , Analgesics, Opioid/therapeutic use , Bodily Secretions/drug effects , Combined Modality Therapy/methods , Cough/epidemiology , Cough/etiology , Cough/pathology , Dyspnea/epidemiology , Dyspnea/etiology , Dyspnea/pathology , Hemoptysis/epidemiology , Hemoptysis/etiology , Hemoptysis/pathology , Humans , Mortality/trends , Palliative Care/standards , Pleural Effusion, Malignant/epidemiology , Pleural Effusion, Malignant/mortality , Prevalence , Respiratory System/drug effects , Respiratory System/physiopathology , Risk FactorsABSTRACT
The United States population not only is aging, but also becoming more ethnically diverse. Approximately half of elders who take medications find adherence challenging, and cultural diversity is one of the variables that may affect adherence. By better understanding patients' cultural perspectives, senior care pharmacists can more effectively address their medication management needs; failure to recognize these differences may contribute to misunderstanding or miscommunication that may affect treatment. When a patient does not adhere to prescribed medications, explore reasons and feelings. Different ethnic groups have varying communication styles and also seek different degrees of family involvement in diagnosis and treatment. Some mistrust in Western health care, choose to use herbs and nonpharmacologic agents, and have different time orientation that may affect adherence. Senior pharmacists have an active role in screening, evaluation, and counseling elderly, ethnically diverse patients. Applying general trends of cultural values should not be mistaken for stereotyping.
