Improving End-Of-Life Care: A Systematic Review Of The Impact And Effectivness Of Palliative Medicine
VOLUME 22, 2025
The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review
VOLUME 6, 2023
Saeed Yahya Alzahrani
Abdulrahim Ali Alghamdi
Abstract
Introduction: The need for palliative medicine has increased in the last few decades on global and local levels as a result of increasing in the prevalence of chronic health problems to improve the quality of life for patients with terminal illness and their caregivers and families
Objectives: To explore the impact and effectiveness of palliative medicine in improving end-of-life care as well as the quality of life of patients and their caregivers.
Methods: A comprehensive literature review search was conducted using relevant databases including studies focusing on impact and effectivness of palliative medicine on end-of-life care.
Results: A total of 2,518 articles were initially identified. Only 13 aticles were eligible for inclusion in this systematic review. Four studies were randomized clinical trials, one quasi experimental study, one none-randomized cmparative sudy, two propective studies, three cross-sectional studies, one mixed (quantitative and qualitative) study and one qualitative study. Most studies were conducted among patints only (n=7), while two studies were conducted among both patients and caregivers and three studies were conducted among only caregivers while only one study was conducted among healhcare providers. Improvement of the patients and/or caregivers` quality of life, coping with dath or functional status was reported in most studies (n=10).
Conclusion: The impact and effectiveness of palliative medicine on end-of-life care is not clear, with some evidence that patients may get benefits from it. A comprehensive nationwide multicentric study is recommended to be conducted in whole Saudi Arabia
Keywords :
End-of-life, Palliative Medicine, Effectiveness, Caregivers, Quality of life.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Abstract
Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords :
Diabetic foot ulcer, angiosome, angioplasty