The 3 most important recent advances in palliative care

Dr David Currow is a professor of palliative medicine at ImPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Australia, and an associate director (research) for the Wolfson Institute, Hull York Medical School, University of Hull.

If you were to name the 3 most important recent advances relevant for everyday practice in palliative care, what would they be?

David Currow, BMed, MPH, PhD: The 3 most important advances relevant to everyday practice in palliative care in recent years, I think, come from delirium and breathlessness.

In delirium, we have seen a randomized controlled trial that suggests no benefit to the use of antipsychotics in reducing the severity or duration of delirium, and with a signal that it may even affect adversely overall survival.

In breathlessness, we have seen that oxygen in people who are not hypoxemic offers little symptomatic benefit over air or, indeed, a hand-held electric fan.

And finally, we have seen that regular, low-dose, sustained-release morphine can be effective in symptomatically reducing chronic breathlessness—the sort of breathlessness that has you house-bound or breathless even [when] just dressing or undressing; remembering that when people get that sort of breathlessness, it may last for years or even decades.