Document 0645
 DOCN  M94A0645
 TI    What is the best model for AIDS palliative care?
 DT    9412
 AU    Malcolm JA; Nineways Specialist Clinic, Broadmeadow, NSW.
 SO    Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:60 (abstract no.
       SPa1). Unique Identifier : AIDSLINE ASHM5/94349010
 AB    In one of competing models AIDS palliation begins when active treatment
       ceases and responsibility for care passes from a treatment to a
       palliative care service. This model (based on cancer care) limits
       service overlap and is economical, but creates practical and ethical
       difficulty in defining when to cease active treatment, promotes
       discontinuity of care and may allow discrimination. It permits treatment
       teams to give symptom palliation lower priority, and palliative care
       services to avoid specific management of complications unique to AIDS. A
       second model recognises that all AIDS treatment is presently palliative
       and directed to minimise symptoms and maximise quality and length of
       life. It requires antiretroviral drugs, treatment of infective and
       neoplastic complications, and provision of high levels of support
       extending over years. Terminal care may be brief. This model requires
       case management strategies to coordinate services. Approaches to
       palliative care developed for cancer require modification for AIDS and
       the challenge is to develop and apply the most appropriate concepts.
 DE    Acquired Immunodeficiency Syndrome/*PHYSIOPATHOLOGY  Administration,
       Oral  Analgesics/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS  Analgesics,
       Addictive/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS  Drug Therapy,
       Combination  Human  Injections, Subcutaneous  Morphine/ADMINISTRATION &
       DOSAGE  Pain/*DRUG THERAPY/ETIOLOGY  Palliative Treatment/*METHODS
       Terminal Care/METHODS  MEETING ABSTRACT

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