BACKGROUND: The rising Filipino population results in a proportionate increase in the aging population and its health care needs.
OBJECTIVE: In order to determine the demographic characteristics and needs of palliative and hospice patients in southern Metro Manila and surrounding provinces seeking care in a non-institutionalized setting, a chart review of 399 patients from 2 community-based hospice and palliative care programs was undertaken.
RESULTS: Results show that the usual demographic profile of a patient seeking hospice and palliative care in the community setting of southern Metro Manila and neighboring provinces is female, 51-60 years old, with a diagnosis of cancer, breast cancer being the most common. Majority had undergone prior chemotherapy or radiation therapy. Hypertension was the most common co-morbidity associated with the primary diagnosis, and pain was the most common symptom reported. The children were the primary caregivers of these patients at home, and written advance care directives were unavailable or initial consultation. The most common spiritual concern of patients was not the fear of death, but being a burden to their family members. Complementary services may be needed in order to help patients and their families cope with the terminal illness. These may include social work to help connect the family to other institutions that provide free medicines, counselling sessions both for the patient and family, respite care or providing a day off for the caregivers, and skills training for the primary care givers.

Human ; Female ; Middle Aged ; Respite Care ; Caregivers ; Palliative Care ; Hospice Care ; Advance Directives ; Adaptation, Psychological ; Breast Neoplasms ; Hypertension ; Primary Health Care

INTRODUCTION: Probiotics such as Saccharomyces boulardii are now advocated for the treatment of diarrhea. The objective of this systematic review and meta-analysis was to determine the effectiveness of Saccharomyces boulardii in the treatment of diarrhea. METHODS: MEDLINE, EBSCO, Clinical Key, and the Cochrane Library were searched for clinical trials which used Saccharomyces boulardii as primary or adjuvant treatment for diarrhea. Outcomes included were treatment success in the form of cessation of diarrhea, decrease in the duration of diarrhea, decrease in hospital days, and improvement of dehydration. The Centre for Evidence-Based Medicine Critical Appraisal tool together with the Cochrane Collaboration tool was used to assess the risk of bias, RevMan 5.4 for encoding, and the Mantel-Haenszel method for analysis to compute a pooled result. RESULTS: Eleven clinical trials involving 1,541 participants were included in the systematic review and meta-analysis. Seven studies showed a non-significant overall decrease in the duration of diarrhea of 1.65 days (p = 0.25), five studies showed an overall significant beneficial response (RR = 1.68, p < 0.001) in the cessation of diarrhea. There was a statistically significant mean decrease (1.01 days, p < 0.001) in duration of hospitalization; and a statistically significant decrease (0.18 days or 4.32 hours, p = 0.04) in the duration of vomiting. CONCLUSION A systematic review and meta-analysis of 11 clinical trials favors the use of Saccharomyces boulardii in the treatment of diarrhea in terms of cessation of diarrhea, decrease in the duration of hospitalization and duration of vomiting.
Saccharomyces boulardii ; Probiotics ; Diarrhea