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The American College of Physicians has published a practice guideline that recommends interventions to improve palliative care of patients with pain, dyspnea, and depression at the end of life. Based on a systematic review of the literature (33 high-quality systematic reviews and 89 relevant intervention studies), the final document recommends that, in patients with serious illnesses near the end of life, clinicians should:
assess pain, dyspnea, and depression;
treat pain with proven therapies (which, for cancer patients, include nonsteroidal anti-inflammatory drugs, opioids, and bisphosphonates);
prescribe opioids for unrelieved dyspnea and oxygen for hypoxemia;
manage depression with proven therapies (which, for cancer patients, include tricy…