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Treating depressive symptoms in patients with a short prognosis is one of the perennial problems encountered by palliative care teams. In spite of current practice, and the fact that some guidelines include the use of psychostimulants, there is a lack of evidence for their use and a study comparing the psychostimulant, Methylphenidate with placebo in palliative care services is long overdue. My choice of Carlos Centano, Alvaro Sans and colleagues’ paper on their multicentre, double-blind, randomised placebo-controlled clinical trial is an important contribution to the sparse data relating to the question. Lauren Rayner and Matthew Hotopf's editorial sets out the context and some implications for practice and research that may be reasonably drawn from the work.
In an ambitious paper with a public health perspective, Jeroen Hasselhaar and colleagues attempt to estimate the size of the European population in need of palliative care and find considerable variation between the countries of the European Union. The study calculated the number of persons dying of cancer and chronic diseases in Europe, taking into account regional differences. It comes up with the figure of between 2.14 and 4.97 million people a year.
Looking forward to finding ways of coordinating care for large numbers of palliative care cases, Clair Smith …