@article{MTMT:36594515, title = {How are transitions from oncology to palliative care regulated across Europe? A grey literature review in eight countries : Pal-Cycles project}, url = {https://m2.mtmt.hu/api/publication/36594515}, author = {Garralda, Eduardo and Radojičić, Tamara and Payne, Sheila and Hooley, Rachel and Busa, Csilla and Koper, Ian and Leppert, Wojciech and Reigada, Carla and Hurducas, Flavia and Brunsch, Holger and Belar, Alazne and Centeno, Carlos and Hasselaar, Jeroen and Arantzamendi, María}, doi = {10.1016/j.healthpol.2025.105522}, journal-iso = {HEALTH POLICY}, journal = {HEALTH POLICY}, volume = {164}, unique-id = {36594515}, issn = {0168-8510}, abstract = {Patients with advanced cancer often encounter significant challenges during the transition from oncology to palliative care, particularly due to hospital discharges that lack clear communication and follow-up plans. This discontinuity in care may be addressed through various regulatory strategies designed to facilitate smooth transitions.To investigate the regulatory landscape governing transitions from oncology to palliative care across eight European countries.A grey literature review followed by a comparative analysis of identified documents was carried out.A total of 20 professional guidelines, strategies, and regulations in England, Germany, the Netherlands, Portugal, and Spain were identified. Identified documents provided inconsistent guidance regarding the promotion of care continuity. Notably, several essential components for ensuring effective transitions were identified across countries: the formulation of collaborative protocols between various levels and types of care, the establishment of clear transition and referral criteria, early identification of palliative care needs, synchronization of patient information across care levels, involvement of family members in the care process, implementation of a comprehensive four-dimensional patient assessment, and regular evaluation and revision of care plans. Certain elements, such as the role of primary care professionals in identifying palliative care patients, realistic discharge timelines, effective communication with patients and families, and approaches to advance care planning and shared decision-making, were inconsistently identified across different countries.To enhance continuity of care for patients transitioning from oncology to palliative care at different levels, it is imperative to develop targeted guidance that incorporates all pertinent elements of care coordination.}, keywords = {Europe; review; Palliative Care; TRANSITIONS; policy; Oncology; continuity; Referral}, year = {2026}, eissn = {1872-6054}, orcid-numbers = {Busa, Csilla/0000-0001-6916-1118} } @article{MTMT:36996966, title = {Understanding multilevel influences on the adaptation of a complex intervention for oncology to palliative care transitions : a qualitative study across seven European countries}, url = {https://m2.mtmt.hu/api/publication/36996966}, author = {Radojičić, T and Belar, A and Preston, N and Payne, S and Surges, S M and Hurducas, F and Leppert, W and Koper, I and MartinsPereira, S and Fülöp, Balázs Dániel and Hasselaar, J and Arantzamendi, M}, doi = {10.1186/s12904-026-02036-w}, journal-iso = {BMC PALLIAT CARE}, journal = {BMC PALLIATIVE CARE}, volume = {25}, unique-id = {36996966}, issn = {1472-684X}, abstract = {Adapting complex healthcare interventions for use across diverse healthcare systems requires balancing fidelity to core components with responsiveness to local contexts. The Pal-Cycles project aims to support transitions in care for patients with advanced cancer across seven European countries. Understanding the multilevel factors that influence adaptation is essential to ensure contextual fit while maintaining intervention integrity.To explore the multilevel factors that influenced the adaptation of the Pal-Cycles intervention across seven European countries.A qualitative study was conducted with purposively sampled country lead team members from all participating countries. Data were derived from focus groups, in which participants reflected on and discussed their experiences of cross-country adaptation meetings, and were analysed using framework analysis.Fourteen country lead team members participated in the study. Analysis identified five areas reflecting multilevel factors that influenced the adaptation of the Pal-Cycles intervention: (1) Organisational variability as a barrier to adapting the Pal-Cycles intervention, (2) Disparities in training and shared motivation to improve palliative care communication, (3) Multidisciplinary collaboration shaped by organisational and cultural contexts, (4) Balancing optimism and practical constraints: stakeholder views on the Pal-Cycles intervention, (5) Working together to adapt the Pal-Cycles intervention across cultures. Organisational variability influenced service availability, integration between oncology and palliative care, and communication pathways. Disparities in previous training and shared motivation shaped clinicians' engagement with the intervention's training component. Multidisciplinary collaboration varied across settings, affecting role clarity and coordination among healthcare professionals. Stakeholder perspectives, including those of cancer clinicians, general practitioners, and consortium members, informed decisions about which elements of the intervention were most relevant in each context. Finally, working together to adapt the intervention across diverse cultural and organisational settings involved iterative discussions that balanced flexibility with preservation of the intervention's core components.The adaptation of Pal-Cycles was shaped by interrelated organisational, professional, and cultural factors. Recognising how local contexts influence the prioritisation and operationalisation of intervention components is essential for achieving a balance between standardisation and flexibility in cross-national healthcare interventions.}, keywords = {ADAPTATION; TRANSITION; Qualitative Research; Complex interventions; Advance cancer}, year = {2026}, eissn = {1472-684X} } @article{MTMT:37024332, title = {A daganatos betegek bázis-és áttöréses fájdalmaira felírt erős opioid gyógyszerek hazai forgalmi adatainak elemzése}, url = {https://m2.mtmt.hu/api/publication/37024332}, author = {Fülöp, Balázs Dániel and Tóth, Bálint and Frank, Nóra and Csikós, Ágnes}, doi = {10.1556/650.2026.33517}, journal-iso = {ORV HETIL}, journal = {ORVOSI HETILAP}, volume = {167}, unique-id = {37024332}, issn = {0030-6002}, abstract = {Bevezetés: Hazánkban a tumoros betegek számára felírt erős opioidok mennyisége elmarad a nyugati országok átlagá- tól, ami hozzájárulhat a betegek elégtelen fájdalomcsillapításához. A WHO irányelve elsődlegesen választandó gyógy- szerekként a per os készítményeket ajánlja, ennek ellenére döntő többségében a betegek fentaniltartalmú tapaszt kapnak. Célkitűzés: A tumoros betegek számára bázis- és áttöréses fájdalom csillapítására felírt erős opioidok magyarországi gyógyszerforgalmi adatainak (2010–2024), valamint a felhasznált gyógyszerek területi megoszlásának (2024) vizsgá- lata. Módszer: A tumoros betegek számára felírt erős opioidok országos és megyénkénti forgalmi adatainak elemzését vé- geztük, az eredményeket orális morfinekvivalens dózisban megadva hasonlítottuk össze. Eredmények: 2010 és 2024 között az összes erős opioid mennyisége mintegy kétharmadára csökkent. A bázisszerek közül csökkent a fentanil-, buprenorfintapasz, retard morfin-, hidromorfon-tabletta, nőtt a retard oxikodontabletta felhasználása. Az áttöréses fájdalomra használt gyógyszerek közül csökkent a morfininjekció és -csepp, növekedett a gyors hatású morfin- és oxikodontabletta mennyisége. A 2024-es évben a fentaniltapasz 79,4%-ot, a retard oxikodon 16,7%-ot, a retard morfin 2,7%-ot, az áttöréses fájdalomra írt gyógyszerek 1,25%-ot tettek ki. Regionálisan a fentanil- tapasz egyenletes megoszlása látszott, ettől Baranya megye és Budapest tér el, ahol más gyógyszerek is nagyobb mennyiségben kerülnek felírásra. A retard morfin és oxikodon felhasználása igen nagy variabilitást mutatott, az áttö- réses fájdalomra használt gyógyszerek felírása jórészt Baranyában történt. Megbeszélés: Az erős opioidok felhasználása az elmúlt 15 évben csökkent. A legnagyobb mennyiségben fentaniltapaszt írnak fel, az áttöréses fájdalom nagy prevalenciája ellenére gyors hatású gyógyszereket kis mennyiségben használnak. A megfelelő fájdalomcsillapítás akadályai részben az egészségügyi ellátók ismerethiányából származhatnak, az erős opioidok felírása sokszor nem a szakmai irányelveknek megfelelően, hanem a helyi szokások alapján történik. Azokon a területeken, ahol jól szervezett palliatív ellátás működik, a felírási gyakorlat jobban közelít a WHO-irányelvek által előírtakhoz. Következtetés: A tumoros betegek fájdalomkontrollját javítaná integrált palliatív rendszerek kialakítása, az egészség- ügyi személyzet palliatív irányú képzése és a gyógyszerek folyamatos elérhetőségének biztosítása. Orv Hetil. 2026; 167(11): 419–429. | Introduction: In Hungary, the amount of strong opioids prescribed for cancer patients remains below that of Western countries, potentially leading to inadequate pain control. Although the World Health Organization recommends per os medication as first-line treatment, most patients receive transdermal fentanyl patches. Objective: To analyze pharmaceutical utilization data of strong opioids prescribed for baseline and breakthrough cancer pain (2010–2024), and to examine regional prescribing patterns (2024). Method: Strong opioid dispensing data for cancer patients were analyzed at both national and county levels. Drug utilization was compared using oral morphine equivalent doses. Results: Between 2010 and 2024, total strong opioid utilization decreased to approximately two-thirds of its initial level. For baseline pain management, the use of transdermal fentanyl, transdermal buprenorphine, retard morphine tablets and hydromorphone tablets declined, while retard oxycodone tablet use increased. For breakthrough pain, morphine injections and oral morphine solution declined, whereas immediate-release morphine and oxycodone tab- let use increased. In 2024, transdermal fentanyl accounted for 79.4% of total opioid use, prolonged-release oxyco- done tablets for 16.7%, prolonged-release morphine tablets for 2.7%, and breakthrough pain medications for 1.25%. Regionally, transdermal fentanyl use was rather uniform, with lower proportions in Baranya County and Budapest. Prolonged-release morphine and oxycodone use showed marked regional variability, while breakthrough pain pre- scriptions were predominant in Baranya County. Discussion: Strong opioid utilization for cancer pain has declined over the past 15 years with fentanyl patches remain- ing dominant. Despite the high prevalence of breakthrough cancer pain, immediate-release opioids are minimally used. Barriers include insufficient knowledge among healthcare professionals, resulting in prescribing practices driven by local habits rather than clinical guidelines; closer adherence to guidelines is observed in regions with well-organ- ized palliative care services. Conclusion: Improved integration of palliative care services, targeted education of healthcare professionals, continu- ous drug availability and simplified prescribing procedures may enhance cancer pain management.}, year = {2026}, eissn = {1788-6120}, pages = {419-429}, orcid-numbers = {Csikós, Ágnes/0000-0002-3322-9122} } @article{MTMT:37075319, title = {General practitioner residents’ mental health and satisfaction during their vocational training}, url = {https://m2.mtmt.hu/api/publication/37075319}, author = {Mohos, András and Kolozsvári, László Róbert and Rinfel, József and Kiss-Kovács, Róbert and Torzsa, Péter and Ágoston, Gergely}, doi = {10.1186/s12875-026-03317-2}, journal-iso = {BMC PRIM CARE}, journal = {BMC PRIMARY CARE}, volume = {27}, unique-id = {37075319}, year = {2026}, eissn = {2731-4553}, orcid-numbers = {Kiss-Kovács, Róbert/0009-0008-6168-4772; Torzsa, Péter/0000-0002-8148-4961; Ágoston, Gergely/0000-0002-8513-5750} } @article{MTMT:37077210, title = {Daganatos betegek félelmei, szorongásai és erőforrásai}, url = {https://m2.mtmt.hu/api/publication/37077210}, author = {Horváth, Rita and Varga, Gergely and Frank, Nóra and Szigeti, Nóra}, doi = {10.33616/lam.36.0113}, journal-iso = {LEGE ART MED}, journal = {LEGE ARTIS MEDICINAE}, volume = {36}, unique-id = {37077210}, issn = {0866-4811}, abstract = {BevezetésA daganatos betegség az egyik leginkább félelmektől övezett betegség. Vizsgálatunk célja, hogy daganatos betegek körében felmérjük a betegséggel összefüggő félelmeket, szorongásokat, valamint feltérképezzük legfontosabb erőforrásaikat.MódszerekKeresztmetszeti kérdőíves vizsgálatunkat a dél-dunántúli régió onkológiai centrumában, a Pécsi Tudományegyetem Klinikai Központ Onkoterápiás Intézetben valósítottuk meg. A betegek bevonása az aktív fekvőbetegrészlegéről és palliatív járóbeteg-szakrendeléséről történt. A betegek félelmeit, szorongásait és erőforrásait nyitott kérdésekkel vizsgáltuk.EredményekA vizsgálatban 113 daganatos beteg vett részt, akik a betegséggel összefüggő félelmeikkel és szorongásaikkal kapcsolatban összesen 165 említést fogalmaztak meg. A leggyakoribb említések a betegség hozzátartozókra gyakorolt hatásaira, a kiszolgáltatottságra és az önellátás elvesztésére, valamint a fájdalmas, lassú halálra, szenvedésre vonatkoztak. A nehéz helyzetekben támaszt nyújtó erőforrásokkal kapcsolatban 209 említést tettek a betegek, melyek között első helyen a család, barátok szerepeltek, amit a hit és vallás, valamint a természet követett.KövetkeztetésA daganatos betegek családi és baráti köre kiemelt fontossággal bír: nehéz időkben támaszt nyújtó erőforrásként vannak jelen, azonban a betegek legjelentősebb félelmei, szorongásai is hozzájuk kapcsolódnak. Elérhetővé kell tenni a pszichoszociális támogatást nemcsak a betegek, hanem hozzátartozóik számára is mind az aktív onkológiai ellátás, mind a palliatív ellátás idején. Az intraperszonális erőforrások körében támogatni kell a hit és a vallás megélését. A betegek félelmeinek, szorongásainak és erőforrásainak körültekintő felmérésével és az ezekre történő reagálással pozitívan befolyásolhatjuk az életminőségüket.}, year = {2026}, eissn = {2063-4161}, pages = {113-119} } @article{MTMT:37217203, title = {Symptom Improvement and Interrelated ESAS Domains Following Outpatient Palliative Care in Hungarian Cancer Patients.}, url = {https://m2.mtmt.hu/api/publication/37217203}, author = {Frank, Nóra and Busa, Csilla and Sághy, Eszter and Pozsgai, Éva and Csikós, Ágnes}, doi = {10.3390/jcm15093532}, journal-iso = {J CLIN MED}, journal = {JOURNAL OF CLINICAL MEDICINE}, volume = {15}, unique-id = {37217203}, abstract = {Background: Outpatient palliative care effectively alleviates symptom burden in advanced cancer patients, yet data from Central-Eastern Europe remain scarce. This retrospective study examined changes in revised Edmonton Symptom Assessment Scale (ESAS) scores from initial outpatient palliative consultation to first follow-up in Hungarian cancer patients, assessing clinically meaningful improvement and inter-symptom associations. Methods: Revised ESAS scores from 119 patients attending an outpatient palliative care clinic (2017-2020) were analyzed using paired baseline and first follow-up assessments (7-30 days). Symptom changes (Time 2-Time 1) were evaluated using Wilcoxon signed-rank tests. Clinically meaningful improvement was assessed with minimal clinically important difference thresholds (0.5× baseline SD). Sankey diagrams visualized symptom transitions, and multivariable linear regression examined inter-symptom associations. Results: Baseline pain was highest (mean 6.29, median 7), followed by fatigue, sleep disorder, and impaired well-being. At follow-up, significant reductions were observed in pain (mean 4.52, p = 0.001), nausea, dyspnea, constipation, sleep disorder, depression, and anxiety (all p < 0.05). Sankey diagrams showed shifts from severe to mild/moderate pain (50% to 24%) and constipation. Clinically meaningful improvement occurred in pain, nausea, and constipation, with 59-65% achieving ≥1-point pain reduction. Regression analyses showed that pain reduction was associated with concurrent improvements in sleep disorder (β = 0.31), depression (β = 0.20), fatigue (β = 0.20), and anxiety (β = 0.14), while dyspnea reduction was associated with concurrent improvements in depression (β = 0.22) and anxiety (β = 0.14). Conclusions: Outpatient palliative care in Hungarian cancer patients resulted in clinically meaningful symptom reductions, particularly pain and dyspnea. Improvements in these core symptoms were associated with concurrent improvements in other symptom domains, underscoring the clinical relevance of inter-symptom associations and supporting early, integrated outpatient palliative care and symptom cluster-based management.}, keywords = {dyspnea; Pain Management; Symptom Assessment; minimal clinically important difference; ESAS; Symptom clusters; cancer symptoms; early symptom management; interrelated symptoms; outpatient palliative care}, year = {2026}, eissn = {2077-0383}, orcid-numbers = {Busa, Csilla/0000-0001-6916-1118; Csikós, Ágnes/0000-0002-3322-9122} } @article{MTMT:37230036, title = {Delayed diagnostic imaging but stable treatment initiation for kidney cancer during the COVID-19 pandemic: a Hungarian cohort study}, url = {https://m2.mtmt.hu/api/publication/37230036}, author = {Rumi, László and Szántó, Árpád László and Bányai, Dániel and Szabó, Éva and Bellyei, Szabolcs and Hubai, Dóra and Takáts, Balázs and Bodnár, Tamás and Girán, János and Kiss, István and Boronkai, Árpád and Pozsgai, Éva}, doi = {10.3389/pore.2026.1612411}, journal-iso = {PATHOL ONCOL RES}, journal = {PATHOLOGY AND ONCOLOGY RESEARCH}, volume = {32}, unique-id = {37230036}, issn = {1219-4956}, year = {2026}, eissn = {1532-2807}, orcid-numbers = {Girán, János/0000-0002-4309-0013} } @{MTMT:37343799, title = {A haldokló beteg és családja}, url = {https://m2.mtmt.hu/api/publication/37343799}, author = {Busa, Csilla and Trompos, Katalin}, booktitle = {A családorvoslás elmélete és gyakorlata}, unique-id = {37343799}, year = {2026}, pages = {712-714}, orcid-numbers = {Busa, Csilla/0000-0001-6916-1118} } @{MTMT:37344225, title = {A gyógyszerrendelés szabályai.}, url = {https://m2.mtmt.hu/api/publication/37344225}, author = {Várnai, Réka}, booktitle = {A családorvoslás elmélete és gyakorlata}, unique-id = {37344225}, year = {2026}, pages = {147-147} } @{MTMT:37344228, title = {A COVID-19, COVID-pneumonia és a long-COVID-szindróma.}, url = {https://m2.mtmt.hu/api/publication/37344228}, author = {Richter, Zsóka and Várnai, Réka}, booktitle = {A családorvoslás elmélete és gyakorlata}, unique-id = {37344228}, year = {2026}, pages = {233-236} }