Literature Review

Local hospice organization announces dementia care program for patients and caregivers Southern Maryland News Net; 11/19/24 Hospice of the Chesapeake has launched a new and innovative dementia care program for dementia patients and their caregivers. The program, in collaboration with The National Partnership for Healthcare and Hospice Innovation (NPHI), The Center to Advance Palliative Care (CAPC) and Aliviado Health, includes free access to the “Dementia Care Patient & Caregiver Resource Guide,” which provides the best-in-class resource for dementia care. The goal is to improve the quality of life for dementia patients, reduce hospitalizations and ease burdens for families and caregivers.Editor's note: The National Partnership for Healthcare and Hospice Innovation (NPHI) is a sponsor for our newsletter.

Bringing stories to life, and death: Why animated movies are more than entertainment for kids The Stony Brook Press; 11/19/24 ... Whether it is the parents of the protagonist dying in the first few minutes in Frozen or the epic finale where the villain succumbs to a fatal fate like in The Hunchback of Notre Dame or The Princess and the Frog, it is somewhat of an oxymoron to call animated movies “childish,” as they often deal with serious topics. These movies are not outliers; there are videos dedicated to Disney’s “body count,” which counts how many characters have died in Disney movies. While these films may be magical or fantastical in plot, the moral truths of death and life covered in them often stir conversations about mortality. “Despite the fact that we would love to have people or animals or our loved ones forever, death is inevitable,” explained Bonnie Nickels, co-writer of the study End-of-Life in Disney and Pixar Films: An opportunity for Engaging in Difficult Conversation. “We can use these films as opportunities to introduce our young viewers and our young children to this idea.” To Nickels, these movies can create a dialogue between parents and children about dying and even model coping methods. “The fact that it’s a common feature in these films, kind of reiterates this idea that it’s common in life.” Editor's note: What movies will your intergenerational family watch through the holidays? This article's referenced study--"End-of-Life in Disney and Pixar Films"--describes, "A content analysis of 57 movies resulted in a total of 71 character deaths. For different generations, what reactions do you remember having experienced yourself, or from others with Bambi's mother; The Lion King's Mufasa; Frozen's parents of the two sisters; Coco's family members? And, what messages were instilled for young Baby Boomers by the always "wicked" stepmothers? Yes, important conversations abound. Click here for a related article, "15 Saddest Disney Deaths, Ranked." 

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

Learn from yesterday, live for today, and hope for tomorrow. The important thing is not to stop questioning. ~Albert Einstein

World Medical Association Declaration of Helsinki-Ethical principles for medical research involving human participantsJAMA; World Medical Association; 10/24Preamble: The World Medical Association (WMA) has developed the Declaration of Helsinki as a statement of ethical principles for medical research involving human participants, including research using identifiable human material or data. The Declaration is intended to be read as a whole, and each of its constituent paragraphs should be applied with consideration of all other relevant paragraphs. While the Declaration is adopted by physicians, the WMA holds that these principles should be upheld by all individuals, teams, and organizations involved in medical research, as these principles are fundamental to respect for and protection of all research participants, including both patients and healthy volunteers.

The Inflation Reduction Act and patient costs for drugs to treat heart failureJAMA Network Open; Erin Trish, PhD; Karen Van Nuys, PhD; Joanne Wu, MS; Nihar R. Desai, MD, MPH; 10/24The 2022 Inflation Reduction Act (IRA) contains several provisions to lower Medicare drug costs, including permitting the Centers for Medicare & Medicaid Services (CMS) to limit the prices of certain medicines and altering the standard Part D benefit to limit patient out-of-pocket costs. CMS has set the prices of 10 drugs effective 2026, including 3 commonly prescribed as part of combination therapy for heart failure (HF): dapagliflozin, empagliflozin, and sacubitril/valsartan. Dapagliflozin and empagliflozin also treat other conditions, including diabetes and chronic kidney disease. In this cross-sectional study of Medicare beneficiary costs ... benefit redesign eliminates the coverage gap in 2025, and caps annual out-of-pocket expenditures, [and] ... will reduce and smooth patient out-of-pocket burden.

Dialysis facility staffing ratios and kidney transplant access among adolescents and young adultsJAMA; Alexandra C. Bicki, MD, MPH; Barbara Grimes, PhD; Charles E. McCulloch, PhD; Timothy P. Copeland, MPP, PhD; Elaine Ku, MD, MAS; 10/24In this study of adolescents and young adults treated at US dialysis facilities, patients at facilities with higher patient to staff ratios had lower incidence of waitlisting and kidney transplant compared with those receiving care at facilities with lower patient to staff ratios. The effect size for the incidence of transplant was similar with respect to both patient to nurse and patient to social worker staffing ratios, but patient to nurse ratio was not statistically significantly associated with the incidence of waitlisting.

Suicide deaths among adolescent and young adult patients with cancerJAMA Network Open; Koji Matsuo, MD, PhD; Christina J. Duval, BA; Briana A. Nanton, BS; Jennifer A. Yao, BA; Erin Yu, BS; Christian Pino, MD; Jason D. Wright, MD; 11/24The overall cancer incidence among adolescent and young adult (AYA) patients is increasing at an alarming rate in the US largely driven by thyroid cancer. Although cancer mortality continues to decrease among AYA patients, those who survive cancer are at elevated risk for emotional distress, mental health problems, and suicide. Together with the population-level increase in the US suicide death rate, the results of this assessment call for attention focused on the increasing suicide death rate among AYA patients with cancer, particularly male individuals. The proportion of AYA patients with cancer of thyroid, testis, or cutaneous melanoma who had a suicide death was greater than 2%, and they most benefit from a psychosocial and mental health evaluation. Because this study noted that many suicide deaths among these AYA patients with cancer occur years after the cancer diagnosis, long-term care and support for cancer survivors is recommended.

Economic value of unpaid family caregiver time following hospital discharge and at end of lifeJournal of Pain and Symptom Management; by Brystana G Kaufman, Wenhan Zhang, Sahar Shibeika, Ro W Huang, Ting Xu, Cory Ingram, Allison M Gustavson, Diane E Holland, Catherine Vanderboom, Courtney H Van Houtven, Joan M Griffin; 12/24Results: Of 282 Family caregivers, 94% were non-Hispanic White, 71% were female, 71% had a college degree, and 51% were in the workforce. Family caregivers of decedents (58%) compared to survivors reported significantly more caregiving hours per person-month (392 vs. 272), resulting in higher estimated economic value per person-month using opportunity ($12,653 vs. $8843), proxy ($5689 vs. $3955), and combined costing methods ($9490 vs. $6443). Conclusion: This study informs more complete economic evaluations of palliative care by estimating the economic value of unpaid caregiving. The high intensity of unpaid caregiving for people with serious illness, especially toward the end of life, should be considered when designing policies and interventions to support family caregivers. Better methods for approximating economic value are needed to address potential inequities in current valuation approaches.

Artificial intelligence and machine learning in cancer pain: A systematic reviewJournal of Pain and Symptom Management; by Vivian Salama, Brandon Godinich, Yimin Geng, Laia Humbert-Vidan, Laura Maule, Kareem A Wahid, Mohamed A Naser, Renjie He, Abdallah S R Mohamed, Clifton D Fuller, Amy C Moreno; 12/24Forty four studies from 2006 to 2023 were included. Implementation of AI/ML tools promises significant advances in the classification, risk stratification, and management decisions for cancer pain. Further research focusing on quality improvement, model calibration, rigorous external clinical validation in real healthcare settings is imperative for ensuring its practical and reliable application in clinical practice.

[Canada] Feasibility of prospective error reporting in home palliative care: A mixed methods studyPalliative Medicine; Allison M Kurahashi, Grace Kim, Natalie Parry, Vivian Hung, Bhadra Lokuge, Russell Goldman, Mark Bernstein; 10/24 Palliative care patients may be particularly vulnerable to experiencing errors due to the complex communication among interdisciplinary team members (including the patient and their caregivers), the use of high-risk medications such as opioids and benzodiazepines, polypharmacy, patient frailty, and patient cognitive decline. Care in patients’ homes presents additional challenges to patient care that are unique from hospital settings: Decreased communication about roles and responsibilities in care can result from involvement of multiple care teams and different electronic records. The collaborative nature of care in a home-based palliative care context may present unique challenges to translating error reporting to improved patient safety. Physicians are amenable to error reporting activities so long as data is used to improve patient safety.

My top 10 list for living with cancer Cure; by Kelly Irvin; 11/19/24 I’m coming up on the ninth anniversary after my diagnosis of stage 4 ovarian cancer in January 2016. As always, this causes me to ponder my life as someone living with cancer for the rest of my life. I ponder why I’m still here and others are not. Have I used this time well? What have I learned that might be of use for other “lifers,” as well as those just starting on this journey? It’s that last question I’m focused on here. The following is my top 10 list for living with cancer when there’s no likelihood of hearing those magical words “cancer-free.” 

Rise in pancreatic cancer tied to better detection, study suggests Becker's Hospital Review; by Elizabeth Gregerson; 11/19/24 The rise in pancreatic cancer diagnoses can be attributed to previously undetected disease and not a rise in cancer occurrence, according to a study published Nov. 19 in the Annals of Internal Medicine. Researchers from Boston-based Brigham and Woman's Hospital and Austin, Texas-based Dell Medical School analyzed U.S. Cancer Statistics and National Vital Statistics System data of adults aged 15-39 from between 2001 and 2019 for the study. Here are five notes from their findings: