Literature Review

Perioperative integration of palliative care and urology for patients with serious urologic illness: A qualitative need finding inquiryJournal of Pain and Symptom Management; Bhagvat J Maheta, Nainwant K Singh, Jonathan Bergman, Cati G Brown-Johnson, Alekhya Gunturi, Nickolas Interrante, John T Leppert, Karl A Lorenz, Isabella G Raspi, Karleen F Giannitrapani; 3/25Many urologic serious illnesses are treated with surgical procedures, which may put patients at a further risk of diminished quality of life. [We] purposefully sampled urologists, palliative care physicians, and clinical team members at fourteen geographically distributed Veteran Health Administration sites. We identified one general overall theme, to "change culture" so that PC [palliative care] is not a "last resort" ... Utilizing telehealth and team member role expansion when discussing the initial diagnosis, with surgery as a potential treatment option, allows for multiple conversations ... Creating a process to ensure goal of care conversations occur, since "urologic procedures can have complications that significantly impact quality of life" ... [and] during the pre-operative visits, interdisciplinary input and evaluation of the patient prior to surgery allows the patient to "have a sort of joint meeting with us and the urologist."

Impact of outpatient palliative care services on resource utilization and cost management in a capitated Medicare populationJournal of Palliative Medicine; Parag Bharadwaj, Gagandeep Gill, Nathan Dyjack, Lindsay Fahnestock, Lorie D'Amore, Shuinn Chang, Nancy Hanna, Tanya Dansky, Gwyn Merz, Annamarie Jones, David Kim, Manjit Randhawa; 3/25The integration of palliative care into the U.S. health care system has grown significantly, with outpatient palliative care services (OPCSs) playing an increasingly vital role in managing patients with serious illnesses. Results [of this study] demonstrate substantial growth in OPCS enrollment, with a 129% increase from 2019 to 2023. Per-member-per-month costs showed a sustained reduction, with a 23% decrease by 2023. In addition, there were consistent reductions in ED [emergency department] visits and IP [in-patient] admissions, indicating effective outpatient care management. Patients transitioning from OPCS to hospice exhibited longer hospice stays, further emphasizing the benefits of early palliative care interventions.

[Germany] Do we have a knowledge gap with our patients?-On the problems of knowledge transfer and the implications at the end of lifeInternational Journal of Environmental Research and Public Health; Nils Heuser, Hendrik Heers, Martin Gschnell, Fabian Urhahn, Severin Schrade, Christian Volberg; 2/25Cancer patients are often unaware of their exact diagnosis, stage of disease, and prognosis. In the patients observed, it was found that many of them were unaware of their stage of disease, which can have a huge impact on their end-of-life decisions, such as the type of treatment they want. Many patients were also unaware of their own treatment. There is a risk that false hopes of cure may be attached to therapies and that, as a result, patients may be less likely to opt for palliative care with a focus on maintaining quality of life.

Saturday newsletters focus on headlines and research - enjoy!

Primary palliative care in assisted living and residential care-A metasynthesisJournal of Hospice & Palliative Nursing; David, Daniel PhD, MS, BSN; Jimenez, Vanessa MPH, BS; Brody, Abraham A. PhD, RN, FAAN; 3/25Assisted living (AL) and residential care (RC) settings are experiencing substantial growth as older adults with lower care needs seek alternatives to nursing homes. Despite this trend, there is a lack of skilled nursing care to support palliative care (PC) in these environments. Studies highlighted challenges and opportunities for delivering primary PC in these environments, emphasizing the importance of addressing physical symptoms, psychological distress, social isolation, and spiritual needs among residents with serious illnesses. The metasynthesis underscores the critical role of primary PC in enhancing quality of life and care continuity for older adults residing in AL/RC settings. It also identifies gaps in current practices and emphasizes the need for tailored interventions and training to support care providers in delivering comprehensive PC to this population. By integrating qualitative research findings with the National Consensus Project guidelines, this metasynthesis provides a comprehensive overview of primary PC in AL/RC settings.

Dr. Oz nomination to lead CMS advances in Senate vote    Modern Healthcare; by Michael McAuliff; 4/3/25 The Senate on Thursday advanced the confirmation of former television host Dr. Mehmet Oz to lead the nation's largest healthcare agencies by serving as administrator of the Centers for Medicare and Medicaid Services. Lawmakers voted 50 to 45 to advance the nomination to a final vote, which is expected Thursday afternoon.  ... He will assume control of an agency in flux that impacts some 160 million Americans and with a budget of around $1.7 trillion. Health Secretary Robert F. Kennedy Jr. is attempting to cut some 20,000 employees across the the Health and Human Services Department while Congress is weighing budget proposals that are likely to require deep cuts in Medicaid. [Continue reading ...]

The HOPE Assessment Tool Series: Managing special circumstancesCHAP press release; by Jennifer Kennedy; 3/25Welcome to the next installment in the HOPE Assessment Tool Blog Series. We are discussing special situations such as patient transfers and traveling patients which may affect HOPE assessment tool completion.

Life’s challenges are not supposed to paralyze you, they’re supposed to help you discover who you are. ~ Bernice Johnson Reagon

US Supreme Court rejects medical marijuana firm's bid to avoid racketeering suit Reuters, Washington, DC; by John Kruzel; 4/2/25 The U.S. Supreme Court ruled on Wednesday against Medical Marijuana Inc (MJNA.PK), opens new tab in its bid to fend off a lawsuit by a commercial truck driver who was fired for failing a drug test after taking cannabidiol, or CBD, that he said was falsely sold as lacking the psychoactive ingredient present in marijuana. The justices, in a 5-4 decision authored by conservative Justice Amy Coney Barrett, upheld a lower court's ruling that had allowed plaintiff Douglas Horn to bring a civil lawsuit against the San Diego-based company under the Racketeer Influenced and Corrupt Organizations Act. [Continue reading ...]

Trump administration orders NIH to eliminate $2.6 billion in federal contracts STAT; by Megan Moteni; 4/3/25 April 8 is the deadline for a 35% cut in services that could affect specimen storage, genetic counseling, administration. Leaders at the National Institutes of Health have been meeting this week to figure out how to cut $2.6 billion in contracts from the biomedical research agency’s budget, ... Early last week, the Trump administration’s federal government-shrinking task force, known as the U.S. DOGE Service, directed the NIH to reduce contract spending across each of its 27 institutes and centers by roughly 35%. The NIH was told to comply by April 8, ... [Continue reading ... access may be limited by subscription]

Navigating the intersection of heart failure and palliative care: A holistic approach to improving quality of life Cureus; by Awanwosa V. Agho, Fatimot Disu, Efeturi M. Okorigba, Okelue E. Okobi, Safiyya Muhammad, Toheeb Bakare, Chioma Ezuma-Ebong, Nneka Muoghalu; 3/30/25 ... Historically, palliative care has often been perceived as a last-resort option, introduced only when curative treatments have failed, creating a false dichotomy between life-prolonging therapies and symptom management. However, modern palliative care frameworks emphasize its integration throughout the disease trajectory, particularly for chronic, progressive illnesses like heart failure. ... Palliative care should ideally be initiated at diagnosis of advanced heart failure or with early signs of significant symptom burden to ensure timely, patient-centered support, as recommended by ACC, AHA, and HFSA guidelines

Fraud alert: HHS-OIG telephone numbers used in scam The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG); 4/3/25 The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) confirmed that official HHS-OIG telephone numbers are being used as part of a spoofing scam targeting individuals throughout the country. These scammers represent themselves as HHS-OIG employees and can alter the appearance of the caller ID to make it seem as if the call is coming from HHS OIG phone numbers found on its public website. The perpetrator may use various tactics to obtain or verify the victim's personal information, which can then be used to steal money from an individual's bank account or for other fraudulent activity. We encourage the public to remain vigilant, protect their personal information, and guard against providing personal information during calls that purport to be from HHS-OIG telephone numbers. We also remind the public that it is still safe to call into the HHS-OIG Hotline to report fraud. We particularly encourage those who believe they may have been a victim of the telephone spoofing scam to report that information to us through the HHS-OIG Hotline 1-800-HHS-TIPS (1-800-447-8477) or online. 

1 red flag that reveals bad leadership fast: One clear sign can tell you a lot about whether someone is leading well or failing miserably. Inc., by Marcel Schwantes; 3/28/25 Bad leadership isn’t always obnoxious, toxic, or obvious. Sometimes it shows up in small, everyday moments—how someone talks to their team, how they handle mistakes, or how they treat people when no one’s watching. You don’t need a long list to spot it, either. A few clear signs can tell you a lot about whether someone is leading well … or just holding the title. ... Here is one quick way to recognize bad leadership before it does real damage: a lack of patience ... [Continue reading ...]