Literature Review



Artificial intelligence and health care waste—Promise or peril?

06/28/25 at 03:45 AM

Artificial intelligence and health care waste—Promise or peril?JAMA Health Forum; William H. Shrank, MD, MSHS; Suhas Gondi, MD, MBA; David J. Brailer, MD, PhD; 6/25One obvious target of AI [artificial intelligence] tools in health care is the reduction of waste. While LLM [large language model] applications to health care are still nascent—many still make errors, and more rigorous evaluations are needed—most agree that the long-term opportunity for AI in health care is tremendous. A recent study estimated that widespread adoption of AI could lead to savings of 5% to 10% of total US health care spending. Realizing even a fraction of this potential would increase the affordability of care for people in the US and free substantial societal resources to make other valuable investments. But getting there will require deliberate choices from leaders and policymakers and careful attention to risks that could set back progress.

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Strengths and opportunities: Clinicians' perspectives on palliative care for Amyotrophic Lateral Sclerosis (ALS) in the United States

06/28/25 at 03:35 AM

Strengths and opportunities: Clinicians' perspectives on palliative care for Amyotrophic Lateral Sclerosis (ALS) in the United StatesMuscle & Nerve; Kara E Bischoff, Gayle Kojimoto, David L O'Riordan, Yaowaree L Leavell, Samuel Maiser, Astrid Grouls, Alexander K Smith, Steven Z Pantilat, Benzi M Kluger, Ambereen K Mehta; 6/25Half of ALS clinicians [surveyed] reported they are able to manage patients' pain (55%) and mood symptoms (52%) "very well." Fewer reported managing care partner needs (43%) and spiritual/existential distress (29%) "very well." Fifty-eight percent of pALS [people with ALS] are referred to outpatient PC and 69% to hospice at some point in the illness. ALS clinicians generally felt satisfied with PC teams' care, but PC clinicians were less confident managing motor symptoms (51% confident) and helping care partners understand how to provide care (51%) and use equipment (25%). Most clinicians felt the quality of PC provided by ALS (77%) and PC (90%) teams is good/excellent. However, qualitative comments highlighted that both ALS and PC clinicians have knowledge gaps, and collaboration between ALS and PC clinicians should increase.

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Zuranolone in palliative care: Promise and practicality for the rapid treatment of depression

06/28/25 at 03:30 AM

Zuranolone in palliative care: Promise and practicality for the rapid treatment of depressionThe American Journal of Hospice & Palliative Care; Eric Prommer; 6/25Zuranolone is an orally available antidepressant classified as a neuroactive steroid. Neuroactive steroids act as positive allosteric modulators for both synaptic and extrasynaptic GABA, making them distinct from currently available drugs targeting major depression and insomnia. By modulating GABA binding sites, neuroactive steroids enhance the function of GABA, which is depressed in major depression. The drug has a rapid onset of action, which differs from currently available antidepressants that are used in palliative care. [This] ... paper will review the pharmacology, pharmacodynamics, safety profile, and clinical studies showing its effectiveness in major depression and how it can potentially be helpful in the palliative care population.

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Temporal trends in opioid-related care and pain among Veterans at the end of life

06/28/25 at 03:25 AM

Temporal trends in opioid-related care and pain among Veterans at the end of lifeJournal of Pain and Symptom Management; by Melissa W. Wachterman, Stuart R. Lipsitz, Erin Beilstein-Wedel, Walid F. Gellad, Karl A. Lorenz, Nancy L. Keating; 7/25In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Over a time period during which opioid safety initiatives were implemented, opioid prescribing near the end of life decreased, accompanied by decreases in opioid-related hospitalizations but increases in pain. These findings suggest that important tradeoffs may exist between reducing opioid-related serious adverse events and undertreating patient pain in the last month of life. Opioid prescribing guidelines could consider incorporating prognosis into recommendations.

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Unanswered questions on private equity in gastroenterology

06/28/25 at 03:20 AM

Unanswered questions on private equity in gastroenterologyJAMA Network; by Jane M. Zhu; 6/25A growing literature on private equity (PE) acquisitions of physician practices has found associated increases in health care prices and utilization, but evidence specific to gastroenterology remains relatively new despite the specialty being a popular target for PE. More than 1 in 8 gastroenterology practices are now owned by PE, with practice fragmentation, lucrative procedural reimbursements, and an aging population factoring into continuing investor interest... Taken together with observations of increased utilization, there may be 2 interpretations of the data presented by Arnold and colleagues. One interpretation of the findings may be that PE acquisition may focus on reducing inefficiencies, improving access by expanding practice capacity, and increasing throughput. Another interpretation may be that PE acquisition is focused on the strategic exploitation of market and pricing power. The latter may have less of an impact on clinical measures like quality of care, but potentially, both strategies could be at play.Publisher's note: Similar questions being asked across hospice, gastroenterology, physician practices, and other areas of healthcare.

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When GIP is not enough: Revocation of hospice to meet patient goals

06/28/25 at 03:15 AM

When GIP is not enough: Revocation of hospice to meet patient goalsJournal of Pain and Symptom Management; by Margaret Krasne, Alden Rinaldi, Richard Leiter; 5/25In 2021, 6.3% of hospice discharges were due to beneficiary revocation. The Hospice Care Index, a quality metric impacting hospice reimbursement, penalizes hospices for revocations, regardless of the reason for revocation. We will review the literature on reasons for hospice revocation, factors affecting revocation rates, the impact of revocation on quality metrics, and strategies for optimizing revocation rates.Publisher's note: This was a poster session at the 2/25 AAHPM conference.

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Physicians' preferences for their own end of life: A comparison across North America, Europe, and Australia

06/28/25 at 03:10 AM

Physicians' preferences for their own end of life: A comparison across North America, Europe, and AustraliaJournal of Medical Ethics; Sarah Mroz, Sigrid Dierickx, Kenneth Chambaere, Freddy Mortier, Ludovica De Panfilis, James Downar, Julie Lapenskie, Koby Anderson, Anna Skold, Courtney Campbell, Toby C Campbell, Rachel Feeney, Lindy Willmott, Ben P White, Luc Deliens; 6/25Setting: Eight jurisdictions: Belgium, Italy, Canada, USA (Oregon, Wisconsin, and Georgia), Australia (Victoria and Queensland). Participants: Three physician types: general practitioners, palliative care physicians, and other medical specialists. Conclusion: Physicians largely prefer to intensify alleviation of symptoms at the end of life and avoid life-sustaining techniques. In a scenario of advanced cancer or Alzheimer's disease, over half of physicians prefer assisted dying. Considerable preference variation exists across jurisdictions, and preferences for assisted dying seem to be impacted by the legalisation of assisted dying within jurisdictions.

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A narrative review of clinicians’ perspectives on palliative care for advanced liver disease

06/28/25 at 03:05 AM

A narrative review of clinicians’ perspectives on palliative care for advanced liver diseaseCurrent Hepatology Reports; Nicholas Hoppmann, Susan Feldman, Aidan Warner; 6/25 Integration of PC [palliative care] services for patients with ALD [advanced liver disease] is complicated by an unpredictable disease course and lack of comprehensive understanding of PC services across healthcare systems. In our current early stage of integration, clinicians’ perspectives highlight two major steps forward on the path to robust PC integration including increasing medical education on PC broadly and within hepatology to dispel misconceptions and provide skills to deliver primary PC as well as increasing collaboration between hepatology and specialty PC tailored to fit individual practice settings.Assitant editor's note: Perhaps the unpredictability of advanced liver disease is exactly why palliative care could be helpful. This may serve as a fruitful opportunity for PC programs to educate hepatologists. 

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[Korea] Alzheimer Disease in Breast Cancer survivors

06/28/25 at 03:00 AM

[Korea] Alzheimer Disease in Breast Cancer survivorsJAMA Network; by Su-Min Jeong, Wonyoung Jung, Hyeonjin Cho, Hea Lim Choi, Keun Hye Jeon, Ki-Woong Nam, Yun-Gyoo Lee, Bongseong Kim, Kyungdo Han, Dong Wook Shin; 6/20Is breast cancer survivorship associated with the risk of Alzheimer dementia (AD), and how are cancer treatments associated with this risk? Breast cancer survivors may have a slightly lower risk of AD compared with cancer-free individuals, potentially influenced by cancer treatments, underscoring the need for further research on long-term neurocognitive outcomes in this population.

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Saturday newsletters

06/28/25 at 03:00 AM

Saturday newsletters focus on headlines and research - enjoy!

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Serious illness conversations in the Emergency Department for older adults with advanced illnesses - A randomized clinical trial

06/28/25 at 03:00 AM

Serious illness conversations in the Emergency Department for older adults with advanced illnesses - A randomized clinical trialJAMA Network; by Kei Ouchi, Susan D. Block, Dorene M. Rentz, Donna L. Berry, Hannah Oelschlager, Youkie Shiozawa, Sarah Rossmassler, Amanda L. Berger, Mohammad A. Hasdianda, Wei Wang, Edward Boyer, Rebecca L. Sudore, James A. Tulsky, Mara A. Schonberg; 6/25Does an emergency department (ED)–based intervention to discuss serious illness care goals improve advance care planning outcomes for older adults with advanced illnesses? In this randomized clinical trial including 141 patients in the ED, a nurse-led intervention to discuss serious illness care goals did not significantly improve patient-reported engagement in advance care planning but did increase subsequent clinician-documented serious illness conversations in the medical records. These findings suggest that ED visits may serve as a critical access point for serious illness conversations in clinically stable older adults with advanced illnesses.

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[Columbia] Anxiety, depression, and quality of life of caregivers of palliative care patients with cancer

06/28/25 at 03:00 AM

[Bogota, Columbia] Anxiety, depression, and quality of life of caregivers of palliative care patients with cancerRevista Cuidarte; by Alejandra María Alvarado García, Lina María Vargas-Escobar, Mauricio Arias-Rojas, Carlos Javier Avendaño-Vásquez, Cesar Antonio Consuegra-Pareja; 2/25Caregivers with moderate or severe depression were more likely to report symptoms of sadness, punishment feelings, self-dislike, suicidal thoughts or wishes, indecisiveness, irritability, changes in appetite, concentration difficulty, and tiredness or fatigue. Among caregivers with mild depression, loss of interest in sex, agitation, and past failure were identified. Strategies for psycho-emotional counseling, education, and support for caregivers are needed.

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Re-examining early in early palliative care: Precedent, reality, and future research priorities

06/28/25 at 02:00 AM

Re-examining early in early palliative care: Precedent, reality, and future research prioritiesJCO Oncology Practice; by Laura A. Petrillo, Julia L. Agne; 6/25Nearly 700,000 people in the United States are living with metastatic solid tumor malignancies in 2025, a number that continues to grow because of advances in survival-extending therapy. Even with therapeutic advances, however, metastatic cancer continues to negatively affect patients' quality of life because of bothersome symptoms and psychological, social, and spiritual distress. Palliative care is specialized medical care focused on alleviating suffering for individuals with serious illness, including those with advanced cancer. On the basis of on substantial evidence demonstrating its efficacy in improving quality of life, ASCO and other organizations now recommend the early integration of palliative care with oncology care for all individuals living with advanced cancer. [Also see accompanying article: Early Integration of Outpatient Palliative Care Among Adults With Advanced Cancer in a Safety-Net Health System: A Patterns of Care Analysis; by Lisa DiMartino, Vincent Merrill, Celette Sugg Skinner, Timothy P. Hogan, Navid Sadeghi, Alva Roche-Green, Winnie Wang, Arthur S. Hong]

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Residential Home Health and Hospice receives 2025 Top Workplaces honors

06/27/25 at 03:20 AM

Residential Home Health and Hospice receives 2025 Top Workplaces honorsPR Newswire; 6/23/25Residential Home Health and Hospice, a division of Graham Healthcare Group, is proud to announce that it has been awarded Top Workplaces 2025 honors by the St. Louis Post-Dispatch. This is the fifth year that Residential Home Health and Hospice has received this award in the St. Louis market.

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Aroostook House of Comfort’s 12th Annual Golf Classic raises $90,000

06/27/25 at 03:15 AM

Aroostook House of Comfort’s 12th Annual Golf Classic raises $90,000[ME] The County; 6/20/25The Aroostook Hospice Foundation proudly hosted its 12th Annual Golf Classic on Saturday, June 14 at the Presque Isle Country Club, raising approximately $90,000 in support of the Aroostook House of Comfort. This achievement was made possible through the generous support of 166 sponsors, 42 teams, 42 raffle and prize donors, 14 in kind donors and 32 volunteers who came together to make the day a success.

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‘It takes a village’: The need to expand community-based pediatric palliative care

06/27/25 at 03:15 AM

‘It takes a village’: The need to expand community-based pediatric palliative careHospice News; by Holly Vossel; 6/25/25Similar to adults, many seriously ill children prefer to die in the home versus in facility-based care settings. But several barriers are preventing greater access to goal-concordant, community-based pediatric palliative care delivery. The challenges in some ways mirror issues among adult populations such as insufficient clinical resources, caregiver burden or lagging family support in the home, as well as financial and logistical constraints. However, in the pediatric space, these obstacles are much more complex and nuanced to navigate, according to Allison Grady, pediatric oncology nurse practitioner and chair of the National Association of Pediatric Nurse Practitioners’ (NAPNAP) Pediatric Palliative Care Special Interest Group.

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Community Hospice & Palliative Care launches "Mail Call" program to honor Veteran patients

06/27/25 at 03:10 AM

Community Hospice & Palliative Care launches "Mail Call" program to honor Veteran patientsJaxChamber; 6/24/25Community Hospice & Palliative Care (Jacksonville, FL) is proud to announce the launch of its new "Mail Call" program, designed to honor and appreciate our veteran patients in a deeply personal way. This initiative expands upon our existing veteran recognition ceremonies, enriching the end-of-life care experience for those who have served our country. The "Mail Call" program invites volunteers, students, and community members to write heartfelt letters to our veteran patients. These letters, reminiscent of the cherished mail from home during their service years, offer messages of gratitude, encouragement, and personal reflections. Participants can choose to include their name or school, allowing students to share their appreciation directly with our veterans.

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Avow selected to provide hospice care in Lee, Glades, and Hendry Counties

06/27/25 at 03:10 AM

Avow selected to provide hospice care in Lee, Glades, and Hendry CountiesSouth Florida Hospital News; 6/25/25Avow is proud to announce that the Florida Agency for Health Care Administration (AHCA) has notified Avow of its intent to select the organization to provide hospice services in Lee, Glades and Hendry counties, following AHCA’s preliminary approval of Avow’s Certificate of Need (CON) application. This important decision will expand Avow’s compassionate, high-quality hospice care for residents throughout Southwest Florida.

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Hospice care not meant to be a last resort, offers more benefits

06/27/25 at 03:05 AM

Hospice care not meant to be a last resort, offers more benefits[NH] The Laconia Daily Sun; by Anna Swanson, Pemi-Baker Hospice & Home Health; 6/24/25Hospice care is often misunderstood. Too many families see it as a last resort — something to turn to only when there’s “nothing else to do.” But at Pemi-Baker Hospice & Home Health, we see it differently. Hospice is not about giving up. It’s about choosing how to live. Hospice care is a gift — a chance to focus on what truly matters when time is short. It’s about comfort, dignity, and presence. It’s about saying yes to meaningful moments and no to unnecessary suffering.

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UnitedHealth Group names Patrick Conway CEO of Optum Health

06/27/25 at 03:05 AM

UnitedHealth Group names Patrick Conway CEO of Optum HealthModern Healthcare; by John Tozzi; 6/26/25The leader of UnitedHealth Group Inc.’s Optum Health care delivery unit has left the role, an early indication of management changes under Stephen Hemsley, UnitedHealth’s new chief executive officer. The division will now be led by Patrick Conway, who was recently promoted to CEO of the broader Optum division that includes Optum Health.

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Measuring what matters: The untapped power of resident experience

06/27/25 at 03:05 AM

Measuring what matters: The untapped power of resident experienceMcKnight's Long-Term Care News; by Charles de Vilmorin; 6/25/25In today’s senior living and long-term care environment, doing well financially depends on doing good — truly good. Communities that thrive are the ones that deliver on the promise of person-directed living, where residents are not passive care recipients but active participants in a life of dignity, purpose and connection. This isn’t just a moral imperative — it’s a strategic one. The industry has long recognized the importance of resident quality of life, but often fails to define or measure it with the same rigor applied to occupancy or staffing ratios. This is a missed opportunity. Resident experience remains one of the most powerful, untapped levers for operational improvement, competitive differentiation and financial growth. It’s time we treat it like the performance driver it is.Publisher's note: The balance of "mission and money" is equally true in hospice.

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Today's Encouragement 6/27/25

06/27/25 at 03:00 AM

If you want to know where your heart is, watch where your mind goes when you daydream. ~Walt Whitman

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Social Media Watch 6/27/25

06/27/25 at 03:00 AM

Social Media Watch 6/27/25

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As SLO County hospice center closes due to financial loss, CEO was paid $485,000

06/27/25 at 03:00 AM

Local hospice center closing after 40 years in SLO[CA] The Tribune; by Chloe Shrager; 6/24/25Wilshire Health & Community Services, a San Luis Obispo-based hospice and community care center, will close its doors on June 30, 2025, after over four decades of operation on the Central Coast. Wilshire offered comprehensive at-home clinical health, senior and hospice care services like nursing, home aids and different types of therapy to thousands of patients across SLO and northern Santa Barbara counties... SLO based hospice care center to close due to financial struggles.

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Healthcare’s broken math: 11 signs the numbers don’t add up

06/27/25 at 03:00 AM

Healthcare’s broken math: 11 signs the numbers don’t add upBecker's Hospital Review; by Scott Becker, Molly Gamble; 6/25/25Healthcare has a daunting and growing supply and demand problem. We have a growing population in the United States and not enough physicians, nurses, allied healthcare providers and technicians. It is a very clear and simple math problem. We have approximately 340 million people in the United States and only about 840,000 direct patient care physicians and about 5.3 million nurses. Similarly, we face shortages across the board in other provider types and critical staff roles. [Imbalances include:]

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