Literature Review

[Germany] Web-based educational tools and decision aids for patients with advanced cancer: A systematic reviewPatient Education and Counseling; Phoebe Ullrich, Henrike Voß, Laura Unsöld, Michael Thomas, Matthias Villalobos; 2/25In advanced cancer care, patient involvement in decision-making is complex. Web-based solutions are promising because of easy accessibility and dissemination and the ability to adapt information to patients' needs and new treatment developments. Still, only a few evidence-based web-based educational tools and decision aids are available. Filling this gap is essential to empower patients to make informed and goal-concordant treatment decisions.

Feasibility study of using electronic patient-reported outcomes to screen patients with advanced solid cancers for palliative care needsJournal of Palliative Medicine; Tara L Kaufmann, Matthew Kearney, Dagoberto Cortez, John W Saxton, Katie Goodfellow, Carolyn Smith, Patrick Chang, Katherine Sebastian, Aaron Galaznik, Julie Scott, Elizabeth Ann Kvale, Arif H Kamal, Antonia V Bennett, Angela M Stover, Ashley M Henneghan, Michael Pignone, Gabrielle Betty Rocque; 3/25Standardized, needs-based screening and triage systems are essential to more effectively address patients' palliative care needs. We developed a 13-item ePRO [electronic patient-reported outcomes] palliative care survey to assess multidimensional palliative care needs and conducted a pilot study (n = 25) of a palliative care screening intervention using ePRO monitoring and presentation of ePRO reports to a multidisciplinary care team. Patients found the ePRO palliative survey acceptable and appropriate. Screening patients for unmet palliative needs using ePRO monitoring is feasible, acceptable, and appropriate among patients, but more work is needed to understand the perspectives of diverse patients and how to integrate ePRO palliative care screening into clinical workflows.

Evaluating performance of the Surprise Question to predict 12-month mortality in patients with end-stage liver diseaseAmerican Journal of Hospice and Palliative Care; Sarah Homann, MD; Jamie Pfaff, MD; Elizabeth Stovicek, MD; Rajiv Agarwal, MD, MSC;, Sumathi K. Misra, MD, MPH; Jill M. Pulley, MBA; Justin K. Siemann, PhD; Ashley Spann, MD, MSCAI; Stacey Tillman, MD; Cheryl L. Gatto, PhD; Mohana Karlekar, MD; 2/25ESLD [end-stage liver disease] is associated with significant morbidity and mortality. Early PC engagement has been proposed as a solution to improve the physical and psychological burden associated with ESLD. ... hepatologists were asked the SQ [surprise question]: “Would you be surprised if this patient were to die in the next 12 months?” as a prompt to consider consultation to specialty PC [palliative care]. While the SQ should not be solely used as a prognostic indicator of death, our study proves that the SQ can be utilized by hepatologists as a screening tool with good sensitivity for identifying patients with ESLD who may be at higher risk of death and therefore may benefit from PC co-management.

Perceptions of patient-clinician communication among adults with and without serious illnessJAMA Network Open; Carine Davila, Sarah Nouri, Stephanie H Chan, Brian Feltz, Anna Gosline, Zamawa Arenas, Jane Kavanagh, Joanna Paladino, Lindsay A Dow, Vicki A Jackson, Rebecca Sudore, Christine S Ritchie, Elizabeth Lindenberger; 3/25In this cross-sectional study, adults with serious illness more often had worse patient-clinician communication experiences. Compared with adults without serious illness, adults with serious illness were more likely to report leaving a visit unsure about next steps ...; being afraid to ask questions or speak up ...; believing they were talked down to or made to feel inferior...; and believing that they were treated unfairly by clinicians ... Further research is needed to better understand and develop interventions to improve perceptions of patient-clinician communication experiences for adults with serious illness.

Prevalence of depression and anxiety among adults with chronic pain-A systematic review and meta-analysisJAMA Network Open; Rachel V. Aaron, PhD; Scott G. Ravyts, PhD; Nicolette D. Carnahan, PhD; Kavya Bhattiprolu, BS; Nicole Harte, MClinPsychol; Claire C. McCaulley, BA; Lauren Vitalicia; Alexandria B. Rogers, PhD; Stephen T. Wegener, PhD; Joanne Dudeney, PhD; 3/25Chronic pain, defined as pain that persists for more than 3 months, is a prevalent and disabling condition affecting 21% of adults. In this systematic review and meta-analysis of depression and anxiety among individuals with chronic pain, approximately 40% of adults had clinically significant depression and anxiety. Women, younger people, and people with nociplastic pain were most likely to have depression and anxiety. The co-occurrence of chronic pain with depression and anxiety is a significant public health concern necessitating routine screening in clinical settings, equitable access to specialty care, and innovative treatment development. 

Disparities in end-of-life symptom burden linked to complex interplay among wealth, health, and social supportJAMA Network Open; Peter A. Boling, MD; 3/25On average, US health care spending in the last year of life alone was $80,000, with 12% ($9,500) being out of pocket and mostly incurred before the final 6 months. This problem worsened in the past decade when the nonspecific diagnosis of failure to thrive was removed as a condition eligible for hospice care and more stringent definitions were applied for dementia, which became the next bubble as the hospice balloon was squeezed. Hospice care is a means of reducing symptom burden, but the Medicare payment model discourages prolonged enrollment during slowly progressing advanced chronic illness and effectively limits funding of social support during hospice care, which is particularly problematic for patients with cognitive and functional impairment and for their friends and families. Considering suffering as a medical condition warranting treatment rather than a social problem requiring support services might help with the evolution of a Medicare policy that might provide a more graduated approach to end-of-life care.

Saturday newsletters focus on headlines and research - enjoy!

Hosparus Health hosts senior resource fair for community NBC WNKY News 40, Bowling Green, KY; by Noah Faerber; 3/18/25 Hosparus Health invited partners from the community to WKU’s Medical Science Complex for a senior resource summit. It offered seniors a chance to speak with different organizations that can help them prepare for their future. From Bowling Green Parks & Rec’s fitness department to different healthcare groups, staff were excited to have so many groups out to help look toward what’s next.

[Australia] Advance care planning has brought 'comfort and peace' to Annaliese Holland ABC News; by Eva Blandis and Daniel Keane; 3/19/25Young South Australian woman Annaliese Holland, who is preparing for major high-risk surgery, has spoken about the importance of advance care planning. The 25-year-old was diagnosed with a rare autoimmune disease and terminal illness several years ago. Ms. Holland wants young people to have more open conversations about death and end-of-life care. ... "I say my life is like walking on a field of landmines, not knowing when it will go off,"  she said. While it is a harrowing statement, she is harnessing her situation to help others — Ms. Holland is a strong supporter of advance care planning.

‘Dying people are incredible teachers’: Hospice nurse leans on personal loss experience to speak about end of life, write children’s books Dayton Daily News, Dayton, OH; by Beth Anspach; 3/20/25 Kim Vesey has experienced more than her share of loss. Her husband, Les, passed away in 2006 of colon cancer. “He died at home with Hospice care,” Vesey said. “Having worked in this area and experiencing it myself, this took it all to a much deeper level and changed my understanding of the process of grief.” ... She was hired for her first Hospice job in 1985. “It’s taught me a lot about life and living and what is important,” she said. “Dying people are incredible teachers.” ... After losing her husband, Vesey continued her work in Hospice care. Then in 2017, her daughter Sarah, who had struggled with severe asthma her entire life, passed away after going into cardiac arrest. She was just 29 years old and left behind a 4-year-old son, Warren. She was also pregnant with her second child. “My experience of losing my daughter shined a light on the struggle for children who are grieving,” Vesey said.“ ... Today, Vesey has published four books with two additional scheduled to be published this year, including a book about losing a beloved pet. ...

Health care system adaptation and resilience during the wildfire crisisJAMA Network; by Attila J. Hertelendy, PhD, Jeremy Maggin, MD, MS, and Gregory Ciottone, MD; 3/19/25 ... Within a span of hours, the Palisades and Eaton fires, propelled by record-breaking Santa Ana winds reaching 150 miles per hour, consumed more than 37,000 acres, destroyed more than 16,000 structures, and claimed 29 lives. All told, greater than 186,000 residents were placed under evacuation orders. ... The experience in Los Angeles County demonstrates the value of maintaining dual-purpose resources: facilities and personnel who can transition between routine operations and emergency response functions. This approach is exemplified by Kaiser Permanente’s successful deployment of mobile health vehicles and the use of clinically trained administrative leaders in direct patient care roles during crisis events. Key elements of successful resource mobilization include:

Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?