Literature Review

Hospice Special Focus Program ListCMS Announcement; 12/20/24December 20, 2024: Today, the Centers for Medicare & Medicaid Services (CMS) released the list of the initial cohort of 50 hospices selected for participation in the Hospice Special Focus Program (SFP) in 2025. The SFP program, led by the Center for Clinical Standards and Quality, drives hospice quality improvement through increased health and safety oversight. This effort is a continuation of CMS’s commitment to improving hospice care for patients and families by holding hospice agencies accountable to national health and safety standards. [The initial cohort of 50 hospices selected for participation in the SFP can be downloaded here.]

Muslim community-engaged research highlights Muslim Americans' end-of-life-healthcare gaps and needs WisconsinMuslimJournal.org; by Sandra Whitehead; 12/20/24 Few Muslim Americans use hospice care, despite its posited benefits. A multi-sectoral team of academicians and community leaders in southeastern Wisconsin decided to find out why. ... Muslims are one of the fastest-growing religious communities in the United States, numbering between 3 to 5 million, with projections it will double by 2050. “With an aging Muslim population, there is a growing need for specialized healthcare services like hospice and palliative care,” the team’s research explains. ... Through a qualitative descriptive study with a Muslim patient and 10 family caregivers, the research team identified their perceptions of hospice care, ethical concerns and experiences. Among their varied perceptions, many saw it as useful only in the last hours of life. Participants also had ethical concerns about the use of sedative medication and with cessation of feeding terminally ill patients. Some had concerns about how hospice care might lead to unnecessary interventions or even hasten death. ...  The team is developing an informational resource, Islamic Bioethical Considerations for the End of Life: A Guide for Muslim Americans, to help Muslims who struggle when thinking about death and dying. 

Mobile app–facilitated collaborative palliative care intervention for critically ill older adults-A randomized clinical trialJAMA Internal Medicine; Christopher E. Cox, MD, MPH; Deepshikha C. Ashana, MD, MBA, MS; Katelyn Dempsey, MPH; Maren K. Olsen, PhD; Alice Parish, MSPH; David Casarett, MD; Kimberly S. Johnson, MD; Krista L. Haines, DO; Colleen Naglee, MD; Jason N. Katz, MD, MHS; Mashael Al-Hegelan, MD, MBA; Isaretta L. Riley, MD, MPH; Sharron L. Docherty, RN, PNP, PhD; 12/24An automated electronic health record–integrated, mobile application–based communication platform that displayed family-reported needs over 7 days, coached ICU attending physicians on addressing needs, and prompted palliative care consultation if needs were not reduced within 3 study days. In this randomized clinical trial, a collaborative, person-centered, ICU-based palliative care intervention had no effect on palliative care needs or psychological distress compared to usual care despite a higher frequency of palliative care consultations and family meetings among intervention participants.

ProCare Hospice of Nevada names nationally recognized hospice expert Keith Everett as new CEOProCare Hospice press release; 12/9/24In a move that underscores its vision to transform the cultural perceptions of advanced illness care, ProCare Hospice of Nevada (PCH) proudly announces Keith Everett as its new Chief Executive Officer. Everett, a proven leader in hospice care, most recently served as the President and CEO of Hospice of Acadiana in Lafayette, Louisiana.

House of Goshen makes history as Chicago’s first black-owned independent inpatient hospice house G20 News Today, Flossmoor, IL; 12/21/24 House of Goshen, a state-of-the-art inpatient hospice facility and the first Black-owned independent hospice center in the Chicago Southland area, is now officially accepting patients. Located at 19810 Governors Highway in Flossmoor, the center represents a pivotal advancement in equitable, compassionate end-of-life care in Chicagoland, the South Suburbs and beyond. The 14,000-square-foot facility offers 14 private suites designed to provide comfort, dignity, and peace for patients and their families. ... “Our goal is to create a sanctuary where every patient and family member feels supported, seen, and cared for,” said Sade Bello, co-founder of House of Goshen. “Being the first Black-owned hospice center in the region comes with immense pride and responsibility. We are committed to setting a standard of care that reflects the diversity and humanity of the communities we serve.”Editor's note: Thank you to the House of Goshen. Readers, pair this with the significance about hospice locations in "Who gets access to a good death?," an article that we posted on 10/24/24.

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

In the end, it's not the years in your life that count. It's the life in your years. ~Abraham Lincoln 

Recommendations to ensure safety of AI in real-world clinical careJAMA; Dean F. Sittig, PhD; Hardeep Singh, MD, MPH; 11/24As HCOs [health care organizations] adapt their clinical and administrative workflows to new AI [artificial intelligence]-driven technologies, unintended adverse consequences will inevitably occur, particularly during transitions. To address these risks, HCOs and AI/EHR [electronic health record] developers must collaborate to ensure that AI systems are robust, reliable, and transparent. HCOs must proactively develop AI safety assurance programs that leverage shared responsibility principles, implement a multifaceted approach to address AI implementation, monitor AI use, and engage clinicians and patients. Monitoring risks is crucial to maintaining system integrity, prioritizing patient safety, and ensuring data security. 

Evolution in documented goals of care at end of life for adolescents and younger adults with cancerJAMA Network Open; Rosemarie Mastropolo, Colin Cernik, Hajime Uno, Lauren Fisher, Lanfang Xu, Cecile A Laurent, Nancy Cannizzaro, Julie Munneke, Robert M Cooper, Joshua R Lakin, Corey M Schwartz, Mallory Casperson, Andrea Altschuler, Lawrence Kushi, Chun R Chao, Lori Wiener, Jennifer W Mack; 12/24Little is known about the nature of change in goals of care (GOC) over time among adolescents and younger adult (AYA) patients aged 12 to 39 years with cancer near the end of life. Understanding how GOC evolve may guide clinicians in supporting AYA patients in making end-of-life decisions. In this cross-sectional study of AYA patients who died of cancer, palliative goals were rarely documented before the last month of life, highlighting the need for timely and ongoing GOC discussions.

Behavioral symptoms and treatment challenges for patients living with dementia: Hospice clinician and caregiver perspectivesJournal of the American Geriatrics Society; Karolina Sadowska BA; Molly Turnwald BA; Thomas O'Neil MD; Donovan T. Maust MD, MS; Lauren B. Gerlach DO, MS; 12/24Dementia affects one in three older adults over age 85 and individuals with dementia constitute the fastest growing population of patients entering hospice care. While cognitive impairment is the hallmark of dementia, behavioral symptoms are reported in nearly all patients with advanced dementia, contributing to both the complexity of end-of-life care and caregiver burden. Behavioral symptoms of dementia are highly prevalent among the US hospice population and are often managed with psychotropic medications prescribed off-label. There are limited treatment guidelines in this population, so the appropriate risk and benefit balance may be highly individual. This qualitative study can help to inform the decision-making of hospice clinicians and caregivers regarding anticipated behavioral changes and limitations of treatment options in dementia end-of-life care. 

Estimation of cancer deaths averted from prevention, screening, and treatment efforts, 1975-2020JAMA Oncology; Katrina A. B. Goddard, PhD; Eric J. Feuer, PhD; Jeanne S. Mandelblatt, MD, MPH; Rafael Meza, PhD; Theodore R. Holford, PhD; Jihyoun Jeon, PhD; Iris Lansdorp-Vogelaar, PhD; Roman Gulati, MS; Natasha K. Stout, PhD; Nadia Howlader, PhD; Amy B. Knudsen, PhD; Daniel Miller, BA; Jennifer L. Caswell-Jin, MD; Clyde B. Schechter, MD; Ruth Etzioni, PhD; Amy Trentham-Dietz, PhD; Allison W. Kurian, MD, MSc; Sylvia K. Plevritis, PhD; John M. Hampton, MS; Sarah Stein, PhD; Liyang P. Sun, MS; Asad Umar, DVM, PhD; Philip E. Castle, PhD; 12/24Overall US mortality has declined over time for most major cancer sites because of progress in prevention, screening, and treatment. Nevertheless, the reignited Cancer Moonshot goal to reduce the age-adjusted cancer mortality rate by 50% in the next 25 years will not be achieved without accelerating progress. In this model-based study using population-level cancer mortality data, an estimated 5.94 million deaths were averted from these 5 cancers [breast, cervical, colorectal, lung, and prostate] combined. Prevention and screening accounted for 8 of every 10 averted deaths, and the contribution varied by cancer site. A comprehensive plan to reduce cancer mortality includes interventions in cancer prevention, detection, diagnosis, treatment, and survivorship care.

High-risk opioid prescribing and nurse practitioner independenceJAMA Health Forum; Lucas D. Cusimano, BS; Nicole Maestas, MPP, PhD; 12/24In 2021, more than 1 in 5 opioid overdose deaths were attributed to prescription opioids in the US, and the rate of such deaths has increased 5-fold since 1999. Concerns around excessive opioid prescribing have been used to argue against the expansion of the scope of practice of nurse practitioners (NPs) ... In this difference-in-differences analysis of opioid prescribing in 16 states, there was no change in the rates of high-risk opioid prescribing in the 6 states that adopted nurse practitioner independence compared with 10 nonadopting neighboring states during the 24 months following adoption. The study found no association between legislation that granted independence to nurse practitioners and rates of risky opioid prescribing. 

Cannabidiol for scan-related anxiety in women with advanced breast cancer-A randomized clinical trialJAMA Network Open; Manan M. Nayak, PhD, MA; Peter Chai, MD; Paul J. Catalano, ScD; William F. Pirl, MD, MPH; James A. Tulsky, MD; Stephanie C. Tung, MD; Nancy U. Lin, MD; Nicole Andrade, BA; Sabrina Johns, MPH; Clint Vaz, MD; Melissa Hughes, MSc; Ilana M. Braun, MD; 12/24The findings of this randomized clinical trial show that CBD [cannabidiol] can be used safely in women with advanced breast cancer and clinical anxiety. Although the study did not meet its primary end point comparing preingestion vs postingestion anxiety change scores between study arms, anxiety levels in the CBD arm were significantly lower 2 to 4 hours after ingestion, suggesting a possible anxiolytic effect and warranting further investigation.