Literature Review

Palliative care and harm reduction: Improving outcomes for patients with cancer, substance use disorderPharmacy Times; by Alexandra Gerlach; 5/24/24Pain management and substance use disorder (SUD) present unique challenges for patients with cancer. At the 2024 Society of Pain and Palliative Care (SPPCP) Virtual Conference, presenters Sachin Kale, MD, MBOE, and Kyle Quirk, PharmD, discussed challenges related to limited training of health care professionals (HCPs) in the management of patients with cancer-related pain and SUD. They highlight a need for a more comprehensive medical model that incorporates harm reduction strategies in palliative care and fosters a patient-centric approach to treatment.

How value-based models can aid palliative care team recruitment Hospice News; by Jim Parker; 5/22/24 A transition from fee-for-service to value-based payment models could help palliative care providers boost recruitment and retention. Providers walk a tightrope when it comes to ensuring that their palliative care services are financially sustainable, including the ability to attract and compensate staff at competitive rates. In today’s predominant reimbursement structure, palliative care programs are often loss leaders. But moving away from fee-for-service towards value-based payment could make a difference when it comes to hiring and retention, according to Dr. Jennifer Blechman, palliative care medical director at the Oregon-based nonprofit Partners in Care. ...

Patients fare better when they get palliative care sooner, not laterScientific American; by Lydia Denworth; 5/14/24Supportive care is often started late in an illness, but that may not be the best way. I was happy to have the help but wished it had been available earlier. I’m not alone in that. Evidence of the benefits of palliative care continues to grow. For people with advanced illnesses, it helps to control physical symptoms such as pain and shortness of breath. It ­addresses mental health issues, including depression and anxiety. And it can reduce unnecessary trips to the hospital. But barriers to access persist—especially a lack of providers. As a result, palliative care is too often offered late, when “the opportunity to benefit is limited,” says physician Kate Courtright of the Perelman School of Medicine at the University of Pennsylvania.

Big Bend Hospice, Tallahassee Memorial HealthCare Plan to Build Value-Based Network, Offer Palliative CareHospice News; by Jim Parker; 5/14/24A new collaboration for transitional care between Florida-based Big Bend Hospice (BBH) and the Tallahassee Memorial HealthCare (TMH) system has more going on behind the scenes. Big Bend, a nonprofit provider, in 2021 formed a new parent company called Seven Oaks Health. TMH has entered into an affiliation agreement with Seven Oaks Health, as the new organization works over the next five years to build a larger value-based network to provide transitional and palliative care, social determinants support, as well as care navigation and other services. Looking to the future, the organizations’ plans to engage in value-based care could manifest through participation in the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) model.

Design and death: palliative care needs more creativity AAP - Australian Associated Press; by Cassandra Morgan; 5/10/24 At the Caritas Christi palliative care unit, "homeliness" is sprawling crayon lines and scribbled messages of "get well soon", drawn by children in its arts room. It's the sense of quiet, the soft carpet underfoot, and the ability for patients to simply open a window, or walk outside their rooms and touch a tree or feel the soil. Architectural expert Rebecca McLaughlan says homeliness is more about what a space allows people to do than how it looks. ... "In subtle ways, these facilities do affect the quality of time and the quantity of time that people spend with their loved ones." ... The researcher is among experts advocating for greater design innovation in the palliative care sector - a concept often dismissed as incongruous with the reality of evolving health and safety regulations.

Thyme Care launches virtual palliative care program, appoints medical director MobileHealthNews; by Jessica Hagen; 5/2/24 Value-based cancer care platform Thyme Care is launching Enhanced Supportive Care, a virtual palliative care support program to assist its members and caregivers with managing physical and psychological symptoms accompanying cancer diagnosis and treatment. The program will be led by Dr. Julia Frydman, the company's first medical director for palliative care. Frydman previously worked in the geriatric and palliative medicine program at New York City's Mount Sinai Health System.

Terror and LGBTQIA+ identity: Thoughts on Dr. Candrian’s Newsweek reflection Anschutz Medical School (Univ of Colorado); by Melissa C Palmer, JD LCSW ACHP-SW APHSW-C; 4/23/24 ... When reflecting on the intersection of LGBTQIA+ culture, being a woman, and the medical community, I have experienced gaslighting and marginalization because of my own identity. Things have changed a little in the past years, particularly in younger generations where sexuality and gender identity are more fluid and accepted. But in healthcare, unconscious bias due to the indoctrination by our elders can cause patients identifying as LGBTQIA+ to receive disparate care. ... Editor's Note: 

Eagle Telemedicine announces solution to counter lack of palliative careCision, PRNewswire-PRWeb; by Eagle Telemedicine; 4/25/24 Eagle Telemedicine adds new specialty to increase access to life-saving palliative care in underserved communities. ... Only 71% of U.S. hospitals provide palliative care and metropolitan hospitals are 15% more likely to offer palliative care than rural hospitals (National Institute of Health). Through Eagle's Tele-Palliative Care, hospitals everywhere can offer this next level of care, any day of the year.

Leadership's perceptions of palliative care during the COVID-19 pandemic: A qualitative study Journal of Pain and Symptom Management, by Tamara Vesel, Audrey Covaleski, Veronica Burkarth, Emma Ernst, Linda Vesel; 4/19/24Background: This study aimed to explore the perceptions, understanding, and utilization of palliative care before compared to during the COVID-19 pandemic among health system leadership. Results: ... Emerging themes included the role of palliative care before compared to during the COVID-19 pandemic, facilitators and barriers to palliative care delivery, and recommendations for future practice. Participants reported that the COVID-19 pandemic increased palliative care utilization, reinforced positive perceptions of the specialty, and emphasized its role in maximizing healthcare efficiency. Many participants found palliative care financing to be a barrier to delivery; ... 

Being seen as a unique person is essential in palliative care at home and nursing homes: A qualitative study with patients and relativesAmerican Journal of Hospice and Palliative Medicine; by Katrin Kochems, MSc, Everlien de Graaf, RN, PhD, Ginette M. Hesselmann, RN, MSc, and Saskia C. C. M. Teunissen, RN, PhD; 4/6/24Conclusion: In both primary care and nursing home care, patients and relatives expressed the same essential elements of palliative care. They emphasized the importance of being recognized as a unique person beyond their patient status, receiving honest and clear information aligned with their preferences, and having care organized to ensure continuity. Adequate competence and skills are needed, together with a care organization that enables continuity to provide safe and person-centered care.

AACN spotlights innovative tool for palliative care consultations

In two states, transforming the model for palliative care [CA & HI]Undark, by Meredith Lidard Kleeman; 4/16/24 "Being ill is like a full-time job,” said Andrew E. Kaufman, a 60-year-old author. Kaufman lives with myasthenia gravis, a neuromuscular disease, as well as other chronic conditions, and his self-care requires a lot of time — and communication. The cascade of his own needs “is frustrating and causes anxiety and a whole host of issues.” Lucky for Kaufman, he lives in California, where he has help from a palliative care team. California is one of the first states in the country to require insurance companies that administer Medicaid benefits to fully cover palliative care services for eligible residents. Editor's Note: Click on the title's link to read more, as this use redefines "palliative care."

Medicaid expansion and palliative care for advanced-stage liver cancer Journal of Gastrointestinal Surgery; by Henrique A Lima, Parit Mavani, Muhammad Musaab Munir, Yutaka Endo, Selamawit Woldesenbet, Muhammad Muntazir Mehdi Khan, Karol Rawicz-Pruszyński, Usama Waqar, Erryk Katayama, Vivian Resende, Mujtaba Khalil, Timothy M Pawlik; dated 4/24/28 (for print) Conclusion: The implementation of ME [Medicaid expansion] contributed to increased rates of palliative treatment for patients residing in ME states after expansion. However, racial disparities persist even after ME, resulting in inequitable access to palliative care.