Literature Review

Obstacles and opportunities for palliative care in the ICU Palliative Care News, by Rachel Edwards; 3/1/24A growing body of research touts the benefits of palliative care for patients, families, and even providers. However, when evaluated through randomized clinical trials, the results tend to lean toward mediocre. Palliative Care News spoke with experts in the field to unpack the reasons behind those results and identify the obstacles that are getting in the way of a more effective approach.

"The great escape": How an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage BMC Palliat Care, by Sam Quinn, Libby Ferguson, Derek Read, and Naomi Richards; 2/28/24Background: This case report ... illustrates how unresolved traumatic experiences across the life course can affect a patient's engagement with palliative care and offers insights into the flexibility and adaptations necessary for taking a trauma informed approach to care for an individual experiencing multiple disadvantage. 

Many older adults don't receive palliative care before deathMedScape, by Marilynn Larkin; 2/28/24 "One of the challenges and a barrier to accessing palliative home care is the difficulty of predicting survival," Amy Hsu, PhD, an investigator at the Bruyère Research Institute in Ottawa, Ontario, Canada, told Medscape Medical News. "Clinicians are good at prognosticating when a patient might be entering their last 3-6 weeks of life, but they have a harder time predicting if someone will survive 6 months or longer."  The team developed the Risk Evaluation for Support: Predictions for Elder-life in their Communities Tool (RESPECT) to see whether access to predicted survival data could inform conversations about a patient's status and palliative care needs. The study was published online on February 26 in the Canadian Medical Association Journal.

NIA is leading efforts to coordinate NIH palliative care researchNational Institute on Aging, by Chandra Keller and Alexis Bakos; 2/28/24

Palliative Care market revenue to surpass USD 6.43 billion by 2028freePRnow; 2/27/24The global market for palliative care reached a value of USD 3.53 Billion in 2020 and is projected to experience a revenue Compound Annual Growth Rate (CAGR) of 7.8% throughout the forecast period. Factors such as an increasing emphasis on enhancing the quality of life for individuals facing life-threatening or debilitating conditions through the alleviation of pain and symptoms, the establishment of professional palliative care organizations, and the broader accessibility of advanced palliative care services worldwide are anticipated to propel market revenue growth in the foreseeable future.

Compassus certified to provide palliative care Tahlequah Daily Press; 2/25/24Compassus, a leading nationwide provider of integrated home-based care services, including palliative care, is now certified to provide palliative care under the Veterans Administration benefit in Oklahoma. The Community Care Network credential is awarded by the U.S. Department of Veterans Affairs to community providers that demonstrate high-quality standards and a commitment to offering veterans the best possible care.

WiHPCA: Applauds State Assembly for approving bill establishing a state Palliative Care Council WisPolitics; 2/22/24[Wednesday,] the [Wisconsin] State Assembly approved Assembly Bill 736, a bill that would establish a state Palliative Care Council. The Wisconsin Hospice and Palliative Care Association (WiHPCA) strongly supports this legislation, which would ultimately help increase awareness and utilization of palliative care throughout the state. The Assembly Committee on Health, Aging, and Long-Term Care voted 16-0 on January 17 to recommend approval of this legislation. This bill would establish a council of individuals with palliative care and other medical expertise to consult and advise the Wisconsin Department of Health Services (DHS) on this type of specialized medical care. 

Understanding the discordance about prognosis between clinicians and terminally ill patients and their surrogates: A conversation with Douglas B. White, MD, MASThe ASCO Post, by Jo Cavallo; 2/25/24Research shows that about half of adults near the end of life in the United States are too ill to participate in decisions about whether to accept life-prolonging treatment, requiring family members and other proxies to serve as surrogate decision-makers for their critically ill loved ones. However, research also shows that surrogates of patients with advanced illness often have optimistic expectations about prognosis, which often lead to the increased use of invasive treatment (including life support) in dying patients and delays in the integration of palliative care.

Rural-urban disparities and trends in utilization of palliative care services among US patients with metastatic breast cancerJ Rural Health; by Jincong Q Freeman, Adam W Scott, and Ted O Akhiwu; 2/20/24Purpose: To assess trends and rural-urban disparities in palliative care utilization among patients with metastatic breast cancer.Conclusions: In this national, racially diverse sample of patients with metastatic breast cancer, the utilization of palliative care services increased over time, though remained suboptimal. Further, our findings highlight rural-urban disparities in palliative care use and suggest the potential need to promote these services while addressing geographic access inequities for this patient population.

Chapters CEO Andrew Molosky: Building an ecosystem of care around the seriously illHospice News, by Jim Parker; 2/13/24Going forward, hospice and other post-acute providers are preparing to operate within a value-based ecosystem, and Florida-based nonprofit Chapters Health System is no exception. ... The organization has been hard at work in recent years to position itself for risk-based relationships and build out a continuum of care for chronically and terminally ill patients, while maintaining positive employee engagement.

Scaling palliative care requires adherence to best practicesAJMC, by Tina Basenese, MA, APN, ACHPN; 2/14/24An important milestone came January 1, 2024, when a new add-on code [G2211] took effect for reimbursement for complex Medicare patient visits, including palliative care. ... Having patients map out their wishes through advance directives is an important metric, but it’s not the goal of palliative care, nor is it the only way to measure whether a program works. Rather, comprehensive palliative care must be truly patient centered. This requires building trust and training palliative care specialists in a manner similar to other subspecialties to create and scale processes that are infused with a culture of communication.

How to support adolescents and young adults with cancer at the end of lifeThe Oncology Nursing Society Voice, by Kimberly Rivera DNP, RN-BC, OCN®, NPD-BC; 2/12/24... [Cancer] is the fourth leading cause of death in adolescents and young adults (AYAs), following accidents, suicide, and homicide. ... Appropriately defining the difference between palliative and end-of-life care can improve AYAs’ engagement with services such as advance care planning—a specific step that increases AYAs’ likelihood of receiving early palliative care. However, many palliative and hospice care services are geared toward pediatric or adult populations and may not meet AYAs’ unique needs, impeding effective care planning.

Palliative care reimbursement, innovation and reformJD Supra - American Health Law Association, by Edo Banach; 2/7/24Sections include: