Literature Review

ASCO palliative care expert panel provides recommendations to integrate health equity into guideline development OncLive, Cranbury, NJ; by Kyle Doherty; 9/4/24 The ASCO Palliative Care Expert Panel [American Society of Clinical Oncology], in collaboration with ASCO’s Health Equity and Outcomes Committee, has published recommendations for integrating health equity measures into future guideline updates. Recommendations advocated for partnerships with increased representation from historically marginalized groups and patient and community-based advocates; a reinforcement of implicit bias training for Expert Panel members as a component of guideline preparation; stratified recommendations and/or guidelines for additional groups; and the review and appraisal of future recommendations by the Expert Panel, patient as well as community advocates, and ASCO reviewers for the inclusion of proper health equity measures before publication.

Bringing palliative care into the light to better serve patientsHospice News; by Jim Parker; 8/30/24For many medical providers across the country, palliative care services can be an unknown option for several patients and their families. A few reasons for that are a lack of awareness surrounding the benefits of palliative care, as well as the misconceptions about what this type of care offers for patients. As such, the model can go underutilized for those who could benefit from it the most. Cathy Wozniak is the executive director of Hospice & Palliative Care of Martha’s Vineyard in Massachusetts (HPCMV). Alongside the organization’s medical director, Dr. Lisa Vieira, she shared recent statistics, showcasing just how imperative palliative care options can be for many Americans.

New ASCO Guidelines stress importance of early palliative care Hospice News; by Jim Parker; 8/26/24 The 2024 update to the American Society of Clinical Oncology’s (ASCO) clinical practice guidelines place renewed emphasis on palliative care. The guidelines are updated periodically by a multidisciplinary team, including a patient representative and experts in medical and radiation oncology, hematology and palliative care. For the 2024 revisions, this panel reviewed 52 randomized controlled trials that evaluated outcomes among cancer patients who received palliative care, ASCO reported. “This is a pivotal time,” the panel’s co-chair Betty Ferrell of City of Hope Cancer Care told the ASCO Post. “This guideline is a call to action for everyone to think about how they are integrating palliative care for all patients with cancer. There are great advances in cancer care, but none of these will be fully effective unless we fully integrate palliative care.”

Cancer treatment 101: A primer for non-oncologists Medscape; by George D. Lundberg, MD; 8/22/24 Each year in the United States, approximately 1.7 million Americans are diagnosed with a potentially lethal malignancy. Typical therapies of choice include surgery, radiation, and occasionally, toxic chemotherapy (chemo) — approaches that eliminate the cancer in about 1,000,000 of these cases. The remaining 700,000 or so often proceed to chemotherapy either immediately or upon cancer recurrence, spread, or newly recognized metastases. ... I'm speaking in generalities, understanding that each cancer and each patient is unique. [Dr. Lundberg summarizes in user-friendly language:]

From fear to empowerment: How palliative care can help University of Utah Huntsman Cancer Institute; 8/21/24 In 2018, Ruth Hill got out of bed one morning and felt her spine literally break. The 53-year-old collapsed to the floor. “I knew something catastrophic had happened,” Ruth says. She soon learned six of her vertebrae had cracked and two had exploded. The doctor at the hospital in Colorado Springs, where Ruth had been visiting her son and grandchildren, gave her even more devastating news. “You’re filled with cancer. It’s incurable,” he told her. “We’re going to take you upstairs and check your brain. If it’s in your brain, you won’t have long to live.” ... [Click on the title's link to continue reading this inspirational story.]

Capitalizing palliative care startups Hospice News; by Jesse Floyd; 8/14/24 As a sector, most standalone palliative care providers are still maturing from startups into long-term, sustainable businesses. ... This means gathering the necessary startup capital to take a new palliative care provider from idea to execution is often the first tangible goal for hopeful entrants into the space. When Jonathan Fluhart and Tiffany Hughes set about getting PalliCare, their Texarkana, Texas-based palliative care provider from theory to reality, they ran headlong into this obstacle. ... “Initially, what we thought we would do is build a palliative program that would nest between the home health and hospice,” Fluhart said. “We started to go into the community to talk with facilities and places that we felt would benefit from our services. Once they learned that we were tied to a home health provider, especially a hospice, it turned them off.” They decided the answer was two-fold: Sever ties with the hospice care provider they worked for; then start casting about for investors. ... 

Dr. El-Jawahri on the impact of palliative care on end-of-life care for AML and MDS OncLive; by Areej R. El-Jawahri, MD; 8/12/24 Areej El-Jawahri, MD, associate director, Cancer Outcomes Research and Education Program, director, Bone Marrow Transplant Survivorship Program, associate professor, medicine, Massachusetts General Hospital, discusses findings from a multi-site, randomized trial (NCT03310918) investigating a collaborative palliative oncology care model for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) receiving nonintensive therapy at 2 tertiary care academic hospitals. Patients in the study who received the palliative care interventions had a median of 41 days from end-of-life care discussions to death, compared with 1.5 days in the standard care group (P < .001). Additionally, patients who received the palliative care interventions were more likely to articulate their end-of-life care preferences and have these preferences documented in electronic health records, El-Jawahri begins. This documentation correlated with fewer hospitalizations in the final 30 days of life, she notes. Furthermore, palliative care recipients experienced QOL improvements and a trend toward reduced anxiety symptoms vs the patients who received usual care, El-Jawahri says. These findings underscore the necessity of integrating palliative care as a standard of care for patients with AML and high-risk MDS, El-Jawahri emphasizes.

Palliative care is important in managing cardiovascular diseaseNJToday; 8/8/24Implementing patient-centered palliative care therapies, including prescribing, adjusting or discontinuing medications as needed, may help control symptoms and improve quality of life for people with heart disease, according to “Palliative Pharmacotherapy for Cardiovascular Disease,” a new scientific statement from the American Heart Association, published in the journal, Circulation: Cardiovascular Quality and Outcomes.

Practicing proactive palliative care in COPD management Medscape - "In Discussion"; podcast by Leah J. Witt, MD and Anand S. Iyer, MD, MSPH; 7/25/24Let's start talking COPD. Today, we're going to keep talking about Mr Rivera, a case we've been following all season. He's a 78-year-old man with COPD, and we're talking to you about palliative care and symptom management. He has group E COPD. He really has a lot of symptoms and frequent exacerbations.

Keys to negotiating ACO palliative care contracts Hospice News; by Molly Bookner; 7/22/24 Accountable Care Organizations (ACOs) are key for scaling palliative care through value-based models. Hospices and palliative care providers can collaborate with ACOs by becoming members of those organizations themselves, or by contracting with them through a preferred provider network. These arrangements allow for the negotiation of mutually beneficial terms that are tailored to the needs and characteristics of patient populations. However, successfully negotiating such contracts requires a strategic approach and a deep understanding of ACOs’ priorities. As the U.S. Centers for Medicare & Medicaid Services (CMS) moves to align all Medicare beneficiaries with an accountable care relationship, these negotiations will become even more paramount.

Can palliative care consults in hospitals improve end-of-life care? National Institute on Aging; 7/18/24 Having clinicians automatically order palliative care increased consultation rates and expedited consultations for seriously ill hospitalized people but did not decrease length of stay, according to an NIA-funded study. The findings, published in JAMA, suggest that while ordering by default rather than by choice improves certain end-of-life care processes, the impact on hospital stay length is limited. ... Overall, while default orders for palliative care consultations did not reduce hospital stays, they did improve the frequency and timing of consultations as well as some end-of-life care processes, aligning with clinical guidelines for high quality palliative care.

In response to ‘Garnet lays off 26 people citing cost saving Warwick Advertiser, Letters to the Editor; by Ethel Hemsi; 7/15/24 For the past seven years I have been a volunteer with the Palliative Care team at Garnet Health Hospital. The whole team has been laid off to save costs. The article says it can be replaced by the hospitalist team of internal medicine providers. In my opinion this team can in no way be replaced by other doctors. Palliative care is a very complex and respectable practice in itself with specially trained doctors and nurses. It does much more than manage a patient’s pain. The palliative care providers are focused on helping patients and their families understand the patient’s condition and come together to make important decisions that patients with serious illnesses face. This includes weighing the pros and cons of various medical treatments as they pertain a patient’s quality of life. ... 

Palliative care training initiative launches to improve quality among incarcerated populations Hospice News; by Holly Vossel; 7/12/24 The California Department of Corrections & Rehabilitation’s Medical Facility (CMF) has launched a new palliative spiritual care training program aimed at improving services for incarcerated individuals. The new two-week spiritual training program was recently provided to palliative care service workers and volunteers to assist CMF’s clinical and nursing staff caring for patients at the facility’s hospice, correctional treatment center and memory care units. A dozen trainees recently completed the program, with CMF planning to provide an annual refresher course to all of its palliative care service workers, according to California Correctional Health Care Services CEO Joseph Garland.