Literature Review

What is palliative care, and can you get it at home?

Duke University names five new Trustees [incluing Amy Abernethy]Press Release; 7/2/24Five new members joined the Duke University Board of Trustees on July 1, university officials announced Tuesday. The new trustees are Amy Abernethy, Melissa Bernstein, Michael Stone, Andrew Greene, and Rickard Stureborg... Abernethy M.D.’94, HS’94-’01 is co-founder of Highlander Health, an organization focused on advancing evidence generation for the new era of medical innovation. An internationally known oncologist, health data expert, and digital health leader, Abernethy is a champion for accelerating the pace at which safe and effective treatments reach patients. She is the former principal deputy commissioner of the U.S. Food and Drug Administration, where she led initiatives in advancing clinical evidence generation and personalized health care and served as the agency's acting chief information officer. More recently, Abernethy served as chief medical officer and president of product development at Verily, Alphabet’s precision health business. Earlier she was Flatiron Health’s first chief medical officer and chief scientific officer. She was also previously professor of medicine at the Duke University School of Medicine and director of the Center for Learning Health Care in the Duke Clinical Research Institute and the Duke Cancer Care Research Program in the Duke Cancer Institute. A hematologist/oncologist, palliative medicine physician, and recipient of the 2021 Distinguished Alumna Award from Duke University School of Medicine, Abernethy has authored more than 500 publications.Publisher's Note: Congratulations Amy!

Anxiety and resilience in palliative medicine physicians BMJ Supportive & Palliative Care; by Cristhian Alexis Velásquez Marín, Carlos Javier Avendaño-Vásquez; 7/2/24, online ahead of printTo identify the relationship between the degree of anxiety and the capacity for resilience in palliative care physicians ..., [we] included 42 Colombian Palliative Care Physicians and administered a sociodemographic questionnaire, the Zung Anxiety Scale and the Resilience Scale. Results: 42 palliative care physicians with an average age of 41 participated in the study. Anxious symptoms were present in 100% of the physicians evaluated. Mild or moderate anxiety was identified in 93.7% of the population and 6.3% of people with severe anxiety symptoms. ... Our results reflect that the population of palliative care physicians has a higher risk and exposure to developing anxiety and its adverse outcomes. We found higher anxiety levels compared with other studies so this population requires greater vigilance and intervention in treating and preventing mental health difficulties.Editor's Note: Executive leaders for palliative care services, use this research to be aware of possible stress-related tolls on your palliative physicians and team members. Ask. Generate dialogue. Do not assume that this applies, but rather use it to tune into and improve the support your physicians need. While this research was in Columbia, it resonates a U.S.recurring trend of the unionization of physicians, often related to burnout and stress overload.

Pediatric Palliative Care is essential to person-centered quality care for children with serious illnessAAHPM Spring Quarterly; by Larry Beresford; 6/27/24It has often been said that children are not little adults and should not be treated as little adults when it comes to their medical care or to the roles played in that care by palliative care and hospice teams. But what should that truism convey to members of AAHPM? How do hospice and palliative medicine (HPM) professionals ensure that children with serious, incurable, or life-threatening illnesses are managed with due consideration of their differences and distinct needs? What do adult palliative care professionals need to know—and contribute to ensuring that these children get the age-appropriate support they need for the duration of their illness?Publisher's Note: Membership may be required to access this article, or perhaps waiting until it is archived.

Garnet Health shutters palliative care program Hospice News; by Jim Parker; 6/25/24 New York state-based Garnet Health has announced a restructuring plan that spells the demise of its inpatient palliative care services. The plan includes layoffs of about 1% of the health system’s workforce, numbering 26 employees. This is estimated to save Garnett $4.6 million in salaries and benefits. “[Garnet] continues to be challenged with significant labor expenses, inflation on supplies and equipment, and low payor reimbursement rates,” the health system indicated in a statement. The restructuring is the result of financial headwinds, including decreased demand. Patient volumes are gradually increasing, but not yet to pre-pandemic levels, the company stated in an announcement.

The opportunity for palliative care in ACO Flex Palliative Care NEws; by Audrie Martin; 6/24/24 On Jan. 1, 2025, the Center for Medicare and Medicaid Services (CMS) Innovation Center will begin implementing a payment model for primary care known as the Accountable Care Organizations (ACOs) Primary Care Flex Model under the Medicare Shared Savings Program (MSSP). The ACO Flex Model is a voluntary initiative to improve funding and other resources to support primary care delivery within the MSSP. The model encourages the formation of new, physician-led ACOs, particularly those serving underserved communities and addressing health disparities. This program is not just a test but also seeks to empower participating ACOs and their primary care providers to employ more innovative, team-based, person-centered and proactive approaches to care. [Click on the title's link for more information.]

Top oncologists say everyone with advanced cancer needs early palliative care. Here are 6 things to know ABC News, New York; by Lindsey Ulin, MD; 6/20/24This year, the American Society of Clinical Oncology — the world’s leading oncology organization — recommended palliative care for everyone with advanced cancer at the time of diagnosis and while receiving treatment. ... By next year, 693,000 people in the United States will have advanced breast, prostate, lung, colorectal, bladder, or skin cancer. ... “What I’m really excited to see is that these guidelines are taking a step back and thinking about [palliative care] from the time of diagnosis,” Dr. Arif Kamal, chief patient officer for the American Cancer Society and an associate professor at Duke University specializing in oncology and palliative care, told ABC News. “It should particularly be used in areas to help people stay on treatment, such as in clinical trials or hematologic malignancies.” Here are six things to know about palliative care:

Center for Hospice Care launches ‘Kaleidoscope’ Palliative Care Program Hospice News; by Jim Parker; 6/17/24 The Indiana-based Center for Hospice Care (CHC) has unveiled a new palliative care program, branded as Kaleidoscope. Kaleidoscope is designed to provide patients with interdisciplinary palliative care in the home setting. Their care model includes services from nurse practitioners, palliative care nurses, community health workers, spiritual care providers and volunteers. The nonprofit also provides palliative care in a clinic setting at its Center for Palliative Care. “Kaleidoscope is a community-based palliative care program where we’re seeing patients in the privacy of their own home,” CHC Medical Director Karissa Misner told local news. “We also still have palliative care in a clinic setting. Now we’re able to offer two different entities for people that still want to go out to a doctor’s appointment.”

Integrating palliative care education into hematology-oncology fellowshipsThe ASCO Post; 6/11/2024An integrated palliative care rotation for hematology-oncology fellows may improve their palliative care knowledge and skill confidence, according to findings presented by Bauman et al at the 2024 ASCO Annual Meeting (Abstract 9007). “Despite national guidelines advocating that patients with advanced cancer receive dedicated palliative care services, many patients lack access to specialty palliative care due to workforce shortages,” stressed lead study author Jessica Bauman, MD, Associate Professor in the Department of Hematology/Oncology, Chief of the Division of Head and Neck Medical Oncology, and Director of the Hematology/Oncology Fellowship Training Program at Fox Chase Cancer Center. “Training hematology-oncologists to provide primary palliative care could close this gap and ensure [the] basic palliative care needs of patients are met,” she highlighted.

Palliative care considerations in frail older adults Annals of Palliative Medicine; by Andrew E Russell, Rachel Denny, Pearl G Lee, Marcos L Montagnini; 6/6/24, online ahead of print...This paper aims to guide clinicians in providing patientcentered care for older adults with frailty in the outpatient setting. Through a comprehensive literature review, we describe the leading models of frailty, frailty screening tools used in the clinical setting, and the assessment and management of palliative care needs in frail patients. We also describe emerging models of care focusing on palliative care for older adults with frailty and discuss issues related to access to palliative care for this population.

Disparities identified in palliative care use among men with prostate cancerRenal + Urology News; by Natasha Persaud; 6/4/24Palliative care utilization among men with prostate cancer is suboptimal but improving, investigators reported at the 2024 ASCO annual meeting in Chicago, Illinois. Stanley Ozogbo, MBBS, MPH, of St Elizabeth Youngstown Hospital in Ohio, and colleagues studied over 2 million prostate cancer hospital admissions using the 2010-2019 US Nationwide Inpatient Sample. The found an overall prevalence of palliative utilization of 5.3% even though palliative care consultations significantly improved by an average of 7.7% per year over the study period. Utilization improved from 2010 through 2016, but then began to decline from 2017-2019. The study identified disparities in palliative utilization. Black patients were 7% less likely than White patients to receive palliative care services, Dr Ozogbo’s team reported. Compared with Medicare recipients, patients with Medicaid, private insurance, or other insurance types had significant 1.5-, 1.3-, and 2.2-fold increased odds of palliative care utilization, respectively. Patients aged 70 years or older were a significant 6% more likely to receive palliative care compared with younger patients. Palliative care use was a significant 9% and 40% more likely for patients admitted to urban vs rural hospitals and teaching vs non-teaching hospitals, respectively, the investigators reported. Hospitals in the Northeast were 1.4- and 1.5-fold more likely to refer to palliative care compared with hospitals in the South or West, respectively.

Palliative care for cancer patients is found to be as effective given virtually as in personSTAT; by Angus Chen; 6/2/24Comfort can be delivered to patients with advanced cancer virtually just as well as in person, according to a new study presented on Sunday at the American Society of Clinical Oncology annual meeting in Chicago. That’s welcome news to palliative care experts who have, in many cases, preferred the convenience and efficacy of telehealth sessions for both themselves and their patients since the Covid-19 pandemic forced virtual visits. ... Palliative care experts are also looking at other ways to help more patients get seen. In another abstract presented at ASCO in Chicago and published in JAMA by MGH’s Temel, she showed the frequency of palliative care visits could be stepped down for patients with fewer physical or emotional symptoms — also without any loss in palliative care efficacy.

Sixth annual Run, Walk n Roll 5K continues mission [more than $110,000] Grosse Pointe News; by GPN Staff; 5/29/24 Providing funding for pediatric palliative care is the goal of the sixth annual Run, Walk n Roll 5K. ... [This] year's event is virtual, so participants can run, walk or roll from anywhere throught the month of June. ... Since its inception, the event has raised nearly $600,000 for the palliative care program at C.S. Mott Children's Hospital in Ann Arbor. This year's event already has more than 70 sponsors, more than $110,000 raised and participants on six continents and across the U.S.