Literature Review

Systemic functioning of Puerto Rican families with a cancer patient: A qualitative-oriented mixed-methods studyJournal of Health Psychology; Nicole M. Vélez Agosto; 4/25Puerto Ricans are part of marginalized communities that are impacted by health disparities, such as lifestyles, health behaviors and access to care (Simmons et al., 2011). The purpose of study was to assess systemic functioning in Puerto Rican families with a cancer patient using the Spanish translated version of the Family Genogram Interview (FGI) that measures Bowen’s four emotional processes in nuclear family and family of origin. Results suggested an acceptable reliability for the FGI-Spanish and higher presence of symptoms in a spouse or partner, symptoms in family of origin, focus on a child and emotional cutoff in family of origin. Qualitative findings suggested that main concerns for participants were related to family changes surrounding illness and familial roles, consistent with Bowen’s theory and clinical implications for designing systemic interventions for Puerto Rican families.

University of Minnesota uses VR to study Alzheimer's, death Government Technology (GT) - Center for Digital Education; by Richard Chin; 5/2/25 At the University of Minnesota, medical school students have been using a virtual reality experience to understand the perspective of a woman dealing with the advanced stages of Alzheimer’s. ... When the University of Minnesota offered to let me experience what it’s like to die, naturally I said yes. Aren’t we all morbidly curious about the undiscovered country, as Hamlet put it, from which no traveler returns? Except this time, happily, I would get to return because it would be a virtual death, an experience in a VR studio that’s part of the university’s Health Sciences Library system. The dying experience is part of a series of VR simulations developed by a nine-year-old California-based company called Embodied Labs. They’ve created immersive, first-person experiences of what it’s like to have dementia, Alzheimer’s or Parkinson disease, vision or hearing loss, to be socially isolated or to experience aging as a LGBTQ person. And what it’s like to die.

Location of terminal care in pulmonary hypertensionCJC Open; Ramzi Ibrahim MD; Adam Habib MD; April Olson MD; Farah Shrourou; Hoang Nhat Pham MD; Mahmoud Abdelnabi MBBCh MSc; Maryam Emami Neyestanak PhD; Sabrina Soin DO; See-Wei Low MD; Bhupinder Natt MD; Mamas A. Mamas BMBCh MA DPhil FRCP; Timothy Barry MB BCh BAO; Chadi Ayoub MBBS PhD; Reza Arsanjani MD; Franz P. Rischard MD; Kwan Lee MD; 4/25Palliative care services have seen an increase in utilization in recent years, yet this uptrend has not been observed uniformly across all groups. The recent decline in mortality within inpatient facilities, despite the persistently high mortality rates of PH [pulmonary hypertension], depicts better coordinated patient-centered care, including hospice and at-home services. Nonetheless, place-of-death disparities remain, linked to demographic variables. Specifically, minority ethnic groups in the US have not experienced this increase. These populations often harbor misconceptions and unconscious biases about the nature of palliative care. The Pulmonary Hypertension Association, recognizing this gap, has advocated for the integration of palliative care into the treatment regimen for patients with PH.

[Taiwan] Palliative care with negative pressure wound therapy application in malignant wounds: a systematic reviewJournal of Wound Care; Xiao-Feng Yao, Yen-Jen Wang, Yang-Sheng Lin; 4/25Of 765 articles screened, 14 eligible studies were included in the review. The location of the hard-to-heal wounds was widely distributed: five wounds on the scalp; three wounds over the anogenital area; and the remaining wounds on the trunk and extremities. The reported outcomes included: improvement of wound healing; decreased exudation and malodour of the wound; decreased pain sensation; eligibility for further treatment; and a shift to the homecare system. The findings of this study suggested NPWT [negative pressure wound therapy] could be a choice in palliative care for patients with malignant wounds. However, more studies are needed to evaluate the efficacy of NPWT in these wounds.

Hospice use by cause of death: A cohort study using Utah population database American Journal of Hospice and Palliative Medicine - Sage Journals; by Rebecca L. Utz, PhD, Michael Hollingshaus, PhD, Attrayee Bandyopadhyay, MS, Kathie Supiano, PhD, Margaret Clayton, PhD, Katherine A. Ornstein, PhD, Djin Tay, PhD, Eli Iacob, Ken Smith, PhD, and Caroline Stephens, PhD; first published online 4/29/25 Illnesses such as cancer often follow a predictable trajectory of decline, while others, such as Alzheimer’s Disease and Related Dementias (ADRD) and Chronic Obstructive Pulmonary Disease (COPD), follow a more dwindling and protracted decline. ... This study assesses whether hospice use differs by the underlying cause of death and whether current hospice eligibility and practices provide optimal EOL to all causes of death. Major Findings: Non-cancer decedents were more likely to have sub-optimal patterns of hospice care, including minimal use, lasting less than a week, and extended use, lasting more than 6 months. Stroke decedents were the most likely to have minimal-use patterns of hospice, whereas dementia and COPD decedents were most likely to have extended use. Conclusion: New models of hospice-like EOL care that can accommodate both short-term and long-term palliative care needs may help meet the diverse needs of patients and families facing different EOL trajectories associated with common causes of death.Editor's note: Compare this data with your own data of disease-related Length of Stay (LOS), live discharges, disease-related accuity needs, and more. How can we improve disease-related patient care, across the different trajectories of palliative/hospice care?

7 signs at home care is needed for someone with dementia VeryWell Health; by Christopher Bergland; 4/25/25 ... At-home dementia care can look different for every family. Some people live alone and may get by with periodic check-ins from professionals in the dementia care community throughout the week. Others might require daily visits from Alzheimer's home care dementia services. Sometimes, a paid caregiver comes to the house daily, or unpaid loved ones provide 24/7 in-home care.

Kidney transplant fast track and likelihood of waitlisting and transplant-A nonrandomized clinical trialJAMA Internal Medicine; Larissa Myaskovsky, PhD; Yuridia Leyva, MS; Chethan Puttarajappa, MD; Arjun Kalaria, MD; Yue-Harn Ng, MD; Miriam Vélez-Bermúdez, PhD; Yiliang Zhu, PhD; Cindy Bryce, PhD; Emilee Croswell, BA; Hannah Wesselman, PhD; Kellee Kendall, MPH; Chung-Chou Chang, PhD; L. Ebony Boulware, MD; Amit Tevar, MD; Mary Amanda Dew, PhD; 3/25Although it is a seemingly intuitive solution to enabling more patients to complete the evaluation process and be added to the waitlist, to our knowledge, few transplant centers use a health care system–facilitated approach like KTFT [Kidney Transplant Fast Track]. In this nonrandomized clinical trial of 1,118 patients with end-stage kidney disease (ESKD) who underwent KTFT and a historical control group of 1,152 patients with ESKD undergoing evaluation for kidney transplant, the KTFT group had a higher likelihood of waitlisting and transplant than the historical control group. Unlike the historical control group, the KTFT group had no significant differences in kidney transplant by race or ethnicity.

HHS cuts funding for NIH-based Women's Health Initiative threatening decades-long study The American Journal of Managed Care (AJMC); by Giuliana Grossi; 4/23/25 HHS is defunding the regional research centers that have been conducting a long-term national health study focusing on preventive strategies for women's health since 1991, the largest study investigating women’s health in US history. The Women’s Health Initiative (WHI) regional centers will close by September 2025, at the end of the fiscal year, according to an announcement from the NIH-based initiative. Investigators at the WHI were informed by HHS earlier this week, although formal written notice from HHS is still pending.  

American Oncology Network achieves success in first performance period of CMMI’s enhancing oncology model Stock Titan, Globe Newswire, Fort Myers, FL; 4/22/25 American Oncology Network (AON), one of the nation’s fastest-growing community oncology networks, today announced strong results from the first performance period in the Centers for Medicare & Medicaid Innovation’s (CMMI) Enhancing Oncology Model (EOM). AON practices participating in the program—in collaboration with value-based cancer care enabler Thyme Care—achieved nearly $6M in cost savings for the Centers for Medicare & Medicaid Services (CMS). AON also earned a performance-based payment while improving patient experience and outcomes.

Stark disparities in treatment and survival time for people with pancreatic cancer Cancer Health, Plymouth Meeting, PA; by National Comprehensive Cancer Network; 4/22/25 New research in the April 2025 issue of JNCCN—Journal of the National Comprehensive Cancer Network found significant disparities based on race, socioeconomic status, and other factors when it came to quality of care and outcomes for people with metastatic pancreatic adenocarcinoma (mPDAC)—which is associated with very high cancer mortality. The researchers used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to study 14,147 patients who were diagnosed with mPDAC between 2005–2019.

Access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease and beneficiaries with cancer MedPAC; by Kim Nueman, Grace Oh, and Nancy Ray; 4/11/25 [From MedPac Presentation Roadmap, Meetings held April 10 & 11, 2025]

Patient-centered communication drives supportive care needs in incurable cancer Oncology Nursing News; by Kristie L. Kahl; 4/16/25 The Primary Palliative Care Communication Intervention (PRECURSOR) may improve the psychosocial experiences of patients with incurable gynecologic cancer and their caregivers in the outpatient setting, according to results of a pilot study presented at the 50th Annual ONS Congress. ... Currently, most of the conversation around supportive care is provider-driven, and clinical tendency is to insert palliative care in the terminal setting. However, the study investigators aimed to integrate supportive care across the cancer continuum.

[Canada] Care utilization patterns among patients dying with advanced chronic obstructive pulmonary diseaseCanadian Journal of Respiratory, Critical Care, and Sleep Medicine; Aleisha Fernandes, Shuaib Hafid, Anastasia Gayowsky, Tetyana Kendzerska, Aaron Jones, Erin Gallagher, Colleen Webber, James Downar, Sophie Corriveau, Douglas G. Manuel, Sunita Mulpuru, David Da Silva-Krul, Amy Hsu, Peter Tanuseputro, Sarina R. Isenberg, Michelle Howard; 3/25Despite primary care providing majority of outpatient care, inpatient utilization is higher amongst patients who are notaccessing PC [palliative care]. These patients are also more likely to die in an acute setting. This study provides insight into the proportion of care patients are being provided from different specialties as well as the distribution of end-of-life outcomes amongst these patterns of care. Future research will benefit from exploring the association between these different patterns and end-of-life outcomes to identify the most optimal care pattern for improving end-of-life outcomes for patients with ACOPD [advanced chronic obstructive pulmonary disease].