Literature Review

Algorithm-based palliative care in patients with cancer-A cluster randomized clinical trialJAMA Network Open; Ravi B. Parikh, MD, MPP; William J. Ferrell, MPH; Yang Li, MS; Jinbo Chen, PhD; Larry Bilbrey; Nicole Johnson, BSN; Jenna White, MSW; Ramy Sedhom, MD; Natalie R. Dickson, MD; Stephen Schleicher, MD; Justin E. Bekelman, MD; Sandhya Mudumbi, MD; 2/25In this randomized clinical trial conducted in a community oncology network between November 2022 and December 2023 among 562 patients with advanced cancer identified by an automated electronic health record algorithm, default orders increased palliative care consultation (44% vs 8%) and decreased end-of-life systemic therapy (6% vs 16%) compared with usual care but did not improve patient-reported or hospice outcomes. The findings suggest that default algorithm-based palliative care orders are a scalable implementation strategy to increase palliative care referrals and reduce intensive end-of-life care. 

1 in 7 Medicaid users go to nursing home after cancer diagnosis, study finds McKnights Long-Term Care News; by Kristen Fischer; 3/5/25 One in 7 Medicaid beneficiaries received care at a nursing home after they were newly diagnosed with cancer, a new study finds. People who went to nursing homes were more likely to be white or Black, and dual-eligible for Medicaid and Medicare, compared to those who did not use nursing homes and primarily had short nursing home stays. The study was published Tuesday [3/4] in the Journal of the American Geriatrics Society. ... Investigators examined data from 338,767 Medicaid beneficiaries spanning 45 states who were newly diagnosed with cancer and were diagnosed with cancer in 2017 or 2018. ... The most prevalent cancer types associated with short and long stays were lung, breast and hematological.  The high number of people who are dual-eligible and going to nursing homes after a cancer diagnosis is an important policy issue, the authors wrote. 

Patient put in hospice at 52 celebrates life years after admission, thanks to heart surgery KCTV-5, Kansas City, MO; by Morgan Riddell; 2/27/25 A local man with heart failure who was told numerous times he only had months to live now has a new outlook on life two years later. ... It started in 2023. Sam Edwards, who was diagnosed with ALS after serving in the military, started experiencing new pains. He went to doctors who all determined Sam was just experiencing issues related to ALS. Then, a doctor at the VA Hospital noticed some tests were off and found Sam was experiencing heart failure. What he needed was open heart surgery, but doctors determined the risk of putting Sam on the operation table was too high. Not only was he at risk of having a stroke and dying on the operating table, but his recovery would also be months long and painful. They declined to do the surgery at the VA and suggested Sam go get a second opinion. This is when he was connected with Dr. Michael Gibson.Editor's note: While we in the palliative and hospice field promote earlier admissions to care and elimination of overtreatment, another side of the coin exists. Click on the title's link to read more about this hospice patient who sought out a second opinion. Imagine: the hospice patient is you (at age 52); or a family member; or a best friend. Especially as AI becomes more prevalent in assessing palliative and hospice referrals, we must see the bigger picture and retain human element. 

Associations between end-stage ALS care and specialty palliative care: A hypothesis-generating studyMuscle and Nerve; Christi M Lero, Annabelle Yang, Elyse Everett, Kyle A Pitzer, Kelly McCoy Gross, Karla T Washington; 2/25Amyotrophic lateral sclerosis (ALS) care is typically delivered via a multidisciplinary approach that may include specialty palliative care (SPC). Patients who received SPC (59%), had lower mean forced vital capacity ... , and more often used respiratory support ... , participated in goals of care conversations ... , reported a healthcare proxy ... , and enrolled in hospice ... than patients who received standard care alone. No differences between groups were found in duration of illness (mean = 51.7 months), use of assistive feeding, Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) scores, ... documentation of a healthcare proxy, length of hospice stay (mean = 47.3 days), or location of death.

Leading early conversations about ICD [implantable cardioverter defibrillator] use in end-of-life cancer care  Cancer Network; by Megan Mullins, PhD, MPH; 2/21/25 Earlier and more frequent talks about disabling ICDs with patients receiving end-of-life care and their families may help avoid excessive pain. ... Regarding implantable cardioverter defibrillators (ICDs) in those with fatal cancers, it is critical that patients know what having a device means and how it impacts end-of-life care, according to Megan Mullins, PhD, MPH. CancerNetwork® spoke with Mullins, assistant professor in the Peter O’Donnell Jr. School of Public Health, the Harold C. Simmons Comprehensive Cancer Center, and the Department of Internal Medicine at UT Southwestern Medical Center, about how ICD deactivation prior to end-of-life care could impact clinical practice in patients with advanced cancers. ... She emphasized that device deactivation would allow the body to undergo the natural dying process without unnecessary painful shocks associated with the use of the device.

US measles outbreaks: Nearly 100 people infected across two states MSN; by Holly Large; 2/24/25 Outbreaks of measles have been declared in both Texas and New Mexico, as health officials report that nearly 100 cases have been identified across the two states. The Texas Department of State Health Services (DSHS) has reported that as of February 21, 90 cases of measles have been identified in the South Plains region since late January, with 16 of these people having been hospitalized with the illness. According to the DSHS, the number of cases is likely to increase, “due to the highly contagious nature of this disease.”

Hospice workers in Tampa experience what it feels like to live with dementiaFox 13 Tampa Bay, FL; by Kailey Tracy; 2/19/25 Keosha Simmons says her father, who died in 2018, was a hard worker and an amazing man. ... "He did live with dementia. It was an early onset of dementia. He ended up with cancer, and it was a later stage when we found out about it, and that's when he came under the care of Empath Health Suncoast Hospice," Simmons said. Simmons is now the Director of Empath’s Community Engagement team. On Wednesday, Simmons and her team did a different kind of training. It was a hands-on simulation to experience what someone with dementia feels. [From this article's "The Brief" Summary.]

New ACS research finds low uptake of supportive care at the end-of-life for patients with advanced cancer EurekAlert! - American Association for the Advancement of Science (AAAS); Peer-Reviewed Publication by American Cancer Society; 2/21/25  Despite considerable efforts to improve the quality of end-of-life care in the United States, a new retrospective study led by American Cancer Society (ACS) researchers revealed that close to half of patients with advanced cancer received potentially aggressive care at the end-of-life at the expense of supportive care. The findings are out today in the Journal of the American Medical Association (JAMA) Health Forum. ... Study results showed only one-quarter of patients diagnosed with advanced cancer received any palliative care in the last 6 months of life, and those who received it did so mainly in the month of death. Overall, 45% of decedents experienced any indicator of potentially aggressive care. There was an increase in the mean number of acute care visits (from 14.0 to 46.2 per 100 person-months), hospice use (from 6.6 to 73.9 per 100 person-months), palliative care (from 2.6 to 26.1 per 100 person-months), and advanced care planning (from 1.7 to 12.8 per 100 person-months) over the last 6 months of life. ...

Measures to prevent and control COVID-19 in skilled nursing facilities-A scoping reviewJAMA Health Forum; Benjamin E. Canter, OTD; Agne Ulyte, MD; Brian E. McGarry, PhD; Michael L. Barnett, MD, MS; 1/25Skilled nursing facilities (SNFs) experienced high mortality during the COVID-19 pandemic, leading them to adopt preventive measures to counteract viral spread. This scoping review identified 16 preventive measures, both nonpharmacologic (eg, staffing, visitor restrictions) and pharmacologic (eg, vaccines, antivirals) interventions. Nonpharmacologic measures were widely implemented but lacked evidence for effectiveness, whereas vaccinations and antivirals showed substantial benefits but were underutilized; up-to-date vaccination status was suboptimal in residents and staff and only a minority of infected residents received antiviral treatment.

Juniper House on National Historic Register K103, Portland, OR; 2/18/25 The Juniper House is among Oregon's latest entries in the National Register of Historic Places ... for its statewide significance as Oregon's first end-of-life care home dedicated exclusively to residents with HIV/AIDS [May 1987] and for its substantial impact on statewide healthcare and LGBTQ+ history. ... In addition to caring for residents, the work of Juniper House included advocacy and educational efforts that were crucial in shaping public opinion and responses to HIV/AIDS.

Center for Hospice Care's BreatheEazy Program supports patients with respiratory issues LaporteCounty.Life; by Garrett Spoor; 2/13/25 One of the toughest health challenges a person can face is the trouble of breathing. Center for Hospice Care comes across a lot of patients who experience this issue and encourages many of them to become a part of their BreatheEazy program. Dr. Karissa Misner, medical director at Center for Hospice Care, considers the BreatheEazy program to be a monumental boost for patients who might have respiratory issues. “This is a specialized pulmonary program for our patients with chronic obstructive pulmonary disease,” Misner said. “It can also be used for many other terminal diagnoses that affect the lungs. Whenever there is any type of illness that causes difficulty in breathing, we can utilize this program.”

People with depression develop long-term health conditions quicker than those without, study finds McKnights Home Care; by Kristen Fischer; 2/13/25 Adults who have experienced depression develop long-term physical conditions about 30% faster than those without depression, a new study finds. Authors of the report said depression needs to be viewed as a “whole body” condition, with treatment approaches that address mental and physical health. The report was published Thursday [2/13/25] in PLOS Medicine. Investigators evaluated the association between depression and the rate at which conditions accrued in midlife and older age.

Sudden unexpected infant death and disparities in infant mortality in the US, 1999-2022JAMA Pediatrics; Elizabeth R. Wolf, MD, MPH; Frederick P. Rivara, MD, MPH; Anabeel Sen, MBBS, MPH; Steven H. Woolf, MD, MPH; 1/25This study found that infant mortality from SUID [sudden unexpected infant death] has increased significantly. Previous data through 2020 showed that SUID increased among Black infants. Our analysis, which included 2021 and 2022 data, showed a more generalized increase. Possible explanations include COVID-19 or other respiratory illnesses, maternal opioid use, and social media’s influence on infant sleeping practices. SUID mortality rates were notably higher among American Indian or Alaska Native, Black, and Native Hawaiian or Other Pacific Islander infants than among Asian and White infants. Disparities in SUID could reflect unsafe sleeping position, prematurity, tobacco exposure, and/or infant feeding practices; further research is needed.