Literature Review

ASCO updates Guidelines on Palliative Care Hematology Adviosor; by Jen Smith; 5/30/24 The American Society of Clinical Oncology (ASCO) has released an update to its guidelines on palliative care for cancer patients. The guidelines and related information were published in the Journal of Clinical Oncology and JCO Oncology Practice. To develop updated recommendations for integrating palliative care into cancer care, an expert panel reviewed randomized controlled trials, systematic reviews, and meta-analyses published during 2015-2023. Based on their findings, the experts recommend that patients with advanced cancer be referred to specialized interdisciplinary palliative care teams soon after diagnosis, while the patients are still receiving active cancer treatment.

How palliative care is changing in today’s health care environment Hospice News; by Molly Bookner; 5/29/24 As the palliative care field continues to grow and transform, understanding the current trends, outlook, relevant challenges and necessary skills for future leaders is critical. Two significant trends impacting the field of palliative care currently, according to experts, are the expansion of services and the integration of technology, particularly artificial intelligence (AI). Dr. Vicki Jackson, board president of the American Academy of Hospice and Palliative Medicine (AAHPM), noted that palliative care has demonstrated a positive impact on patient-reported outcomes across various illnesses, including cancer, heart, liver, kidney disease and dementia. 

Disparities in palliative care use for patients with blood cancer who died in the hospital The American Journal of Hospice & Palliative Care; by Tien-Chan Hsieh, Yee Hui Yeo, Guangchen Zou, Chan Zhou, Arlene Ash; 5/27/24 online ahead of printBackground: Palliative care can enhance quality of life during a terminal hospitalization. Despite advances in diagnostic and treatment tools, blood cancers lag behind solid malignancies in palliative use. It is not clear what factors affect palliative care use in blood cancer. Conclusions: This study highlights disparities in palliative care use among blood-cancer patients who died in the hospital. It seems likely that many of the 46% who did not receive palliative care could have benefitted from it. Interventions are likely needed to achieve equitable access to ideal levels of palliative care services in late-stage blood cancer.

Nurse practitioners improve skilled nursing's dementia care outcomes, but regulatory barriers remain: studyMcKnights Long-Term Care News; by Josh Henreckson; 5/13/24[Nurse pracitioners'] NPs’ involvement can significantly improve end-of-life care outcomes for residents with Alzheimer’s disease and related dementias (ADRD), according to the results of a new study in JAMA Health Forum. ... Those benefits, however, were shrunk by state regulations on the scope of care NPs are allowed to provide. ...  Elizabeth White, PhD, assistant professor of health services, policy and practice at Brown University [describes,] “For example, when a state restricts NPs from signing Do Not Resuscitate orders, that can serve as a barrier to advance care planning and could contribute to unnecessary hospitalizations at the end of life.” Editor's Note: We posted this JAMA Health Forum article on : Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia. 

New dementia guide provides best Standards of Care from 100+ not-for-profit hospice, palliative and advanced illness organizations PR Newswire; by National Partnership for Healthcare and Hospice Innovation (NPHI); 5/9/24 The National Partnership for Healthcare and Hospice Innovation (NPHI), the national voice for not-for-profit hospice care, in collaboration with Aliviado Health and the Center to Advance Palliative Care (CAPC), announces today the release of the NPHI "Dementia Care Resources Provider Guide." The new guide aims to improve the quality of life for patients with dementia, reducing hospitalizations, and easing the burden of advanced illness for families and caregivers. A dementia diagnosis poses substantial challenges for both patients and their families, impacting millions of Americans nationwide. Shockingly, the Alzheimer's Association reports that an estimated 6.7 million individuals in the U.S. currently live with dementia. 

Thyme Care launches virtual palliative care program, appoints medical director MobileHealthNews; by Jessica Hagen; 5/2/24 Value-based cancer care platform Thyme Care is launching Enhanced Supportive Care, a virtual palliative care support program to assist its members and caregivers with managing physical and psychological symptoms accompanying cancer diagnosis and treatment. The program will be led by Dr. Julia Frydman, the company's first medical director for palliative care. Frydman previously worked in the geriatric and palliative medicine program at New York City's Mount Sinai Health System.

The cancer caregiving burden trajectory over time: varying experiences of perceived versus objectively measured burden The Oncologist, by Laura A Siminoff, Maureen Wilson-Genderson, Marcin Chwistek, Maria Thomson; 4/23/24 Conclusions: Cancer caregiving is dynamic; [caregivers] CGs must adjust to the progression of the patient's disease. We found an association between subjective and objective burden both within and between CGs. Black CGs were more likely to report lower subjective burden compared to their White counterparts. More detailed investigation of the sociocultural components that affect caregiver experience of burden is needed to better understand how and where to best intervene with targeted supportive care services.

Black patients with ovarian cancer had lower-quality end-of-life care, study says American Journal of Managed Care (AJMC), by Brooke McCormick; 4/21/24 Non-Hispanic Black (NHB) patients with ovarian cancer (OC) received lower-quality end-of-life (EOL) care than non-Hispanic White (NHW) patients, according to a study published in Cancer Research Communications. ... Although trends and disparities in EOL care among patients with OC are well documented, the researchers noted that the role of health care access (HCA) in quality EOL care has not been well characterized; HCA is comprised of 5 distinct, interrelated care access dimensions, namely affordability, availability, accessibility, accommodation, and acceptability. 

Care for Alzheimer's on Medicaid is unorganized, frustrating, inhumanThe Indianapolis Star, by Darcy Metcalfe; 4/14/24What it is like to die of Alzheimer’s in America? Without a doubt, it is nothing as it is portrayed on NBC’s hit series This is Us. At the end of this series, the character Rebecca dies from Alzheimer’s and falls peacefully asleep, snuggly tucked in her warm bed at home, surrounded by family and 24-hour skilled nursing care. Throughout the six seasons of This is Us, I simultaneously witnessed my father’s slow dying from Alzheimer’s in a reality that was worlds away from Rebecca’s. ...

Comment: Rule must change to allow dialysis as end-of-life care HeraldNet, by Matthew Rivara and Mackenzie Daniek; 4/13/24More than 1 in 7 American adults live with chronic kidney disease, making it one of the most common chronic disease conditions in the United States. ... Medicare will generally not reimburse health care providers for dialysis treatments if a patient has elected to enter hospice care, as dialysis treatments are considered by Medicare to be “curative” rather than “palliative” care. Because of this, most patients getting dialysis for ESRD must forego all dialysis treatment after entering a hospice program.

The iconic stethoscope is getting a 21st century makeoverManaged Healthcare Executive, by Peter Wehrwein; 4/4/24 Two years ago, a pair of New Zealand physicians wrote an opinion piece in a peer-reviewed journal of the Royal Australasian of Physicians about point-of-care ultrasound. The gist of their argument was that ultrasound ought to be used more routinely to detect various heart and lung conditions. The somewhat cheeky title of that article is “Update on Echocardiography: Do We Still Need a Stethoscope?” Jason Bellet has spent more than a decade making pretty much the opposite case: Not only do healthcare professionals still need a stethoscope, they need a vastly improved, 21st century version that harnesses digital technology and artificial intelligence (AI).

Qualitative analysis of initial palliative care consultations in amyotrophic lateral sclerosis Journal of Pain and Symptom Management; by Christine L Watt, Ian C Smith, Jill Rice, Rebekah Murphy, Ari Breiner, Maria Duff, Danica Nogo, Shirley H Bush, Susan McNeely, Usha Buenger, Belinda Zehrt, Jocelyn Zwicker; 4/2/24, online ahead of print Background: Palliative care (PC) benefits patients with amyotrophic lateral sclerosis (ALS), however the needs of patients and caregivers and the optimal timing of PC discussions remains unclear. This study reports the analysis of PC consult notes from a larger feasibility trial. The specific aims of this analysis were to i) identify the PC needs of patients with ALS via qualitative analysis and ii) identify characteristics of patients and caregivers that could predict specific PC needs.

FDA approves AI Tool that can detect sepsis Forbes, by Cailey Gleeson; 4/3/24 The U.S. Food and Drug Administration approved an AI tool that can diagnose sepsis, Prenosis, the company behind the software, announced Wednesday, the latest in a series of agency approvals for AI diagnostic tools. ... At least 350,000. That’s how many adults who develop sepsis die from the condition or are discharged to hospice annually, according to the U.S. Centers for Disease Control and Prevention.