Literature Review

Telehealth vs in-person early palliative care for patients with advanced lung cancer-A multisite randomized clinical trialJAMA; Joseph A. Greer, PhD; Jennifer S. Temel, MD; Areej El-Jawahri, MD; Simone Rinaldi, ANP-BC; Mihir Kamdar, MD; Elyse R. Park, PhD, MPH; Nora K. Horick, MS; Kedie Pintro, MS; Dustin J. Rabideau, PhD; Lee Schwamm, MD; Josephine Feliciano, MD; Isaac Chua, MD, MPH; Konstantinos Leventakos, MD, PhD; Stacy M. Fischer, MD; Toby C. Campbell, MD; Michael W. Rabow, MD; Finly Zachariah, MD; Laura C. Hanson, MD; Sara F. Martin, MD; Maria Silveira, MD; Laura Shoemaker, DO; Marie Bakitas, DNSc; Jessica Bauman, MD; Lori Spoozak, MD; Carl Grey, MD; Leslie Blackhall, MD; Kimberly Curseen, MD; Sean O’Mahony, MB, BCh, BAO; Melanie M. Smith, MD; Ramona Rhodes, MD; Amelia Cullinan, MD; Vicki Jackson, MD; for the REACH PC; 9/24 The delivery of early palliative care virtually vs in person demonstrated equivalent effects on quality of life in patients with advanced NSCLC [non-small cell lung cancer], underscoring the considerable potential for improving access to this evidence-based care model through telehealth delivery. [These] findings underscore the potential to increase access to evidence-based early palliative care through telehealth delivery.

Care utilization for neurodegenerative diseases compared to patients with cancer Physician's Weekly; 10/14/24 Neurodegenerative diseases are a leading cause of death, yet healthcare utilization and costs during the end-of-life (EoL) period are poorly understood.  Researchers conducted a retrospective study to describe and compare resource utilization among U.S. Medicare decedents with neurodegenerative diseases and cancer. ... The results showed 1,126,799 Medicare beneficiaries, of which 357,926 had a qualifying diagnosis. Individuals with neurodegenerative diseases were older and more frequently received Medicaid assistance than those with brain or pancreatic cancer. ... The study concluded that individuals with neurodegenerative diseases were more likely to visit ED and less likely to utilize inpatient and hospice services at the EoL compared to those with brain or pancreatic cancer. 

Palliative care use low in patients with heart failure in the United States Cardiology Advisor; by Ron Goldberg; 10/10/24 Palliative care (PC) use for end-of-life care in heart failure (HF) in the United States is low, with geographic and racial variations in access and application, and PC is becoming necessary for younger, healthier patients seeking a better quality of life, according to study findings published in the Journal of the American Heart Association. ... "PC for HF remains low in the United States. Racial and geographic variations in access and use of PC exist for patients with HF,” the investigators concluded. “These findings suggest that palliative care is not only an end-of-life care for older patients with HF but can be necessary for younger, healthier patients with needs for advanced therapies and for better quality of life.”

Palliative care ‘ahead of the game’ in approaches to treating rare diseases Hospice News; by Holly Vossel; 10/9/24 Researchers are ramping up efforts to better understand the complex trajectories of rare diseases, with evidence mounting around palliative care’s potential to improve outcomes among those patients. The Center for Innovation & Value Research recently launched the second phase of its Rare Disease Project, an initiative aimed at examining the diverse range of these illnesses and the patients impacted by them. The project is designed to learn more about the innovative, person-centered care models that can help address common challenges that these patients and their caregivers face — including approaches that integrate palliative care services. A pivotal point of the research for palliative care providers is understanding how their services help support patients — physically, practically and spiritually — as their diseases progress, according to Rick Chapman, chief science officer at the Center for Innovation & Value Research, which is part of the National Health Council.

From small to tall: breed-varied household pet dogs can be trained to detect Parkinson's DiseaseAnimal Cognition; Lisa Holt, Samuel V Johnston; 10/24Parkinson's Disease (PD) is a clinically diagnosed disease that carries a reported misdiagnosis rate of 10-20%. Recent scientific discoveries have provided evidence of volatile organic compounds in sebum that are unique to patients with PD. Twenty-three canines of varying breeds, ages, and environmental backgrounds were included. For this two-year reporting period, when averaged as a group, the 23 dogs were 89% sensitive and 87% specific to olfactory distinction between PD-positive and PD-negative human donor samples. Study findings support the application of companion dogs, trained with force-free, reward-based methodologies, for the detection of PD-positive and PD-negative samples under controlled conditions.

New coalition launches to advance palliative cancer care Hospice News; by Jim Parker; 9/30/24 A new organization, Together for Supportive Cancer Care, launched Monday with a mission to expand access to palliative care among cancer patients. A charitable group, The Sheri and Les Biller Family Foundation, convened more than 40 member organizations, including health care providers, pharmaceutical companies, patient advocacy groups, public policy experts, employers and insurers, among others. “For decades, leaders around our country have worked to show the promise and impact of supportive care programs for people living with cancer, their caregivers and their loved ones,” said Audrey Haberman, the foundation’s CEO, in a statement. “The launch of Together for Supportive Cancer Care builds on this work and is an important step toward creating a health care system where early and ongoing access to supportive care is not a privilege, but a fundamental part of the cancer journey for everyone.” 

Long-term use of muscle relaxant medications for chronic pain-A systematic reviewJAMA Network Open; Benjamin J. Oldfield, MD, MHS; Brynna Gleeson, BA; Kenneth L. Morford, MD; Zoe Adams, MD; Melissa C. Funaro, MLS; William C. Becker, MD; Jessica S. Merlin, MD, PhD, MBA; 9/24Chronic pain, commonly defined as pain that lasts beyond 3 months and/or extends past normal tissue healing time, affects millions of US residents, with a 2021 prevalence of 21%. In this systematic review ... muscle relaxant medications were assessed. Muscle relaxants may be more beneficial than placebo for treating trigeminal neuralgia, painful cramps, and neck pain, but for fibromyalgia, low back pain, and other syndromes, they did not appear to be beneficial. Clinicians should be vigilant for adverse effects and consider deprescribing if pain-related goals are not met. 

The power of collaboration: Pharmacists and nurses partner to enhance patient care American Society of Health-System Pharmacists (ASHP) News Center; by Karen Blum; 9/23/24 Pharmacists and nurses work together on today's most pressing health challenges - from managing heart failure to deprescribing in palliative care to tackling obesity in pre-transplant patients. The Collaborative Care Grant for Nurses and Pharmacists from the ASHP Foundation and American Nurses Foundation recognizes the potential impact of this interdisciplinary teamwork on improving healthcare outcomes. At UPMC Presbyterian Hospital, the grant program helped fund the creation of a medication optimization clinic (MOC) for those with heart failure with reduced ejection fraction. “It made a lot of sense to bring together our collective expertise to manage these patients to get them on more optimal medications,” said James Coons, a clinical pharmacist in cardiology at UPMC Presbyterian Hospital. Coons, an ASHP member and professor at the University of Pittsburgh School of Pharmacy, worked with nurse practitioner and longtime collaborator, Jennifer Kliner, on the project.

The evolving landscape of Amyotrophic Lateral Sclerosis: A fatal disease!  Delveinsight; 9/24/24 Amyotrophic Lateral Sclerosis (ALS) is a devastating neurodegenerative disease characterized by the progressive degeneration of motor neurons, leading to muscle weakness, paralysis, and ultimately, death. ... Despite ALS being relatively rare, affecting 2-5 per 100,000 people worldwide, the question Is ALS on the rise? is gaining attention. While global prevalence has not significantly increased, improved diagnostic techniques, earlier detection, and greater awareness have led to a more accurate identification of ALS cases. Many researchers believe that enhanced surveillance and better tools for genetic testing are uncovering more cases than previously recognized, rather than a true rise in the disease’s incidence. However, with an aging global population, the burden of ALS may grow, as age is a major risk factor. Editor's note: Do you provide disease-specific training for your staff? ALS patients' and families' needs are unique. A significant disease comparison is between ALZ (Alzheimer's) and ALS. With ALZ (Alzheimer's), the brain decreases its abilities to function while the body can remain strong; the person is mobile with cognitive limitations. In contrast, with ALS, the body decreases its abilities to function while the brain/mind/emotions can remain strong. The person is immobile with cognitive awareness, but extreme physical limitations in communicating one's thoughts, emotions, and needs. ALS-specific communication tools provide crucial help for all. For more information in your location, visit The ALS Association's USA map.

[Africa] Cancer care terminology in African languagesJAMA Network Open; Hannah Simba, PhD; Miriam Mutebi, MD; Moses Galukande, MD; Yahya Mahamat-Saleh, PhD; Elom Aglago, PhD; Adamu Addissie, PhD; Lidya Genene Abebe, MS; Justina Onwuka, PhD; Grace Akinyi Odongo, PhD; Felix M. Onyije, PhD; Bernadette Chimera, MS; Melitah Motlhale, PhD; Neimar de Paula Silva, PhD; Desiree Malope, MS; Clement T. Narh, PhD; Elizabeth F. Msoka, MS; Joachim Schüz, PhD; Efua Prah, PhD; Valerie McCormack, PhD; 8/24This survey study of 107 health care workers and cancer researchers revealed diverse cancer terminology in 44 African languages across 32 countries in Africa. Translations of key terms including cancer, malignant, chronic, and radiotherapy commonly conveyed elements of fear and tragedy. In this survey study of cancer communication and the translation of oncology terminology in African languages, the findings suggest that the terminology may contribute to fear, health disparities, and barriers to care and pose communication difficulties for health professionals. The results reinforce the need for culturally sensitive cancer terminology for improving cancer awareness and communication.

[Canada] Cognitive symptoms across diverse cancersJAMA Network Open; Samantha J. Mayo, RN, PhD; Kim Edelstein, PhD; Eshetu G. Atenafu, MSc, PStat; Rand Ajaj, HBSc; Madeline Li, MD, PhD; Lori J. Bernstein, PhD; 8/24In this cross-sectional study of 5078 survey respondents with cancer seeking psychosocial support, over half of these patients reported having cognitive symptoms of any severity. A third of these patients reported moderate to severe cognitive symptoms, which were associated with disease, treatment, and other symptoms. Findings of this study suggest that higher severity of cognitive symptoms was consistently associated with higher symptom burden; these findings could be used to inform decision-making regarding access to cognitive screening, assessment, and supportive care in outpatient oncology clinics.

Individual-and community-level risk factors of cancer-related financial hardship among cancer survivorsJAMA Network Open; Apoorv Dhir, MD; Kristian Donald Stensland, MD, MS, MPH; Lindsey Allison Herrel, MD, MS; Rishi Robert Sekar, MD, MS; 8/24Cancer survivors face substantial economic hardships during and after oncologic care, compounding the physical and psychosocial implications of a cancer diagnosis and compromising treatment adherence, quality of life, and survival. In this cross-sectional study, approximately 50% of cancer survivors experienced cancer-related financial hardship, with a disproportionate number of survivors who were younger, were Medicare or Medicaid beneficiaries, were socioeconomically disadvantaged, and had advanced disease. Although policy efforts to curb the costs of cancer care are essential, acknowledging the role of community and structural barriers and identifying socially vulnerable populations for targeted interventions represent a potential strategy toward mitigating financial hardship and delivering equitable cancer care.