Literature Review

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.

CMS: Kidney Care Choices Model boosted home-based dialysis, but more data needed Hospice News; by Holly Vossel; 9/23/24 The Center for Medicare & Medicaid Innovation’s (CMMI) Kidney Care Choices (KCC) Model demonstration has increased utilization of dialysis in the home and has fostered greater clinician training in addressing related conditions. However, more time and data are needed to evaluate the reimbursement model’s impact on quality and cost, according to the first annual model evaluation report from the U.S. Centers for Medicare & Medicaid Services (CMS). The report includes the agency’s analysis of KCC model results during the first performance year since its launch on Jan. 1, 2022. Having this reimbursement path available could ease pressures for palliative care patients making decisions about their serious illness care options.

[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.

Trends in mortality after incident hospitalization for heart failure among Medicare beneficiariesJAMA Network Open; Adam S. Vohra, MD, MBA; Ali Moghtaderi, PhD; Qian Luo, PhD; David J. Magid, MD, MPH; Bernard Black, JD, MA; Frederick A. Masoudi, MD, MSPH; Vinay Kini, MD, MSHP; 8/24In this study of Medicare fee-for-service beneficiaries, there was a substantial decrease in in-hospital mortality for patients hospitalized with incident HF [heart failure] from 2008 to 2018, but little to no reduction in mortality for subsequent periods up to 3 years after hospitalization. These results suggest opportunities to improve longitudinal outpatient care for patients with HF after hospital discharge.

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.

Telehealth palliative care helps people living with advanced cancer Cancer Health; by Liz Highleyman; 9/9/24 Virtual palliative care can be as effective as in-person care, according to a recent study. Oncology palliative care is intended to relieve symptoms and improve quality of life. It is not the same as hospice care, and it can help people at any stage of cancer. National guidelines recommend integrating palliative care from the time of diagnosis for people with advanced cancer, but it is underutilized in part due to a shortage of trained providers. This study included 1,250 adults at 22 U.S. cancer centers who were diagnosed with advanced non-small-cell lung cancer. They had palliative care sessions every four weeks conducted either via video or in person. After six months, quality-of-life scores were equivalent in the two groups. They also did not differ significantly in terms of depression or anxiety, coping skills, understanding treatment goals or perception of their prognosis.

Long-term dementia risk in Parkinson DiseaseNeurology; Julia Gallagher, Caroline Gochanour, Chelsea Caspell-Garcia, Roseanne D Dobkin, Dag Aarsland, Roy N Alcalay, Matthew J Barrett, Lana Chahine, Alice S Chen-Plotkin, Christopher S Coffey, Nabila Dahodwala, Jamie L Eberling, Alberto J Espay, James B Leverenz, Irene Litvan, Eugenia Mamikonyan, James Morley, Irene H Richard, Liana Rosenthal, Andrew D Siderowf, Tatyana Simuni, Michele K York, Allison W Willis, Sharon X Xie, Daniel Weintraub, Parkinson's Progression Markers Initiative; 9/24It is widely cited that dementia occurs in up to 80% of patients with Parkinson disease (PD), but studies reporting such high rates were published over two decades ago, had relatively small samples, and had other limitations. We aimed to determine long-term dementia risk in PD using data from two large, ongoing, prospective, observational studies. Participants from the Parkinson's Progression Markers Initiative (PPMI), a multisite international study, and a long-standing PD research cohort at the University of Pennsylvania (Penn), a single site study at a tertiary movement disorders center, were recruited. Results from two large, prospective studies suggest that dementia in PD occurs less frequently, or later in the disease course, than previous research studies have reported.

Respiratory patients less likely to get palliative care Hospice News; by Jim Parker; 9/3/24 Patients with some respiratory conditions often do not receive outpatient palliative care and have relatively higher rates of intensive care admissions than those with other illnesses. This includes patients with lung cancer, chronic obstructive pulmonary disease (COPD) and a condition called idiopathic pulmonary fibrosis (IPF), according to a recent study published in the pulmonology journal CHEST. These patients tend to have high symptom burden, diminished quality of life and aggressive health care utilization at the end of life, the study found.

New ASCO Guidelines stress importance of early palliative care Hospice News; by Jim Parker; 8/26/24 The 2024 update to the American Society of Clinical Oncology’s (ASCO) clinical practice guidelines place renewed emphasis on palliative care. The guidelines are updated periodically by a multidisciplinary team, including a patient representative and experts in medical and radiation oncology, hematology and palliative care. For the 2024 revisions, this panel reviewed 52 randomized controlled trials that evaluated outcomes among cancer patients who received palliative care, ASCO reported. “This is a pivotal time,” the panel’s co-chair Betty Ferrell of City of Hope Cancer Care told the ASCO Post. “This guideline is a call to action for everyone to think about how they are integrating palliative care for all patients with cancer. There are great advances in cancer care, but none of these will be fully effective unless we fully integrate palliative care.”

Improving post-hospital care of older cancer patients Cancer Health; by University of Colorado Cancer Center and Greg Glasgow; 8/26/24 A few years ago, University of Colorado Cancer Center member and hospitalist Sarguni Singh, MD, began to notice a troubling trend: Older adults with cancer who were leaving the hospital for skilled nursing facilities after treatment were being readmitted to the hospital or having worse outcomes while in rehabilitation. ... Singh knew of an intervention called Assessing and Listening to Individual Goals and Needs (ALIGN) — a palliative care social worker-led protocol aimed at improving quality of life, aligning goals of care, and providing support to patients and caregivers — and she began using it for cancer care. ... The results were overwhelmingly positive, and patients and caregivers told us, ‘This was so helpful,’” says Singh, associate professor of hospital medicine in the CU School of Medicine.

Palliative care is a viable option for frail elderly patients with neurocognitive disorders admitted for hip fractures BMC Musculoskeletal Disorders; by Justine Boulet, Etienne L Belzile, Norbert Dion, Chantal Morency, Mélanie Bérubé, Alexandra Tremblay, Stéphane Pelet; 8/10/24 Most patients presenting with a hip fracture regardless of their comorbidities are surgically treated. A growing body of research states that a certain type of elderly patient could benefit more from a palliative approach. ... The presence of [a nuerocognitive disorder] NCD and diminished prefracture autonomy strongly support counseling for palliative care. The high rate of complications when surgery is proposed for frail patients with multiple comorbidities suggests that the concept of palliative surgery needs to be revisited. 

Cognitive impairment in the workplace Alzheimer's Association; email 8/14/24, webpage posted 8/8/24 Due to the aging of the U.S. population, rates of cognitive impairment and dementia in the workplace are on the rise. This creates challenges for employers, many of whom may not know how to best support employees who are experiencing symptoms of cognitive impairment. Conversely, employees may be hesitant to share with their employer the challenges that they’re experiencing. ... Recommendations Regarding Dementia in the Workplace ... [Click on the title's link for this excellent HR information.]