Literature Review

[Italy] Fever in a palliative care setting: Clinical insights and implications from a prospective observational cohort studyPalliative Medicine; by Stefania Cheli, Elena Angeli, Oscar Corli, Sofia Dinegro, Agostino Zambelli, Tania Carta, Romina Shazivari, Michaela Smolikova, Paolo Franceschi, Francesco Molà, Yara Silva Cruzeiro, Emilio Clementi, Andrea Gori; 5/26Fever is a frequent but complex symptom in adults with a limited prognosis, arising from multifactorial causes beyond infection. The study was conducted in an inpatient hospice palliative care unit within the Luigi Sacco Hospital in Milan, Italy (January and December 2024). Fever occurred in 40% of patients, with a median onset of 5.5 days after admission. In 39.7% of cases, fever was attributed to infections, mainly catheter-associated urinary tract infection. Its strong association with medical devices highlights the need for proportional, personalised interventions that primarily consider prognosis, symptom relief, and quality of life.

Hospice enrollments from the emergency department feature short admissions and high-acuity hospice care Health Affairs; by Helen P. Knight, Kourosh Ravvaz, Alexander Fiksdal, Lin Shen, Isaac S. Chua, Claire K. Ankuda, Haiden A. Huskamp, Hojjat Salmasian, Joan M. Teno, and David W. Bates; 6/1/26 ... In this sample, 4.3 percent of initial enrollments in hospice originated from the ED. ED-to-hospice admissions featured short lengths-of-stay (21.7 percent were two days or less) and high rates of general inpatient level of care at the time of enrollment (23.6 percent). The 10 percent of hospice agencies with the highest proportion of ED-to-hospice enrollments were less often for-profit than agencies ranked below the fiftieth percentile in respect to proportion of ED-to-hospice enrollments. Further research is needed to increase understanding of how much patients benefit from ED-to-hospice transfers when their hospice stays before death are very short, and what drivers lead to these ED-to-hospice transfers.

Emotional and ethical impacts on healthcare professionals performing cardiopulmonary resuscitationAmerican Journal of Hospice & Palliative Medicine; by Patrick J. Macmillan, Susan Hughes, Dumindra Gurusinghe, Allison Go, Chase Lancaster, Iris Price; 6/26Many studies exist outlining poor outcomes related to cardiopulmonary resuscitation (CPR) administered to patients who are elderly and/or have comorbid medical conditions with sudden cardiac arrest. Studies show only 10% of patients with out-of-hospital cardiac arrest and initial asystole survive until they reach the hospital. Less than 5% survive until hospital discharge with good neurologic function. This study presents data that suggests that there is an association between moral distress and performing CPR on individuals who are elderly with multiple comorbid medical conditions. More than sixty percent of our respondents were challenged emotionally during these types of code situations, and a similar number of healthcare workers felt the code could be considered unethical.

Reach of palliative care in Parkinson disease-Progress and gaps after a national team-based implementation projectNeurology in Clinical Practice; by Sandhya Seshadri, Umer Akbar, Peggy Auinger, Nicole Andrea Lessard, Megan Dini, Sally A. Norton, Hillary D. Lum, Jodi Summers Holtrop, Janis M. Miyasaki, Christina L. Vaughan, Benzi M. Kluger; 6/26While clinical trials demonstrate PC [palliative care] improves quality of life for PWP  [people with Parkinson disease] and carepartners, little is known about the impact of PC on their experiences of receiving care in real-world settings. At COEs [Parkinson's Foundation US-based Centers of Excellence], [surveyed] PWP reported significant increases in non-motor symptom (NMS) assessment ... and pain management ...  Emotional and spiritual needs were addressed more frequently ... Advance care planning (ACP) discussions [and documentation] rose ... Communication ratings and knowledge of PC were high (>85%) and stable across surveys.

National Health Expenditure Projections, 2025–34: Strong utilization growth initially, legislative impacts laterHealth Affairs; by Jacqueline A. Fiore, Andrea M. Sisko, John A. Poisal, Sheila D. Smith, Gigi A. Cuckler, Andrew J. Madison, Sean P. Keehan, Kathryn E. Rennie, and Nicholas J. Feehley; 6/26By 2034, national health spending is projected to total nearly $9.0 trillion and to represent 20.6 percent of the economy, compared with $5.3 trillion and 18.0 percent in 2024. The rate of national health spending growth during this period is influenced by continued elevated use of medical services and goods through 2026; major legislative changes that affect insurance coverage and spending through 2028; and continued demographic shifts toward public programs, mainly Medicare. The insured share of the population is expected to be 90.5 percent in 2034, compared with 91.8 percent in 2024.

Serious illness and health care threats to personal legacy goalsThe Permanente Journal; by Marlaine Figueroa Gray, Matthew P Banegas, Nora B Henrikson; 6/26High-quality care for people with serious illness requires understanding what matters most. Although goals-of-care conversations may emphasize values and treatment preferences, patients hold goals related to identity, relationships, and legacy; how they wish to be remembered and what they hope to leave behind. Five themes emerged [from the participant interviews]: 1) participants actively planned for legacy, with legacy goals often clarified by serious illness; 2) illness and its care introduced threats to legacy goals; 3) financial strain and insurance coverage were major threats; 4) participants believed their care would differ if teams understood their legacy goals; and 5) participants wanted to communicate their legacy goals to their care teams. Integrating legacy-related conversations into palliative care may enhance person-centered care by addressing identity, relationships, and meaning alongside medical preferences.Assistant Editor's note: This article summary describes a very important aspect of end-of-life planning. Exploring with patients their legacy goals is as important as discussing their preferences surrounding their care. Including legacy goals as an integral component of goals of care and advance care planning discussions would yield a greater understanding of what kind of care would most honor the patient.

Contextualizing the dead donor rule in an era of voluntary euthanasiaNew England Journal of Medicine; by Carter Winberg, Ian Ball, Robert D. Truog; 7/26Growing acceptance of voluntary euthanasia, which opens the door to death by organ donation, warrants a recontextualization of the dead donor rule and assessment of the ethical principles involved.Publisher's note: This article was discussed by NPR (A new proposal for organ donation sparks concern; NPR; by Rob Stein; 7/26). Should surgeons be allowed to perform euthanasia by removing patients' hearts and other organs while they're still alive? Doctors try a controversial technique to reduce the transplant organ shortage The idea, dubbed "Death by Organ Donation," would enable euthanasia patients to donate organs for transplantation in a way that would make their organs more likely to be usable. It would also kill them. There are interesting ethical points on both sides of the discussion.

Evaluation of a pharmacist-driven discharge medication reconciliation service Pharmacy Times; by Missy Montino, PharmD, Madison Holmes, PharmD, BCPS, Shannon Pierce, PharmD, CPh, BCPS, Randi Silcox, PharmD, Anna-Marie Freeland, PharmD, Bola Habeb, MD; 7/13/26 Introduction: Medication reconciliation is a systematic process utilized to ensure the accuracy and consistency of a patient’s medication information across transitions in care. It involves comparing the patient’s current medication regimen with the prescribed medications to identify and resolve discrepancies, such as omissions, duplications, dosing errors, or potential drug interactions. ... Discussion and Conclusion: ... This study adds to the body of evidence supporting pharmacy’s positive impact on patient health outcomes, specifically in reducing 30-day readmission rates and identifying clinical interventions. This reinforces the benefit of a pharmacist-driven discharge medication reconciliation service. ...

Utilization of hospice and palliative care among patients with mental illness: a retrospective cohort study Journal of the American Geriatrics Society; by Sean O'Mahony, Utpol Das, Yuanyi Zhang, Anirudh S. Babu, Mukaila A. Raji, James Gerhart, Yong-Fang Kuo; 7/11/26 Background: Individuals with mental illness (MI) experience premature mortality and health disparities, yet little is known about their access to hospice and palliative care. Conclusions: Mental illnesses were associated with complex hospice utilization patterns characterized by longer length-of-stay, higher likelihood of enrollment far from death, lower likelihood of enrollment within 180 days before death, and lower palliative care consultation use in some groups.

The doctor will see you now--or will they? Theorizing AI’s impact on Black patients and providers in health careSocial Currents; by Adia Harvey Wingfield, Tyrell Spencer; 6/26As far as recent innovation practices go, artificial intelligence (AI) represents one of the major disruptions reshaping various aspects of human life. Health care is perhaps one of the industries where AI stands to be most transformative, particularly as it is increasingly used to diagnose illnesses, assist in creating treatment plans, reduce human error, and offer routine patient services. Yet despite its rapid growth, AI technology still reflects human biases and perceptions, allowing it to replicate existing inequalities. These inequalities could take on particular significance given persistent occupational stratification and increasing racial diversity. In this paper, we theorize how the growing reliance on AI in the US health care system will affect Black care providers and patients.