Literature Review

Association between physician age and patterns of end-of-life care among older AmericansJournal of the American Geriatrics Society; by Hiroshi Gotanda, Ryo Ikesu, Anne M. Walling, Jessica J. Zhang, Haiyong Xu, David B. Reuben, Neil S. Wenger, Cheryl L. Damberg, David S. Zingmond, Anupam B. Jena, Nate Gross, Yusuke Tsugawa; 4/15We found that differences in patterns of EOL care between ben-eficiaries cared for by younger and older physicians were small, and thus, notclinically meaningful. Future research is warranted to understand the factorsthat can influence patterns of EOL care provided by physicians, including ini-tial and continuing medical education.

Developing, implementing, and evaluating the visiting Neighbors’ program in rural Appalachia: A quality improvement protocolPLoS One; by Ubolrat Piamjariyakul, Susan R. McKenrick, Angel Smothers, Angelo Giolzetti, Helen Melnick, Molly Beaver, Saima Shafique, Kesheng Wang, Kerri J. Carte, Brad Grimes, Marc W. Haut, R. Osvaldo Navia, Julie Hicks Patrick, Kirk Wilhelmsen; 1/24Older adults living alone in rural areas frequently experience health declines, social isolation, and limited access to services. To address these challenges, our medical academic university supported a quality improvement project for developing and evaluating the Visiting Neighbors program in two rural Appalachian counties. Our Visiting Neighbors program trained local volunteers to visit and guide rural older adults in healthy activities. These age-appropriate activities (Mingle, Manage, and Move- 3M's) were designed to improve the functional health of older adults. The program includes four in-home visits and four follow-up telephone calls across three months.

Top ten tips palliative care clinicians should know about the psychiatric manifestations of nonpsychiatric serious illness and treatmentsJournal of Palliative Medicine; Gregg A. Robbins-Welty, Paul A. Riordan, Daniel Shalev, Danielle Chammas, Paul Noufi, Keri O. Brenner, Joshua Briscoe, William E. Rosa, Jason A. Webb; 5/24Mental health issues are widespread and significant among individuals with serious illness. Among patients receiving palliative care, psychiatric comorbidities are common and impact patient quality of life. Despite their prevalence, PC clinicians face challenges in effectively addressing the intricate relationship between medical and psychiatric disorders due to their complex, intertwined and bidirectionally influential nature.

End of life outcomes following Comfort Care Orders: A single center experience The American Journal of Hospice & Palliative Care; by Matthew Tucker, Dayna Hovern, John Liantonion, Elizabeth Collins, Adam F Binder; 5/13/24 Conclusions: The majority of patients placed on comfort care died during their hospitalization demonstrating a real need for comprehensive end of life care and immediate hospice services. For those discharged with hospice services, they spent an excessive amount of time in the hospital waiting for services to be arranged.

Impact of implementing serious illness conversations across a comprehensive cancer center using an interdisciplinary approach The American Journal of Hospice & Palliative Care; by Karen Guo, Garrett Wasp, Maxwell Vergo, Matthew Wilson, Megan M Holthoff, Madge E Buus-Frank, James J Perry, Amelia M Cullinan; 5/10/24Objectives: (1) Increase Serious Illness Conversation (SIC) use across oncology teams via an interdisciplinary quality improvement (QI) approach and (2) assess patient reported shared decision making (SDM) experiences with clinicians engaged in SIC implementation.Results: Oncology teams screened a total of 538 patients, identified 278 eligible patients, and completed 144 SIC conversations. The teams improved the proportion of documented SIC among eligible patients from near 0% to a collective frequency of 52%.

60 racial disparities in hospitalization outcomes among women With metastatic breast cancer in the United States by palliative care utilizationCancer Network; by Debu Tripathy, MD; 5/10/24 Background: While studies have reported that members of racial and minority populations hospitalized with metastatic breast cancer (MBC) have lower palliative care use than non-Hispanic White women, disparities in hospital-associated outcomes among inpatients have not been explored in this population. We examined the racial disparities in hospitalization outcomes among adult women with a diagnosis of MBC, stratified by receipt of palliative care. Conclusions: Despite the improvement in palliative care use over the years, members of racial minority populations continue to have poorer outcomes. However, patients who are Black with MBC who received palliative care had similar in-hospital mortality and were less likely to be discharged to a facility when compared with their White counterparts.

Association between opioid use disorder and palliative care: a cohort study using linked health administrative data in Ontario, CanadaCMAJ; by Jenny Lau, Mary M. Scott, Karl Everett, Tara Gomes, Peter Tanuseputro, Sheila Jennings, Rebecca Bagnarol, Camilla Zimmermann and Sarina R. Isenbergl; 4/29/24Background: People with opioid use disorder (OUD) are at risk of premature death and can benefit from palliative care. We sought to compare palliative care provision for decedents with and without OUD.Conclusion: We identified important differences in palliative care provided at the end of life between people with and without OUD. People with OUD were less likely to receive palliative care despite accessing palliative care earlier, which may reflect their end-of-life illness trajectories and underlying structural vulnerability that may prompt them to receive palliative care primarily in acute care. Health care providers should receive training in palliative care and addiction medicine to support people with OUD. 

An exploration of managing emotional labour and maintaining professional integrity in children's hospice nursing International Journal of Palliative Nursing; by Mandy J Brimble, Sally Anstey, Jane Davies, Catherine Dunn; 4/17/24Aim: To investigate how children's hospice nurses manage emotional labour and professional integrity in their long-term relationships with parents. Findings: Three overarching, cross-cutting themes were identified—purposeful positioning; balancing personability and professionalism; coping with and counterbalancing emotional labour. All themes were indicative of and/or built upon emotional intelligence constructs, such as self-awareness, self-regulation, appropriate (managed) empathy, social skills and intrinsic motivation. Innate features of children's hospice work were important for perpetuating intrinsic motivation and satisfaction.

What's in the Black Box of a successful nurse and social worker team palliative telecare intervention (ADAPT)? (RP317)Journal of Pain and Symptom Management; by Lyndsay DeGroot, PhD, RN, CNE; Kevin Wells; Brianne Morgan, BSN; Michelle Upham, MSW, LICSW; David B. Bekelman, MD, MPH; 5/24Key Message: A nurse and social worker palliative telecare team provided structured symptom management, psychosocial care, and individualized medical changes to improve quality of life, depression, and anxiety for patients with COPD, HF, and ILD. Impact: A nurse and social work palliative telecare team used collaborative care to tailor recommendations to the unique needs and symptoms of each patient, thereby improving quality of life.

Home care clinicians' perspectives on Advance Care Planning for patients at risk for becoming incapacitated with no evident advance directives or surrogates Journal of Hospice & Palliative Nursing; by Landau, Aviv Y. PhD, MSW; Venkatram, Chinmayi BA; Song, Jiyoun PhD, AGACNP-BC, APRN; Topaz, Maxim PhD; Klitzman, Robert MD; Shang, Jingjing PhD; Stone, Patricia PhD; McDonald, Margaret MSW; Cohen, Bevin PhD; 4/24 Abstract: ... This qualitative descriptive study elicited perspectives of home health nurses and social workers regarding barriers and facilitators to creating advance care plans in home health settings, with particular attention to patients with few familial or social contacts who can serve as surrogate decision-makers. ...  Participants reported a multitude of barriers to supporting patients with advance care planning at the provider level ... Participants noted that greater socialization and connection to existing educational resources regarding the intended purpose, scope, and applicability of advance directives could benefit home care patients.

Shocked at end-of-life: An educational video for hospice workers about Implantable Cardioverter-Defibrillators Journal of Pain and Symptom Management; by Sarah Godfrey, MD, MPH; Christine L. Chen, MD; Melanie S. Sulistio, MD; Sharika Kumar, MD; and Kelley Newcomer, MD; 2/24 Introduction: Hundreds of thousands of patients with implantable cardioverter-defibrillators (ICDs) die yearly. Though ICD shocks can be lifesaving, they can also be severely painful. One third of ICD patients are shocked in the last day of life irrespective of DNR status. Over 97% of hospice programs admit patients with ICDs, yet only 10% have deactivation policies and less than 50% of hospice patients have their ICD deactivated. ...  Conclusion: Hospice personnel have limited knowledge about ICDs, prohibiting best care of patients with these devices at EOL. A short educational video increased knowledge and may serve as a helpful tool. Improving ICD knowledge amongst hospice personnel is essential to ensuring the unique needs of hospice patients with ICDs are met.

Leadership's perceptions of palliative care during the COVID-19 pandemic: A qualitative study Journal of Pain and Symptom Management, by Tamara Vesel, Audrey Covaleski, Veronica Burkarth, Emma Ernst, Linda Vesel; 4/19/24Background: This study aimed to explore the perceptions, understanding, and utilization of palliative care before compared to during the COVID-19 pandemic among health system leadership. Results: ... Emerging themes included the role of palliative care before compared to during the COVID-19 pandemic, facilitators and barriers to palliative care delivery, and recommendations for future practice. Participants reported that the COVID-19 pandemic increased palliative care utilization, reinforced positive perceptions of the specialty, and emphasized its role in maximizing healthcare efficiency. Many participants found palliative care financing to be a barrier to delivery; ... 

Dana-Farber retracts string of studies in systematic review of data integritySTAT+, by Angus Chen; 4/18/24An ongoing investigation into data integrity at Dana-Farber Cancer Institute has resulted in a string of retractions, the latest of which is a 2006 Science paper co-authored by institute president and CEO Laurie Glimcher. The retraction notice, published in Science on Thursday, noted that the authors had become aware of discrepancies in key scientific images that led them to lose confidence in key figures in the study, although the study’s lead author opposed the retraction. The issues with this paper, along with concerns with more than 50 other articles co-authored by four of Dana-Farber's top researchers, were highlighted in a January blog post by the scientific sleuth Sholto David.