Literature Review

Patient, caregiver, and clinician perspectives on the time burdens of cancer careJAMA Network Open; Arjun Gupta, MD; Whitney V. Johnson, MD; Nicole L. Henderson, PhD; Obafemi O. Ogunleye, MEd; Preethiya Sekar, MD; Manju George, MVSc, PhD; Allison Breininger, MA; Michael Anne Kyle, PhD, RN; Christopher M. Booth, MD; Timothy P. Hanna, MD, PhD; Gabrielle B. Rocque, MD; Helen M. Parsons, PhD; Rachel I. Vogel, PhD; Anne H. Blaes, MD, MS; 11/24Cancer and its care impose significant time commitments on patients and care partners. These commitments, along with their associated burden, have recently been conceptualized as the “time toxicity” of cancer care. Patients with advanced solid tumors spend approximately 20% to 30% of their days alive with health care contact. In this qualitative analysis of patients, informal care partners, and clinicians, participants highlighted the diverse sources of time burdens, how these time burdens affected care partners alongside patients, and how the time burdens extended to the wider network around them. Time burdens had outcomes ranging from causing psychosocial distress, and “seemingly short” ambulatory appointments turning into all-day affairs. These findings will guide the oncology community to map, measure, and address time burdens for persons affected by cancer.

Palliative nursing in home health care across the lifespanAmerican Journal of Nursing; by Murali, Komal Patel; Ma, Chenjuan; Harrison, Krista L.; Hunt, Lauren J.; Rosa, William E.; Boyden, Jackelyn Y.; 12/24Primary palliative nursing in home health care (HHC) can be delivered to medically complex patients across the lifespan. Primary palliative nursing provides patient- and family-centered care for serious illness by alleviating the stress and symptoms of illness; coordinating care; and supporting the social, cultural, and psychological aspects of care. In this article, two case scenarios of patients in different phases of life serve as examples of primary palliative nursing in HHC. Key elements and challenges of delivering primary palliative nursing care in HHC are also highlighted.

Focusing on life rather than illness: the lived experience of children with life-threatening and life-limiting conditions-a qualitative study Palliative Care and Social Practice; by Trine Brun Kittelsen, Charlotte Castor, Anja Lee, Lisbeth Gravdal Kvarme, Anette Winger; 11/29/24 This study seeks to address gaps in existing knowledge, especially the limited inclusion of children's perspectives and the exclusion of children with communicative and cognitive disabilities. The aim of this study was to explore the lived experiences of children living with LT/LL conditions. ... The findings showed that the children's attention revolved around life rather than illness. The analysis revealed the presence of three themes: wanting to engage in life, being dependent on familiar relations, and the importance of cherished items.

AI can’t worry about patients, and a clinical ethicist says that mattersJAMA; Yulin Hswen, ScD, MPH; Jennifer Abbasi; 11/24This conversation is part of a series of interviews in which JAMA Network editors and expert guests explore issues surrounding the rapidly evolving intersection of artificial intelligence (AI) and medicine. Today, Hull is an associate professor and serves as associate director of the biomedical ethics program at Yale, where her clinical practice focuses on echocardiography and cardiac care of patients with cancer. She spoke about ethical boundaries for using AI in the clinic in a recent conversation with Yulin Hswen, ScD, MPH, an associate editor at JAMA and the newly launched JAMA+ AI and an assistant professor of epidemiology and biostatistics at the University of California, San Francisco. Medicine is, they remind the reader, “as much art as science, as much a moral endeavor as a technical one.”

Resuscitation attempt and outcomes in patients with asystole out-of-hospital cardiac arrestJAMA Network Open; Junki Ishii, Mitsuaki Nishikimi, Kazuya Kikutani, Shingo Ohki, Kohei Ota, Tatsuhiko Anzai, Kunihiko Takahashi, Masashi Okubo, Shinichiro Ohshimo, Taku Iwami, Nobuaki Shime; 11/24This cohort study analyzed data from a nationwide prospective OHCA [out-of-hospital cardiac arrest] registry in Japan ... presenting with asystole, ... the proportion with a favorable neurological outcome at 30 days was substantially low, and no prehospital ALS [advanced life support] procedure was associated with a favorable neurological outcome. These findings suggest that discussions regarding implementation of a termination of resuscitation rule for such patients are warranted.

Donor time to death and kidney transplant outcomes in the setting of a 3-hour minimum wait policyJAMA Network Open; Samuel J. Tingle, MBBS; Nicholas D. H. Chung, MBBS; Abdullah K. Malik, MBBS; Georgios Kourounis, MBBS; Emily Thompson, PhD; Emily K. Glover, MBBS; Jennifer Mehew, PhD; Jennifer Philip, MD; Dale Gardiner, MBBS; Gavin J. Pettigrew, PhD; Chris Callaghan, PhD; Neil S. Sheerin, PhD; Colin H. Wilson, PhD; 11/24Due to concerns regarding organ viability, most organ donation organizations internationally wait no longer than 1 to 2 hours for potential donation after circulatory death (DCD), possibly underutilizing an important organ source; UK policy mandates a minimum 3-hour wait time. In this cohort study of 7,183 DCD kidney transplant recipients, donor time to death was not associated with short-term or long-term kidney transplant outcomes. This study suggests that organ donation organizations can safely extend the minimum wait time to 3 hours to significantly increase the number of kidneys available for transplant internationally.

It gives you a really great feeling, knowing that what you are doing is making somebody's day: Provider perspectives on implementing the individualized positive psychosocial interactionPsychological Services; Cassandra Keiser, Molly Noble, Kimberly VanHaitsma, Katherine M Abbott; 11/24The Individualized Positive Psychosocial Interaction (IPPI) is an evidence-based program that supports engaging people living with dementia and their care partners in the nursing home (NH). IPPIs are brief, one-to-one, preference-based activities to improve well-being and decrease behavioral and psychological symptoms of dementia. Champions voiced that the IPPI program was cost-effective, adaptable to their local contexts, and provided training to staff to support residents experiencing distress. Overall, the IPPI program goals are aligned with nursing home organization goals, supporting staff in providing comfort to residents communicating distress, and can be feasibly implemented.

[Netherlands] Electronic health in the palliative care pathway for patients with head and neck cancerJAMA Otolaryngology- Head & Neck Surgery; Boyd N. van den Besselaar, MD; Kira S. van Hof, MD; Aniel Sewnaik, PhD; Robert. J. Baatenburg de Jong, PhD; Marinella P. J. Offerman, PhD; 11/24Head and neck cancer (HNC) generally has a poor prognosis, with more than 40% disease-specific mortality, ... with a median survival of 4 to 5 months. Given the unique nature of HNC, with a wide range of specific cancer-related symptoms, special consideration should be given to end-of-life care. In this quality improvement study, patients and next of kin were satisfied with most aspects of the hybrid palliative care pathway, and remote care seemed to be a promising means of delivery. These insights represent the initial steps toward gaining a deeper understanding of patients’ needs during specific moments in a hybrid palliative trajectory. They may support health care professionals in optimizing personalized and value-based palliative care delivery.

Guidelines for the prevention, diagnosis, and management of urinary tract infections in pediatrics and adults-A WikiGuidelines group consensus statementJAMA Network Open; Zachary Nelson, PharmD, MPH; Abdullah Tarık Aslan, MD; Nathan P. Beahm, PharmD; Michelle Blyth, MD, MSPH; Matthew Cappiello, MD; Danielle Casaus, PharmD; Fernando Dominguez, MD; Susan Egbert, PharmD; Alexandra Hanretty, PharmD; Tina Khadem, PharmD; Katie Olney, PharmD; Ahmed Abdul-Azim, MD; Gloria Aggrey, MD; Daniel T. Anderson, PharmD; Mariana Barosa, MD, MSc; Michael Bosco, PharmD; Elias B. Chahine, PharmD; Souradeep Chowdhury, MBBS; Alyssa Christensen, PharmD; Daniela de Lima Corvino, MD; Margaret Fitzpatrick, MD, MS; Molly Fleece, MD; Brent Footer, PharmD; Emily Fox, PharmD; Bassam Ghanem, PharmD, MS; Fergus Hamilton, MRCP, PhD; Justin Hayes, MD, MPH; Boris Jegorovic, MD, PhD; Philipp Jent, MD; Rodolfo Norberto Jimenez-Juarez, MD; Annie Joseph, MBBS; Minji Kang, MD; Geena Kludjian, PharmD; Sarah Kurz, MD; Rachael A. Lee, MD, MSPH; Todd C. Lee, MD, MPH; Timothy Li, MBChB; Alberto Enrico Maraolo, MD, MSc; Mira Maximos, PharmD, MSc, ACPR; Emily G. McDonald, MD, MSc; Dhara Mehta, PharmD; Justin William Moore, PharmD, MS; Cynthia T. Nguyen, PharmD; Cihan Papan, MD; Akshatha Ravindra, MD; Brad Spellberg, MD; Robert Taylor, PhD; Alexis Thumann, PharmD; Steven Y. C. Tong, MBBS (Hons), PhD; Michael Veve, PharmD, MPH; James Wilson, DO; Arsheena Yassin, PharmD; Veronica Zafonte, PharmD; Alfredo J. Mena Lora, MD; 11/24Urinary tract infections (UTIs) are among the most common infections globally, notably impacting patient quality of life and posing substantial clinical and economic challenges. In this third WikiGuidelines consensus statement, we provide an evidence-based approach to UTI management developed by a global network of experts for practical use across diverse clinical settings. This guideline fills a critical gap by providing pragmatic, broadly applicable recommendations tailored for generalist care and systems-based practice. Our guidance is rooted in the best available evidence and is designed for clinicians from various backgrounds and health care environments. It emphasizes a patient-centered approach to the diagnosis, prevention and treatment of UTIs and related genitourinary infections.

World Medical Association Declaration of Helsinki-Ethical principles for medical research involving human participantsJAMA; World Medical Association; 10/24Preamble: The World Medical Association (WMA) has developed the Declaration of Helsinki as a statement of ethical principles for medical research involving human participants, including research using identifiable human material or data. The Declaration is intended to be read as a whole, and each of its constituent paragraphs should be applied with consideration of all other relevant paragraphs. While the Declaration is adopted by physicians, the WMA holds that these principles should be upheld by all individuals, teams, and organizations involved in medical research, as these principles are fundamental to respect for and protection of all research participants, including both patients and healthy volunteers.

The Inflation Reduction Act and patient costs for drugs to treat heart failureJAMA Network Open; Erin Trish, PhD; Karen Van Nuys, PhD; Joanne Wu, MS; Nihar R. Desai, MD, MPH; 10/24The 2022 Inflation Reduction Act (IRA) contains several provisions to lower Medicare drug costs, including permitting the Centers for Medicare & Medicaid Services (CMS) to limit the prices of certain medicines and altering the standard Part D benefit to limit patient out-of-pocket costs. CMS has set the prices of 10 drugs effective 2026, including 3 commonly prescribed as part of combination therapy for heart failure (HF): dapagliflozin, empagliflozin, and sacubitril/valsartan. Dapagliflozin and empagliflozin also treat other conditions, including diabetes and chronic kidney disease. In this cross-sectional study of Medicare beneficiary costs ... benefit redesign eliminates the coverage gap in 2025, and caps annual out-of-pocket expenditures, [and] ... will reduce and smooth patient out-of-pocket burden.

Dialysis facility staffing ratios and kidney transplant access among adolescents and young adultsJAMA; Alexandra C. Bicki, MD, MPH; Barbara Grimes, PhD; Charles E. McCulloch, PhD; Timothy P. Copeland, MPP, PhD; Elaine Ku, MD, MAS; 10/24In this study of adolescents and young adults treated at US dialysis facilities, patients at facilities with higher patient to staff ratios had lower incidence of waitlisting and kidney transplant compared with those receiving care at facilities with lower patient to staff ratios. The effect size for the incidence of transplant was similar with respect to both patient to nurse and patient to social worker staffing ratios, but patient to nurse ratio was not statistically significantly associated with the incidence of waitlisting.