Literature Review
All posts tagged with “Clinical News.”
Palliative care nurses see us in our final hours — these are the life lessons they've learnt
07/03/24 at 03:00 AMPalliative care nurses see us in our final hours — these are the life lessons they've learnt ABC News; by Iskhandar Razak; 6/29/24 Anne Myers was once confused and shaken by death. After more than a decade as a nurse, including in hospital ICUs, her mother died. "I'd seen a lot of deaths in my nursing life, but it was the closest human to me that had died," she said. "It kind of sent me down a 'oh my god, I don't know what's happening to me', this grief I'm experiencing." Soon afterwards, she became a palliative care nurse. "I ended up just going down the path of 'what is death, what is death and dying all about?'" she recalled. More than 15 years later, here's what she and other palliative care nurses have discovered on how to die well and live well.
Factors affecting palliative care collaboration with pain medicine specialists
07/02/24 at 03:00 AMFactors affecting palliative care collaboration with pain medicine specialists Clinical Pain Advisor; by James Maitlall, MD; 6/27/24 Structured collaboration between physicians working in palliative care (PC) and pain medicine (PM) may increase PC physician referral of seriously ill patients to PM specialists and potentially optimize their care, according to study results published in the Journal of Pain and Symptom Management. ... In a survey study, a multicenter team of investigators explored attitudes and beliefs among US PC physicians regarding PM specialists, as well as factors potentially impacting collaboration between physicians in these 2 areas of practice. ... The American Academy of Hospice and Palliative Medicine (AAHPM) approved the survey for distribution to 1000 of its physician members, who were selected at random. ... The investigators concluded, “Although we found that PC physicians have highly positive attitudes about the value of PM specialists, referral rates remain low, even for IDDS implantation, which has perhaps the largest body of evidence for patients with complex cancer-associated pain.”
[American Heart Association] Palliative care beneficial to manage symptoms, improve quality of life for people with CVD
07/02/24 at 03:00 AM[American Heart Association] Palliative care beneficial to manage symptoms, improve quality of life for people with CVD [cardiovascular disease] American Heart Association; by NewMediaWire; 7/1/24 Implementing patient-centered palliative care therapies, including prescribing, adjusting or discontinuing medications as needed, may help control symptoms and improve quality of life for people with heart disease, according to “Palliative Pharmacotherapy for Cardiovascular Disease,” a new scientific statement from the American Heart Association, published today in the Association’s journal, Circulation: Cardiovascular Quality and Outcomes. The new scientific statement reviews current evidence on the benefits and risks of cardiovascular and essential palliative medications. The statement provides guidance for health care professionals to incorporate palliative methods as part of holistic medication management at all stages of a patient’s health conditions, emphasizing the importance of shared decision-making and goal-oriented care.
Q&A: What is the ID clinician’s role in end-of-life care?
07/01/24 at 03:00 AMQ&A: What is the ID clinician’s role in end-of-life care? Healio; by Caitlyn Stulpin; 6/27/24 Patients receiving infectious diseases (ID) consultation over the past decade were increasingly complex, generally sicker and more likely to die soon after a consultation was performed, according to a study. Researchers said that the rate of infectious diseases (ID) consultation relative to hospital admissions doubled during that time, suggesting that ID physicians are more often being faced with the challenge of caring for complex patients. Because of this, Alison G.C. Smith, MD, MSC, and Jason E. Stout, MD, MHS, and colleagues aimed to assess the role of these physicians when it came to end-of-life care, leading them to conduct a retrospective cohort study of all patients with an ID consult at the Duke University Health System between Jan. 1, 2014, and Dec. 31, 2023.
Story Rounds inspires real talk by doctors about their toughest work
07/01/24 at 03:00 AMStory Rounds inspires real talk by doctors about their toughest work Standford Medicine - SCOPE Beyond the Headlines; by Mark Conley; 6/27/24 Jay Shah, MD, took a deep breath as he stood on the Berg Hall stage and looked out across the crowd. It was made up of 150 of his Stanford Medicine peers, some of them longtime mentors and collaborators. ... Shah had been chosen to lead off the latest rendition of Story Rounds, the WellMD and WellPhD and the Medical Humanities and Arts Program (MedMuse) co-sponsored live storytelling program -- a safe place for MDs, clinical students and residents to share with their colleagues. ... Shah's tale was an impassioned 13-minute story of metamorphosis: Of going from a doctor determined to trudge forward without self-reflection, watching it destroy his marriage and spiral his mental health, to one who recognized the harm in not processing the difficult situations and emotions that come with the job -- such as the pain, guilt and loneliness of losing a patient and feeling like it was all his fault. His was the first of five stories that evening, delivered in a personal storytelling format inspired by Public Radio Exchange's podcast The Moth. It encapsulated a growing movement toward doctors talking openly about burnout, stress and mental health -- and trying to support one another, whether they're a wide-eyed first-year resident or a veteran health care leader like Shah.
AMA Advocacy 2024 efforts
07/01/24 at 03:00 AMAMA Advocacy 2024 efforts American Medical Association; by AMA; Updated June 2024, 6/27/24 There are far too many everyday practice challenges interfering with patient care. That’s why the American Medical Association is advocating to keep physicians at the head of the health care team, reform the Medicare physician payment system, relieve the burdens of overused prior authorizations and so much more. [Key advocacy efforts include:]
Chronic loneliness can raise stroke risk in older adults, findings show
06/28/24 at 03:00 AMChronic loneliness can raise stroke risk in older adults, findings show McKnights Long-Term Care News; by Kristen Fischer; 6/24/24 A new study links loneliness to stroke risk, showing that those who are regularly lonesome have a 56% higher risk for stroke than those who are more socially connected. Situational loneliness wasn’t linked to a higher risk for stroke, which indicates that the stroke risk stems from chronic loneliness. Investigators led by a team from Harvard T.H. Chan School of Public Health published their report Monday in eClinicalMedicine. Research has already linked loneliness to an increased risk for cardiovascular disease. The new report is one of the first to evaluate the association between loneliness and stroke risk.
Palliative care physician: ‘Healing is possible’ even when cure is not
06/27/24 at 03:00 AMPalliative care physician: ‘Healing is possible’ even when cure is not Healio, Chicago, IL; by Jennifer Byrne; 6/26/24During her fellowship as a palliative care physician, Sunita Puri, MD, met a patient who taught her that healing is possible even when cure is not. Alice, a 35-year-old woman, had acute myeloid leukemia. ... Nobody wanted to say it out loud, but Alice was dying. “She was only a couple years older than me. She’d lived in San Francisco, a few streets away from where I lived in my residency,” Puri, program director of the hospice and palliative medicine fellowship program at UMass Chan School of Medicine. ... “She had a vibrancy that I had always hoped to embody, but she was intubated, wide awake, on dialysis and starting to suffer from ascending paralysis.” ... During rounds one day, Puri told her attending that she was at a loss about how to help Alice and didn’t feel she was doing anything meaningful for her. “My attending said, ‘What if just being at her bedside is achieving something meaningful?’” Puri recalled. “I’d always understood healing and cure to be different, but this was when I really felt it.” ... “What if healing is choosing to understand that there’s going to be suffering that we can’t alleviate — and sometimes that’s our own — but the most important thing to bring to that is presence?” she said. [Click on the article's title to continue reading.] Editor's Note: Though not directly related to this article, read "Today's Encouragement" at the end of today's newsletter.
Advanced lung cancer: Studies explore palliative care delivered by telehealth and in a stepped-care approach
06/27/24 at 03:00 AMAdvanced lung cancer: Studies explore palliative care delivered by telehealth and in a stepped-care approachThe ASCO Post - American Society of Clinical Oncology; by Alice Goodman; 6/25/24 Early palliative care can be integrated into the course of treatment for patients with advanced lung cancer via delivery by telehealth with outcomes similar to when palliative care is delivered via in-person visits, according to results of the REACH PC trial presented by Joseph Greer, PhD, of Harvard Medical School, Boston, at the 2024 ASCO Annual Meeting Plenary Session. A separate randomized noninferiority study presented at the ASCO meeting by Jennifer S. Temel, MD, FASCO, also of Harvard Medical School, Boston, found that stepped palliative care was noninferior to monthly visits with early integrated palliative care. Results of the stepped-care study were published in JAMA to coincide with the presentation at ASCO. [This article includes:]
Dementia decisions: Making tough choices about hospice, palliative care
06/26/24 at 03:00 AMDementia decisions: Making tough choices about hospice, palliative care Being Patient; by Katy Koop; 6/25/24 In the later stages of Alzheimer's, palliative and hospice care can be necessary. But how do you find a facility designed for dementia patients? ... Dr. Maribeth Gallagher, director of Arizona’s Hospice of the Valley dementia program, joins Being Patient video reporter Mark Niu to discuss how to make these difficult decisions and what makes a palliative or hospice care program “dementia-capable.” Gallagher’s work directing the Hospice of the Valley’s dementia program has received national and international awards for its innovative approaches. Her focus on dementia care was initially inspired by her personal experiences as a family caregiver, sharing the journey with her loved one from diagnosis to death. [Click on the title's link for the full conversation, in both audio and text.]
Children’s Healing Center opens in Ypsilanti Township in July
06/26/24 at 03:00 AMChildren’s Healing Center opens in Ypsilanti Township in July DBusiness Magazine, Detroit, MI; by R. J. King; 6/24/24 The Children’s Healing Center will open its doors in Ypsilanti Township on July 8, offering children with weakened immune systems and their families a safe and clean place to play. ... The facility is the Children’s Healing Center’s second location after first opening its doors in Grand Rapids in 2015. The new state-of-the-art 11,000-square-foot facility features a hospital-grade environment where families can engage in a diverse range of innovative programming free of charge. “It has always been our goal to open a second location of the Children’s Healing Center,” says Amanda Barbour, founder and CEO of Children’s Healing Center. “The kids, young adults, and families who rely on us have very few options for social interaction, so we provide an invaluable outlet to build friendships and fight the effects of isolation and loneliness. The Children’s Healing Center states it is a first-of-its-kind year-round recreational facility for kids and young adults aged 0-26 with weakened immune systems and their families that provides opportunities for play, programming, education, and socialization.
Spirituality as a determinant of health: Emerging policies, practices, and systems
06/25/24 at 03:00 AMSpirituality as a determinant of health: Emerging policies, practices, and systemsHealth Affairs; by Katelyn N. G. Long, Xavier Symons, Tyler J. VanderWeele, Tracy A. Balboni, David H. Rosmarin, Christina Puchalski, Teresa Cutts, Gary R. Gunderson, Ellen Idler, Doug Oman, Michael J. Balboni, Laura S. Tuach, Howard K. Koh; 6/24Reimagining public health’s future should include explicitly considering spirituality as a social determinant of health that is linked to human goods and is deeply valued by people and their communities. Spirituality includes a sense of ultimate meaning, purpose, transcendence, and connectedness. With that end in mind, we assessed how recommendations recently issued by an expert panel for integrating spiritual factors into public health and medicine are being adopted in current practice in the United States.
The opaque industry secretly inflating prices for prescription drugs
06/25/24 at 03:00 AMThe Opaque Industry Secretly Inflating Prices for Prescription DrugsThe New York Times; by Rebecca Robbins and Reed Abelson; 6/21/24Pharmacy benefit managers are driving up drug costs for millions of people, employers and the government. This is the first article in a series about how pharmacy benefit managers prioritize their interests, often at the expense of patients, employers and taxpayers. Americans are paying too much for prescription drugs. It is a common, longstanding complaint. And the culprits seem obvious: Drug companies. Insurers. A dysfunctional federal government.Publisher's Note: Pharmacy costs are second only to staffing for hospices. Dr. Drew Mihalyo and I presented on the complexities of prescription drug pricing at the 2017 Louisiana~Mississippi Hospice & Palliative Care Organization conference. This article, and others like them, will likely both educate and infuriate readers. The more things change, the more they stay the same...
Column: Hospice offers redirection of care
06/25/24 at 03:00 AMColumn: Hospice offers redirection of care The Andalusia Star News; by Vickie Wacaster; 6/22/24 Watching someone you love grow weaker and weaker with each passing day is challenging. Yet, sadly, many of us experience this. In my own life, when my late husband was diagnosed with a terminal, non-curable, yet treatable disease, I felt we were living on a roller coaster of emotions, appointments, and treatment options. ... Every day was a journey into uncharted territory for both of us. ... It was only during the last few days that we found the strength to say “no more treatments” and asked for hospice. ... Physicians recognize that hospice is not a withdrawal of care but a redirection of care to meet the needs of patients with an advanced terminal illness/disease. ...Editor's Note: The word "redirection" powerfully, easily shifts the course of care. The person remains at the center, with the focus being the person, not the disease. This is not a denial of dying and death, but rather a signpost, a gentle way to open the difficult conversation for providing information and asking "what matters most to you, now?"
Unity launches Guide that enhances quality of life for dementia patients and their caregivers
06/24/24 at 03:00 AMUnity launches Guide that enhances quality of life for dementia patients and their caregivers The Chamber - Manitowoc County, De Pere, Wisconsin; Press Release; 6/20/24 In honor of The Longest Day Of The Year which is celebrated on June 20th to raise awareness and outshine the darkness of Alzheimer's disease, Unity, in partnership with National Partnership for Healthcare and Hospice Innovation (NPHI), announces the release of a new dementia care resources guide that will improve quality of life for dementia and Alzheimer’s patients, reduce hospitalizations, and ease the burden for families and caregivers. ... The new guide represents the best standards of care for mid-, advanced-, to end-stage dementia and was put together with the collective input of 100+ not-for-profit hospice, palliative care, and advanced illness care organizations. [Click on the title's link for more information, and to download the free guide.]
Alzheimer’s history on maternal side linked to higher disease risk, study finds
06/21/24 at 03:00 AMAlzheimer’s history on maternal side linked to higher disease risk, study finds McKnights Long-Term Care News; by Kristen Fischer; 6/17/24 People with a history of Alzheimer’s disease on their mother’s side or both parents’ sides of the family had higher levels of amyloid plaques in their brains compared to those with fathers who had the disease, according to a study published Monday in JAMA Neurology. Increased amyloid, a biomarker for Alzheimer’s disease, was also found in those whose fathers had early onset of symptoms. But it wasn’t as high as in people who had higher amyloid on their mothers’ side of the family, the data showed. Mass General Brigham researchers used amyloid imaging on 4,413 cognitively unimpaired adults who were between 65 and 85.
Cancer therapy at end of life may not boost survival
06/20/24 at 03:00 AMCancer therapy at end of life may not boost survival Cure; by Brielle Benyon; 6/17/24 Patients with advanced solid cancers who received systemic therapy toward the end of life typically did not live any longer than patients who did not receive treatment, according to research published in JAMA Oncology. Because cancer treatments can damper quality of life, it is crucial that patients and their loved ones discuss goals of care and prognosis with their oncology team, two experts emphasized. “I think once we progress to advanced and metastatic cancer when cure is no longer feasible, it’s important to consider goals-of-care conversations,” said study author Maureen Canavan, associate research scientist at Yale School of Medicine.
Cachexia and anorexia in serious illness: A podcast with Eduardo Bruera
06/20/24 at 03:00 AMCachexia and anorexia in serious illness: A podcast with Eduardo BrueraGeriPal [podcast]; by Eric Widera, Alex Smith, Eduardo Bruera; 6/13/24I always find cachexia in serious illness puzzling. I feel like I recognize it when I see it, but I struggle to give a clear definition or provide effective ways to address it. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. Eduardo established one of the first palliative care programs in 1984, created the Edmonton Symptom Assessment Scale (ESAS), and significantly contributed to the evidence base for palliative care symptoms that many of us rely on daily. During our discussion with Eduardo, we delved into how we can define cachexia and anorexia, why they occur in conditions like cancer, how to assess for them, and explored the interventions that are helpful and those that are not in the treatment of these conditions.
When your parents die: Becoming an adult orphan
06/20/24 at 03:00 AMWhen your parents die: Becoming an adult orphan The Montecito Journal; by Deann Zampelli; 6/18/24 Shortly after I got married, my 64-year-old mother lost her battle with breast cancer. Seven years later my father joined her. The loss isn’t any less painful just because you are a grown-up. ... Many don’t realize that grief isn’t linear. We don’t go through a neat little phase, checking off each stage as we complete it. The famous (and somewhat debunked) five stages of grief introduced by Elisabeth Kübler-Ross in the 1960s (Denial, Anger, Bargaining, Depression, Acceptance) were from a study she did on the emotional states of patients who were dying. It was their stages she was referencing, not ours. ... I came to a frightening realization. ... It suddenly dawned on me that my siblings and I were next in line to kick it. [Click on the title's link to continue reading.]Editor's Note: While serving in your hospice leadership roles, you experience the ongoing aging, changes and likely even deaths of your own family members, friends, and mentors. Do you, your hospice communications, and/or your grief services rely on the outdated "Stages of Grief" model? These "stages" opened the door in the 1960's for talking about death and dying, but became overpopularizd for surviving and healing after the loss. These have been replaced with extensive bereavement/loss/grief research, clinical best practices, and more. For expert information, resources, and bereavement professionals, examine www.adec.org, the Association for Death Education and Counseling.
Telehealth can broaden reach of palliative care for lung cancer patients, per MGH study
06/19/24 at 03:00 AMTelehealth can broaden reach of palliative care for lung cancer patients, per MGH study MedCity News; by Frank Vinluan; 6/16/24 Palliative care provided by video was equivalent to in-person visits with a clinician, according to study results presented during the recent annual meeting of the American Society of Clinical Oncology. Investigators say these results indicate telehealth can make palliative care accessible to more cancer patients. ... Guidelines of ASCO and other professional organizations recommend integrating palliative care from the time of a diagnosis of advanced cancer. Nevertheless, many patients don’t get this care, Greer said. On the clinician side, there are not enough specially trained palliative care clinicians, he explained. From the patient perspective, living in a rural area or lacking transportation can make it difficult to access such care.
New AMA president says he's ready to take on big challenges facing doctors amid payment cuts and rising burnout rates
06/19/24 at 03:00 AMNew AMA president says he's ready to take on big challenges facing doctors amid payment cuts and rising burnout rates Fierce Healthcare; by Emma Beavins; 6/13/24 Bruce Scott, M.D., took the reins of the American Medical Association (AMA) for his first full day on Wednesday, June 12, succeeding immediate past president Jesse Ehrenfeld, M.D. ... During his tenure, Scott said he wants to emphasize the things that unite providers rather than the things that divide them. ... Some of the AMA’s biggest policy priorities include reducing prior authorization, bolstering Medicare payments for physicians and tamping down on increased scope of practice by non-physician providers. Scott said he hopes to follow in the steps of Ehrenfeld in engaging policymakers on these topics. In addition to banding together on those cross-discipline issues, Scott wants to advocate for rural clinics.
4 percent of those aged 65+ have dementia diagnoses: report
06/19/24 at 03:00 AM4 percent of those aged 65+ have dementia diagnoses: reportMcKnight's Senior Living; by Kimberly Bonvissuto; 6/14/24Four percent of US adults aged 65 or more years have a dementia diagnosis, with rates of dementia increasing with age, according to newly released data. Data from the 2022 National Health Interview Survey, or NHIS, revealed that the rate of dementia diagnoses ranged from 1.7% for adults aged 65 to 74 years to 13.1% in those 85 and older, according to the National Health Statistics Reports issue released Thursday by the Centers for Disease Control and Prevention. ... Among all residential care communities, 42% of residents have diagnoses of Alzhiemer’s disease or other dementias, according to the report. By comparison, 31% had heart disease, and 29% had depression.
Dying of heart failure: how do we improve the experience?
06/19/24 at 03:00 AMDying of heart failure: how do we improve the experience? The Medical Journal of Australia - MJA; by Dominica Zentner, Vithoosharan Sivanathan, Jennifer Philip and Natasha Smallwood; published online 6/17/24 ... Despite the improvements afforded by multiple pharmacological, surgical and interventional developments in heart failure, the goal of therapy remains delayed disease progression for many. Cognisant of this reality, recent heart failure guidelines all highlight the important role of palliative care. ... The MJA recently published an article regarding the imperative of reframing palliative care. ... We suggest that ...
Spousal caregivers need emotional support before losses, not just after, study finds
06/18/24 at 03:00 AMSpousal caregivers need emotional support before losses, not just after, study findsMcKnight's Long-Term Care News; by Donna Shryer; 6/9/24A recent study suggests that healthcare professionals and policymakers should expand their focus on supporting the emotional well-being of individuals whose spouses have dementia, especially in the years leading up to their partners’ deaths. The clinical investigation, published in the Journal of the American Geriatrics Society, indicates that these caregivers experience heightened levels of psychological distress compared to those whose partners have normal cognitive function. ... After the partner’s death, the levels of loneliness and depression were similar across all groups, regardless of the deceased partner’s cognitive status. This suggests that the period before the loss is particularly challenging for those caring for a spouse with dementia. Furthermore, about two-thirds (64%) of these spouses reported lower life satisfaction compared to nearly three-quarters (74%) of those with cognitively healthy partners. However, the study found no significant difference in social isolation levels among the groups.
Why doctors aren’t participating in organ donation after cardiac death
06/17/24 at 03:00 AMWhy doctors aren’t participating in organ donation after cardiac death Physician's Weekly; by Frank D. Brodkey, MD, FCCM; 6/13/24Organ donation after cardiac death (DCD) differs from the more traditional organ donation after brain death (DBD) insofar that DCD donors are alive and donate organs after discontinuation of life support so that a natural death with cessation of heartbeat and circulation may occur, followed by extraction of organs. This may increase the availability of transplantable organs, leading to improvement in the lives of other humans. According to the Health Resources and Services Administration, 5896 donations, representing 36% of all donations in 2023, were DCD, representing an increase of 40.7% over the preceding three years. There, however, are significant ethical and scientific issues in the performance of DCD with concepts of end-of-life care, personal autonomy, and concepts of dignity of life and death. ...