Literature Review

Understanding the discordance about prognosis between clinicians and terminally ill patients and their surrogatesThe ASCO Post, by Jo Cavallo; 2/14/24A Conversation with Douglas B. White, MD, MASResearch shows that about half of adults near the end of life in the United States are too ill to participate in decisions about whether to accept life-prolonging treatment, requiring family members and other proxies to serve as surrogate decision-makers for their critically ill loved ones. However, research also shows that surrogates of patients with advanced illness often have optimistic expectations about prognosis, which often lead to the increased use of invasive treatment (including life support) in dying patients and delays in the integration of palliative care.

These 8 traits make great doctors, and residents can develop themAMA, by Brendan Murphy; 2/5/24

Highest-paying cities for nurses in every stateBecker's Clinical Leadership, by Mariah Taylor; 2/6/24Here is the top metro area in every state with the median annual wage for nurses. [Highest paying cities include:]

ChatGPT analyzes speech patterns to identify Alzheimer’s 87 percent of the time, researchers showMcKnight's Senior Living, by Aaron Dorman; 2/9/24Since ChatGPT went live roughly 15 months ago, researchers have been studying whether artificial intelligence tools can be used to treat or predict Alzheimer’s... One of the main symptoms of dementia, even at earlier stages, is confusion or speech difficulties... ChatGPT was able to correctly identify Alzheimer’s 87% of the time, a new study shows.

Exploring the relationship between hospice care and end-of-life doulasPhaneuf Funeral Homes & Crematorium; 2/7/24Highlighting the collaborative nature of this relationship, [Lee] Webster pointed out, “Doulas are not out to steal [healthcare professionals’] jobs, but are another set of tools in the tool chest.” The supportive role of doulas can enhance the comprehensive care provided by hospice teams. “People everywhere involved with the doula movement are struggling with this [integration],” Webster added.

Where things stand: a summary of pending federal cannabis legislationReuters, Jean E. Smith-Gonnell and Cole White; 2/8/247Federal legislation pertaining to cannabis reform, once a political oddity, now commands significant resources and attention in Congress. With numerous bills under consideration, the landscape is both dynamic and complex. ... In this overview, we aim to provide clarity amidst the legislative maze and get to the root of the most significant cannabis legislation introduced in 2023. 

Children to have a place to grieve: Shepherd’s Cove Hospice plans musical-themed activity garden at Albertville facility Sand Mountain - The Reporter, by Mary Bailey; 2/6/24Shepherd’s Cove Hospice is in the beginning stages of building a space where children can grieve and cope with loss on site at their facility. The “Shepherd’s Cove Activity Garden” will be a place where children will be able to run, play and continue to be children while dealing with their emotions.

How PBM legislation would transform the industryModern Healthcare, by Lauren Berryman; 1/24/24The pharmacy benefit manager industry could look a lot different soon if Congress follows through with bipartisan efforts to pass bills governing the sector. PBMs such as CVS Caremark, Express Scripts and OptumRx would face new transparency requirements that would give health insurance companies, employers, customers and regulators new insights into how they negotiate prices for prescription medicines—and how much of the savings they generate find their way to patients and plan sponsors. Pending legislation also would prohibit lucrative practices such as spread pricing.

Transforming value-based dementia care—Implications for the GUIDE ModelJAMA Intern. Med; by Tarun Ramesh; Kushal Kadakia, MS; Lidia Moura, MD, MPH, PhD; 2/5/24Dementia disproportionately affects older adults and represents an increasingly difficult population health and financial challenge for Medicare. Annual spending for Medicare beneficiaries with dementia is approximately 3 times higher than that for patients without dementia, with excess costs attributable to substantial fragmentation across the care journey. Patients with dementia experience polypharmacy and frequent hospitalizations and require careful coordination across multiple specialty health care professionals with support from unpaid caregivers. However, traditional fee-for-service (FFS) payment models may not adequately support costly medical and social needs for patients with dementia and their unpaid caregivers.Editor's Note: Full access requires subscription or other online library access to JAMA.

Cancer is the leading cause of death in HIV-positive individualsManaged Healthcare Executive, by Logan Lutton; 1/17/24In those with human immunodeficiency virus (HIV), there is a 10-fold higher cancer risk than in the general population, according to the annual Cancer Facts and Figures report from the American Cancer Society published today. Because HIV compromises the immune system, it increases the risk of infections like human papillomavirus (HPV) that can lead to cervical cancer. Ten cancers are associated with HIV. These include non-Hodgkin lymphoma, cervical, liver, anal, and lung cancers.Access to care is another barrier for the community. There are still nine states where it is legal for healthcare professionals to refuse to care for LGBTQ+ patients: Alabama, Arkansas, Florida, Illinois, Mississippi, Montana, Ohio, South Carolina, and Tennessee. The patients in these states account for an estimated 20% of the entire LGBTQ+ population.

Emergency department management of common end-of-life and palliative care symptoms: Three casesCureus, by Alice Chang, James Espinosa, Alan Lucerna; 2/4/24... Patients with serious illness, even hospice patients, present to the ED in increasing numbers for symptom management. It has become essential for emergency physicians to care for patients who are not seeking life-sustaining measures but instead need quality-of-life interventions. The development of a clear, concise review of the most common acute symptoms can provide a framework for EM physicians to adequately address the needs of patients at the EOL.

3 Reasons Continuous Home Care utilization is fallingHospice News, by Jim Parker; 2/2/24Utilization continuous home care has dropped precipitously during the past decade, with labor pressures, regulatory scrutiny and billing challenges as contributing factors. Continuous home care (CHC) represented 0.9% of hospice care days during 2022, according to the National Hospice and Palliative Care Organization (NHPCO). This is down from 1.8% in 2013.Notible mentions: Sarah Simmons and Patrick Harrison, NHPCO.