Literature Review
All posts tagged with “Clinical News | Advanced Illness Management News.”
Podcast: Outcomes post-cardiac arrest and palliative medicine consultation for seriously ill patients
03/11/24 at 03:00 AMPodcast: Outcomes post-cardiac arrest and palliative medicine consultation for seriously ill patientsThe Rounds Table Podcast, Episode 81; recorded 3/7/24 This week, Drs. Mike and John Fralick discuss two recent papers exploring patient outcomes after in-hospital cardiac arrest and the role of default Palliative Medicine consultation for seriously ill hospitalized patients. Two papers, here we go!
Compassionate extubation and beyond: Is there a need for more guidance in managing end-of-life in the intensive care unit?
03/11/24 at 03:00 AMCompassionate extubation and beyond: Is there a need for more guidance in managing end-of-life in the intensive care unit? Chest Physician, by Angela L. Birdwell, DO, MA; Nehan Sher, MD Approximately 20% of deaths in the United States occur during or shortly after a stay in the ICU and approximately 40% of ICU deaths involve withdrawal of artificial life support (WOALS) or compassionate extubation. ... How the team approaches WOALS can make a difference to both patients and decision-makers. Unfortunately, there is striking variation in practice and lack of guidance in navigating issues that arise at end-of-life in the ICU.
Description and outcomes of a palliative care pharmacist-led Transitions of Care program
03/11/24 at 02:00 AMDescription and outcomes of a palliative care pharmacist-led Transitions of Care program J Palliat Med, by Connor McCormick, Mamta Bhatnagar, Robert M Arnold, Maria Felton Lowry; 3/6/24Background: Patients with palliative care needs are at high risk of medication errors during transitions of care (TOC). Palliative Care Pharmacist Interventions surrounding Medication Prescribing Across Care Transitions (IMPACT) program was developed to improve the TOC process from hospital to community setting for cancer patients followed by palliative care. Conclusion: Our pilot study demonstrates that integrating a pharmacist in TOC for seriously ill patients is feasible and valuable.
Palliative care across the spectrum of heart failure
03/11/24 at 01:45 AMPalliative care across the spectrum of heart failure JACC Heart Fail; y Laura P Gelfman, Moritz Blum, Modele O Ogunniyi, Colleen K McIlvennan, Dio Kavalieratos , Larry A Allen; online ahead of print 2/27/24; print 3/8/24 Persons with heart failure (HF) often suffer from poor symptom control, decreased quality of life, and poor communication with their health care providers. ... New models are required that are better informed by high-quality data, engage a range of health care providers in primary palliative care principles, and have clear triggers for specialty palliative care engagement, with specific palliative interventions tailored to patient's illness trajectory and changing needs.
Wound coding changes bring compliance, legal questions
03/07/24 at 03:30 AMWound coding changes bring compliance, legal questions McKnights Long-Term Care News, by Josh Henreckson; 3/5/24 Changes to end-of-life wound classification in a recent Minimum Data Set update should be a positive for long-term care, but regulatory and legal ambiguity still surrounded the new coding procedures at press time.
Judge: Iowa hospice program told worker to ‘let people die’
03/07/24 at 03:00 AMJudge: Iowa hospice program told worker to ‘let people die’ Iowa Capital Dispatch, by Clark Kauffman; 3/5/24An Iowa judge has awarded jobless benefits to a hospice worker who allegedly quit after being told to let patients die rather than provide them with services.
Healthcare access dimensions and racial disparities in end-of-life care quality among ovarian cancer patients
03/07/24 at 03:00 AMHealthcare access dimensions and racial disparities in end-of-life care quality among ovarian cancer patients Cancer Research Communications; by Shama Karanth, Oyomoare L. Osazuwa-Peters; Lauren E. Wilson, Rebecca A. Previs, Fariha Rahman, Bin Huang, Maria Pisu, Margaret Liang, Kevin C. Ward, Maria J. Schymura, Andrew Berchuck, and Tomi F. Akinyemiju; 3/5/24 This study investigated the association between healthcare access (HCA) dimensions and racial disparities in end-of-life (EOL) care quality among Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Hispanic patients with ovarian cancer (OC).
Understanding the role algorithms play in our lives and navigating palliative care
03/07/24 at 02:00 AMUnderstanding the role algorithms play in our lives and navigating palliative careListen - Life Matters, by Hilary Harper, presenter podcast; 3/4/24Every day, we interact with dozens of algorithms as we go about our lives, but many of us don't understand how they work. How do we get the the best out of these tools while keeping the potential dangers in check?Editor's Note: From palliative care experts Australia; information about algorithms and Artificial Intelligence (AI) transfers to our USA palliative care (of course, without applications to CMS systems).
Johns Hopkins study reveals medical marijuana lowers pain, hospital visits
03/07/24 at 02:00 AMJohns Hopkins study reveals medical marijuana lowers pain, hospital visits BNN, by Wojciech Zylm; 3/5/24Recent research highlights significant improvements in well-being for cannabis users, offering hope for those with chronic illnesses. The study showcases a potential shift in the perception and utilization of medical cannabis in healthcare.
Rising suicide risk among seniors due to loneliness, mobility, financial insecurity, study finds
03/07/24 at 02:00 AMRising suicide risk among seniors due to loneliness, mobility, financial insecurity, study finds McKnights Home Care, by Adam Healy; 3/5/24As the number of adults over 65 continues to grow, suicide rates among older adults have also been rising, according to data from the National Center for Health Statistics. Between 2008 and 2017, the share of suicide-related emergency department visits among adults 65 years and older more than doubled. These older adults face age-related stressors that can negatively affect mental health, such as declining physical health, reduced mental sharpness, or the loss of friends or loved ones, which can heighten the risk of suicide.
Editorial: Illness trajectories in the age of big data
03/06/24 at 03:15 AMEditorial: Illness trajectories in the age of big data The BMJ; by Peter Tanuseputro, Colleen Webber, and James Downar; 3/1/24For decades, healthcare providers have understood that patients follow typical trajectories of health decline as they approach the end of life, and they have used this understanding to help patients and families anticipate the dying process. Traditional trajectories focus on function or overall health status and include sudden death, terminal illness ..., organ failure ..., and frailty ... Two Education articles in the BMJ add novel dimensions to our understanding of health decline. Murray et al explain how declines in function do not always mirror declines in social, psychological, and spiritual dimensions. They also add a new trajectory, multimorbidity, to describe a person with conditions from multiple trajectories (such as heart disease from organ failure and cognitive impairment from frailty).
Creating comfort through communication: Strategies for supporting mental wellbeing in palliative care
03/06/24 at 02:00 AMCreating comfort through communication: Strategies for supporting mental wellbeing in palliative careWorldHealth.net; 3/4/24... To provide comprehensive and compassionate care, this article explores the various strategies for communicating and supporting mental well-being in palliative care.
What is the appropriate response when a colleague is not following an aid-in-dying law?
03/05/24 at 03:00 AMWhat is the appropriate response when a colleague is not following an aid-in-dying law? American Clinicians Academy on Medical Aid in Dying - Ethics Consultation Service; posted by Jean Abbott, MD, MH; originally posted 2/2/24 and emailed 3/4/24 Outline of Ethics Question: A resource practitioner for aid-in-dying care has encountered practitioners who have not followed the requirements of the laws in that state, including eligibility, documentation, and other standard legal or medical elements of aid-in-dying care. The resource practitioner wonders what ethical responsibilities should guide their response to these concerns. Definition of “resource practitioner”: An experienced prescriber who acts as a source of information or a mentor for others prescribing or consulting for patients considering aid in dying. Their role is to advise the provider on aid-in-dying best medical practices and the process required to comply with the law.
Obstacles and opportunities for palliative care in the ICU
03/05/24 at 03:00 AMObstacles and opportunities for palliative care in the ICU Palliative Care News, by Rachel Edwards; 3/1/24A growing body of research touts the benefits of palliative care for patients, families, and even providers. However, when evaluated through randomized clinical trials, the results tend to lean toward mediocre. Palliative Care News spoke with experts in the field to unpack the reasons behind those results and identify the obstacles that are getting in the way of a more effective approach.
Debate intensifies over palliative care's reach: Wootton vs. Finlay's divergent views
03/01/24 at 03:00 AMDebate intensifies over palliative care's reach: Wootton vs. Finlay's divergent viewsThe Wall Street Journal, by Getta Pillai; 2/29/24Discover the differing perspectives of Sarah Wootton and Dr. Ilora Finlay on the effectiveness of palliative care. Gain insights into the challenges and potential solutions in end-of-life care.
Many older adults don't receive palliative care before death
03/01/24 at 03:00 AMMany older adults don't receive palliative care before deathMedScape, by Marilynn Larkin; 2/28/24 "One of the challenges and a barrier to accessing palliative home care is the difficulty of predicting survival," Amy Hsu, PhD, an investigator at the Bruyère Research Institute in Ottawa, Ontario, Canada, told Medscape Medical News. "Clinicians are good at prognosticating when a patient might be entering their last 3-6 weeks of life, but they have a harder time predicting if someone will survive 6 months or longer." The team developed the Risk Evaluation for Support: Predictions for Elder-life in their Communities Tool (RESPECT) to see whether access to predicted survival data could inform conversations about a patient's status and palliative care needs. The study was published online on February 26 in the Canadian Medical Association Journal.
"The great escape": How an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage
03/01/24 at 03:00 AM"The great escape": How an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage BMC Palliat Care, by Sam Quinn, Libby Ferguson, Derek Read, and Naomi Richards; 2/28/24Background: This case report ... illustrates how unresolved traumatic experiences across the life course can affect a patient's engagement with palliative care and offers insights into the flexibility and adaptations necessary for taking a trauma informed approach to care for an individual experiencing multiple disadvantage.
Facing dementia: Clarifying end-of-life choices, supporting better lives
03/01/24 at 03:00 AMFacing dementia: Clarifying end-of-life choices, supporting better lives The Hastings Center; 2/28/24The report includes 10 recommendations for policymakers, research funders, clinical and legal practitioners, and professional societies. ... “Facing Dementia: Clarifying End-of-Life Choices, Supporting Better Lives” is the major product of a Hastings Center research project, codirected by Hastings senior research scholar Nancy Berlinger and President Emerita Mildred Z. Solomon.
Right-sizing interprofessional team training for serious-illness communication: A strength-based approach
02/29/24 at 03:00 AMRight-sizing interprofessional team training for serious-illness communication: A strength-based approach PEC Innvov, by Liana Eskola, Ethan Silverman, Sarah Rogers, Amy Zelenski; distributed 2/28/24Objective: Palliative care communication skills help tailor care to patients' goals. With a palliative care physician shortage, non-physicians must gain these serious illness communication skills. Historically, trainings have targeted physician-only groups; our goal was to train interprofessional teams.
Surgeon shares biggest lesson: ‘Never underestimate the power of hope'
02/29/24 at 03:00 AMSurgeon shares biggest lesson: ‘Never underestimate the power of hope Mofitt Cancer Center, by Corrie Pellegrino; 2/27/24An Interview with Dr. Monica Avila. ...[Question] What is the biggest lesson you’ve learned from a patient?[Response] I think the biggest lesson is to never underestimate the power of hope and the power of the patients’ will to live. I’ve had patients literally placed on hospice care who I have taken to the operating room, had successful optimal debulking for ovarian cancer and who are living life right now after chemotherapy. So I never underestimate patients’ ability to keep going and keep living.
[Palliative Care] Are we consulting, sharing care, or taking over? A conceptual framework
02/29/24 at 03:00 AMAre we consulting, sharing care, or taking over? A conceptual frameworkPalliat Med Rep, by José Pereira, Christopher Klinger, Hsien Seow, Denise Marshall, Leonie Herx; 2/23/24Background: Primary- and specialist-level palliative care services are needed. They should work collaboratively and synergistically. Although several service models have been described, these remain open to different interpretations and deployment.Aim: This article describes a conceptual framework, the Consultation-Shared Care-Takeover (C-S-T) Framework, its evolution and its applications.
Embracing the platinum rule in palliative care: Treating patients the way they want to be treated
02/29/24 at 02:00 AMEmbracing the platinum rule in palliative care: Treating patients the way they want to be treated Anschutz, by Tari Advani, MD; 2/26/24 One of the first take aways from this journey, for me, in a mid-career directional change from emergency medicine to palliative care was a move away from the golden rule and towards the platinum rule. Treat patients the way they want to be treated, not the way we want to be treated. It is so simple, it allows people to exist in their own context, with their own histories and their own wishes. And, we, as caretakers, take the kind of care of them that they want. Where had that idea been during the past 20 years of my career? How many situations had I judged, wrongly, based on my own preferences, not the preferences of the patient.
Study gives credence to range of dementia caregiver decision tools
02/28/24 at 03:00 AMStudy gives credence to range of dementia caregiver decision toolsMcKnights Home Care, by Kristen Fischer; 2/27/24A new study analyzes some evidence-backed tools to help substitute decision-makers make choices to honor an individual’s medical, personal and end-of-life wishes. ... Substitute decision-makers are family members or friends of older adults who cannot speak for themselves (such as those with dementia). Data from the study, which was published on Saturday in Journal of the American Society of Geriatrics, was derived from 25 articles published between 2003 and 2022.
Subcutaneous patient-controlled analgesia in home-based palliative care: "It's as straightforward as pushing a button, right at my fingertips"
02/28/24 at 03:00 AMSubcutaneous patient-controlled analgesia in home-based palliative care: "It's as straightforward as pushing a button, right at my fingertips" J Pain Palliat Care Pharmacother, by Miguel Julião, Patrícia Calaveiras, Eduardo Bruera, Paulo Faria de Sousa; 2/26/24Subcutaneous patient-controlled analgesia (SCPCA) in home-based palliative care is a potentially valuable option for providing effective pain relief to some patients, particularly when conventional analgesic approaches prove ineffective or are refused.
Racial differences in shared decision-making about critical illness
02/28/24 at 03:00 AMRacial differences in shared decision-making about critical illnessJAMA Intern Med, by Deepshikha C. Ashana, MD, MBA, MS; Whitney Welsh, PhD; Doreet Preiss, PhD; et al; published online 2/26/24Question: How do critical care clinicians approach shared decision-making with Black compared with White caregivers of critically ill patients?Findings: In a thematic analysis of 39 audio-recorded clinician-caregiver meetings, racial differences were most evident in the following clinician behaviors: providing emotional support to caregivers, acknowledging trust and gratitude expressed by caregivers, disclosing medical information, and validating caregivers' treatment preferences.