Literature Review

An opportunity to advance cannabis science—DEA reschedulingJAMA Psychiatry; Kevin P. Hill, MD, MHS; Anshul V. Puli, BS; 2/25In 1970, the US Congress enacted the Controlled Substances Act (CSA), establishing a scheduling system for drugs based on their medical use, abuse potential, and safety. The most restrictive classification is Schedule I; cannabis along with other drugs, such as heroin and lysergic acid diethylamide (LSD), have this classification. May 13, 2024, the Drug Enforcement Agency (DEA), the agency regulating substance scheduling, issued a Notice of Proposed Rulemaking to investigate rescheduling cannabis from Schedule I to Schedule III. This was due to a recommendation from the US Department of Health and Human Services (HHS) to reschedule based on its review of the medical and scientific cannabis research. Still, the FDA investigated HHS’ CAMU [cannabis’ current accepted medical use] claim and found some credible scientific support for treating “anorexia related to a medical condition, nausea and vomiting (eg, chemotherapy-induced), and pain.”

Central Coast VNA & Hospice expands registered nursing services in Monterey Buzz; 3/5/25 Central Coast VNA & Hospice is significantly expanding its registered nursing care services in Monterey, providing residents with increased access to high-quality, personalized healthcare delivered directly in their homes. … Key expanded services include advanced care planning, which helps patients and families make informed medical decisions, and a palliative care program focused on relieving symptoms and reducing stress for patients with serious illnesses. The organization also offers specialty programs targeting specific health conditions such as cardiac care, diabetic care, and orthopedic support. 

Can default palliative care referrals increase consults? Medscape; edited by Gargi Mukherjee; 3/4/25 A default palliative care referral intervention increased palliative care consultations by more than fivefold and decreased end-of-life systemic therapy by more than half among patients with advanced cancer being treated in the community oncology setting. ...

Patient put in hospice at 52 celebrates life years after admission, thanks to heart surgery KCTV-5, Kansas City, MO; by Morgan Riddell; 2/27/25 A local man with heart failure who was told numerous times he only had months to live now has a new outlook on life two years later. ... It started in 2023. Sam Edwards, who was diagnosed with ALS after serving in the military, started experiencing new pains. He went to doctors who all determined Sam was just experiencing issues related to ALS. Then, a doctor at the VA Hospital noticed some tests were off and found Sam was experiencing heart failure. What he needed was open heart surgery, but doctors determined the risk of putting Sam on the operation table was too high. Not only was he at risk of having a stroke and dying on the operating table, but his recovery would also be months long and painful. They declined to do the surgery at the VA and suggested Sam go get a second opinion. This is when he was connected with Dr. Michael Gibson.Editor's note: While we in the palliative and hospice field promote earlier admissions to care and elimination of overtreatment, another side of the coin exists. Click on the title's link to read more about this hospice patient who sought out a second opinion. Imagine: the hospice patient is you (at age 52); or a family member; or a best friend. Especially as AI becomes more prevalent in assessing palliative and hospice referrals, we must see the bigger picture and retain human element. 

Mobile hospital-at-home pilot to deliver care to rural patients Modern Healthcare; by Diane Eastabrook; 2/26/25  Mobile medical units will deliver hospital-at-home care to patients in rural communities as part of a five-year pilot program aimed at expanding healthcare access in underserved areas. The Advanced Research Projects Agency for Health recently awarded an undisclosed amount of funding to Boston’s Mass General Brigham, University of Utah’s Huntsman Cancer Institute and Kentwood, Michigan-based Homeward Health to develop programs that will extend hospital-level care to patients in remote communities using mobile platforms.

Humana selects Thyme Care for oncology services MociHealthNews and HIMSS Media; by Anthony Vecchione; 3/3/25 Humana has unveiled an agreement with value-based cancer care platform Thyme Care with the aim of providing oncology support for its Medicare Advantage (MA) members. The agreement impacts MA members who reside in Michigan, New York, Illinois, Indiana, Tennessee, Pennsylvania and New Jersey. Eligible Humana members will have access to Thyme Care’s services, which include 24/7 virtual care navigation. Additionally, patients will be connected to a care team made up of oncology nurses, nurse practitioners, social workers and resource specialists. Thyme Care's team will provide medication guidance, urgent care support, chronic condition management and palliative care support.

How much does end-of-life care generally cost? 50 Plus Finance; by David Leto; 3/3/25 [For the public] ... Knowing how much end-of-life care generally costs can help you manage and prepare your finances appropriately to ease the burden on you and loved ones when the time comes. ... The cost of end-of-life care can vary widely depending on the services required. On average, however, Americans spend between $10,000 and $70,000 on such care, with the majority of expenses often occurring in the last year or month of life. These costs can stem from hospital stays, at-home care, or nursing facility care. Hospice, which focuses on comfort and pain management, typically costs less than intensive medical treatments but still averages several thousand dollars each month, or around $150 a day with insurance. Understanding these figures helps you set realistic financial expectations and prepare for them. ...

19-year-old says home hospice is a gift, not doom and gloom Keloland Media Group, Sioux Fall, SD; by Tom Hanson; 2/27/25 ... Cheyenne may be 19, but she is wise beyond her years, especially when it comes to something doctors discovered when she was 11. “I have stage 4 Metastatic Osteosarcoma, which is bone cancer in my lungs and It hasn’t responded very well to treatment, so that’s so I’m on hospice, but not because, I’m not on hospice because its the end right now, I’m on hospice because just so I have that extra support,” she said. Cheyenne knows people often misunderstand what hospice is all about. “It’s like doom and gloom and it’s like the end, there’s nothing they can do and that’s just not the case, she said. She was able to go on her road trip because Sanford’s Home Hospice team, including Becky Jibben, helped plan the trip and organize support teams along the way if Cheyenne needed help.

WVU nursing faculty aim to enhance rural home care for chronically ill through NIH award WVU Today - West Virginia University, Morgantown, WC; Press Release; 2/26/25 Three West Virginia University nursing faculty know firsthand the difficulties faced by family caregivers and their chronically ill loved ones. With a $2.7 million award from the National Institutes of Health’s National Institute of Nursing Research that is one of the largest ever for the WVU School of Nursing, the faculty researchers aim to support these families while increasing access to care in the rural reaches of the Mountain State by testing an integrated, nurse-led intervention for family home care management of end-stage heart failure and palliative care. ... Through their lived experiences, as well as their previous studies using nursing science to develop and test nurse-led interventions, the three said they hope to improve family caregivers’ and their loved ones’ overall health and well-being, including reducing depression and anxiety, and monitoring and managing end-of-life symptoms.

Montana House considers bill to put more sideboards on medical assistance in dying NBC KPVI-6, Pocatello, ID; by Darrell Ehrlick; 2/26/25 ... On Wednesday, in a hearing of the House Judiciary Committee that was full of as much testimony as tears, opponents and supporters of medical aid in dying, sometimes called “physician-assisted suicide,” discussed House Bill 637, which would codify requirements for physicians to use the process. ... Demonstrating the often complex political issue that can’t be broken down by party lines, Rep. Ed Stafman, D-Bozeman, who is also a lawyer and rabbi, said he was truly conflicted on the bill, and wondered how Juras, also an attorney, viewed the proposed legislation in light of the state constitution’s right to dignity. ... Testimony from medical professionals ranged from strong support to opposition,  ... [Click here for] Here's what [Montana] House Bill 637 would do ...

Hospitals may buckle under 'tsunami' of patients Modern Healthcare; by Alex Kacik; 2/25/25 Health systems are treating sicker patients, straining already full emergency departments and inpatient units. Many health systems are struggling to keep up with the increasingly complex healthcare needs of an aging population, leading to overcrowded emergency rooms and delays in care. Providers are ramping up strategies to treat patients more efficiently and keep those who aren't as sick out of emergency departments. These strategies are critical as capacity wanes and providers face a potential decline in federal healthcare funding, executives said. Health systems are revamping patient admission and discharge processes; bolstering virtual, home and urgent care offerings; expanding clinician recruitment efforts and adding observation beds. But providers are concerned they won't be able to act quickly enough to meet the growing demand for care.

‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life Healio; by Josh Friedman; 2/26/25 Nathan I. Cherny, MD, has worked all around the world. At every stop — from Australia to Israel, and Memorial Sloan Kettering Cancer Center in between — he has seen people with cancer receive overly aggressive treatment at the end of life. ... In a review published in ESMO Open, Cherny and a cohort of multinational colleagues highlighted numerous reasons why overtreatment occurs among patients approaching the end of life, ... They listed more than 20 contributing factors, including desire for control of the cancer, denial and anger, family pressure and hope preservation. The two factors that contribute most to overtreatment are optimism bias and the “counterphobic determination to treat,” which involves clinicians having a difficult time introducing the suggestion of palliative care revert to offering further treatments, Cherny said. ... Responsibility for decisions does not need to fall solely on oncologists, Cherny added. Palliative care physicians, social workers, chaplains and others can be part of a team to assist patients with their choices. ... The number of patients who are overtreated differs at each institution. “Each institution has its own culture of care,” Cherny said. Editor's note: This article puts forth significant insights for all palliative and hospice clinicians, interdisciplinary teams, and palliative/hospice executive leaders. Apply Cherny's to your referral sources: "Each institution has its own culture of care." Apply these findings to your own palliative and hospice services. 

Leading early conversations about ICD [implantable cardioverter defibrillator] use in end-of-life cancer care  Cancer Network; by Megan Mullins, PhD, MPH; 2/21/25 Earlier and more frequent talks about disabling ICDs with patients receiving end-of-life care and their families may help avoid excessive pain. ... Regarding implantable cardioverter defibrillators (ICDs) in those with fatal cancers, it is critical that patients know what having a device means and how it impacts end-of-life care, according to Megan Mullins, PhD, MPH. CancerNetwork® spoke with Mullins, assistant professor in the Peter O’Donnell Jr. School of Public Health, the Harold C. Simmons Comprehensive Cancer Center, and the Department of Internal Medicine at UT Southwestern Medical Center, about how ICD deactivation prior to end-of-life care could impact clinical practice in patients with advanced cancers. ... She emphasized that device deactivation would allow the body to undergo the natural dying process without unnecessary painful shocks associated with the use of the device.