Literature Review

Humana to takeover 23 Walmart Health locations with new CenterWell senior care clinics. Here's where Louisville Courier Journal; by Olivia Evans; 7/25/24 Humana, the Louisville-based health insurance giant, has announced its health care services branch of the company, CenterWell, will open 23 senior primary care centers in Walmart Supercenters. The centers will operate under the CenterWell Senior Primary Care and Conviva Care Centers brand names, according to a press release from Humana.

Education curricula need to incorporate whole-person care beyond electives Pharmacy Times; by Ashely Gallaher; 7/21/24“[Whole-person care is] simply caring for a person and not just their pills. It's making sure that we're focusing on medications as tools to help people live better, healthier lives, and not as the focus of their lives,” Kashelle Lockman, PharmD, MA, clinical assistant professor and clinical pharmacy specialist at the University of Iowa. ... 3 Key Takeaways:

New medication, staging criteria signal a potential shift in Alzheimer’s care Psychiatric News; by Linda M. Richmond; 7/12/24 The latest antibody treatment for Alzheimer's disease may prompt the industry toward the use of biomarkers--rather than traditional cognitive and functional testing--for diagnosis and staging. Will the new drug make a meaningful difference in patients' lives despite its risks and hefty price tag?

Palliative pharmacotherapy for cardiovascular disease: A scientific statement from the American Heart Association Circulation: Cardiovascular Quality and Outcomes - American Heart Association (AHA) / American Stroke Association (ASA); by Katherine E. Di Palo, PharmD, MBA, MS, FAHA, Shelli Feder, PhD, APRN, ACHPN, FPCN, FAHA, Yleana T. Baggenstos, PharmD, Cyrille K. Cornelio, PharmD, Daniel E. Forman, MD, Parag Goyal, MD, MSc, Min Ji Kwak, MD, MS, DrPH, and Colleen K. McIlvennan, PhD, DNP, FAHA on behalf of the American Heart Association Clinical Pharmacology Committee of the Council on Clinical Cardiology and Council on Cardiovascular and Stroke Nursing; 7/24 ... Compared with other serious illnesses, medication management that incorporates a palliative approach is underused among individuals with cardiovascular disease. This scientific statement describes palliative pharmacotherapy inclusive of cardiovascular drugs and essential palliative medicines that work synergistically to control symptoms and enhance quality of life. We also summarize and clarify available evidence on the utility of guideline-directed and evidence-based medical therapies in individuals with end-stage heart failure, pulmonary arterial hypertension, coronary heart disease, and other cardiomyopathies while providing clinical considerations for de-escalating or deprescribing. Shared decision-making and goal-oriented care are emphasized and considered quintessential ... across the spectrum of cardiovascular disease.

2 Ketamine palliative care projects explore interdisciplinary collaborationHospice News; by Holly Vossel; 6/29/24Two ketamine-assisted therapy projects are examining ways to develop training and collaboration models for utilization among palliative care patient populations. A growing body of research is uncovering the potential benefits of ketamine therapies to help with symptom management. But greater understanding of the drug and its impacts is needed to help palliative care providers and other health professionals guide patient experiences, according to Dr. Michael Fratkin, board president of the Institute for Rural Psychedelic Care. Fratkin is also a palliative care specialist at Humboldt Center for New Growth.

Targeted palliative care enhances outcomes in advanced cancer Physician's Weekly; 7/15/24 ... Excessive polypharmacy is common in patients with cancer, especially older adults. According to a 2023 study published in Cancer, up to 80% of older patients take five or more medications, and up to 40% take 10 or more. Patients who receive numerous medications as part of supportive care may be at increased risk for potentially inappropriate medications and drug-drug interactions, which could impact their QOL. The study authors emphasized the importance of meaningful screening and interventional tools to optimize the use of medications for palliative care in these patients. In a more recent study published in the Journal of Clinical Oncology, Giusti Raffaele, MD, and colleagues aimed to streamline pharmacotherapy by targeting the most impactful symptom.

Optum to pay $20M to settle improper prescription allegations Becker's Hospital Review; by Rylee Wilson; 6/28/24 OptumRx will pay $20 million to settle allegations it improperly dispensed some opioid medications, the Justice Department said June 27. The settlement resolves an investigation into if OptumRx improperly filled certain opioid prescriptions between 2013 and 2015. The Justice Department alleged the pharmaceutical benefit manager improperly dispensed opioids in combination with other drugs, including benzodiazepines and muscle relaxants, from its mail-order pharmacy operations in Carlsbad, Calif. Opioids prescribed alongside benzodiazepines and muscle relaxants are commonly referred to as "trinity" prescriptions. These prescriptions raise red flags that the drugs may not be for legitimate medical use, and could lead to the diversion of controlled substances, the Justice Department said. In its investigation, the department alleged OptumRx dispensed trinity prescriptions without resolving red flags. OptumRx does not admit liability as part of the settlement.

The 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...

Of Mice and Meaning: Multidisciplinary perspectives on the interconnectedness of pain, stress, and suffering The Free Library; by Claire Woodward and Taylor Woodward, Indiana University Bloomington; 6/13/24 ... We are siblings and scholars from seemingly disparate disciplines (one in humanities and one in neurobiology), yet we are both engaged in work to understand--and ultimately alleviate--various facets of pain and suffering. We currently work in two different laboratories at the same institution (Indiana University). Taylor works in a lab with mice and Claire works in a lab on storytelling. Our scholarship includes interpreting reactions to pain, stress, and suffering, both felt and observed, behavioral and aesthetic. Such observations provide further insights into understanding how the mind and the brain process pain and suffering. ...

Navigating the complexities of palliative care for patients with comorbidities and complicated symptomsPharmacy Times; 6/6/24In an interview with the Pharmacy Times, Justin Kullgren, PharmD, FAAHPM, Palliative Medicine Clinical Pharmacist Specialist and PGY2 Pain Management & Palliative Care Residency Program Director at The Ohio State University Wexner Medical Center, James Cancer Hospital, shares insights into palliative care and common challenges faced by pharmacists treating patients with complicated symptoms. He discusses the complex nature of patient cases in palliative care, emphasizing the importance of effective treatment management, pain tolerance, and overcoming patient barriers to treatment.

Controversial conversations: Key takeaways from The Jeffrey Fudin Debates on pain and palliative care practices Pharmacy Times; Interview with Lee Kral, PharmD, FASHP, NBC-HWC, CPMC, CPE; 6/5/24In an interview with the Pharmacy Times®, Lee Kral, PharmD, FASHP, NBC-HWC, CPMC, CPE, clinical pharmacy specialist of pain management at the University of Iowa Hospitals and Clinics, shares her insights into pain management in palliative care for patients with cancer-related chronic pain. She highlights the crucial role of pharmacists in managing patient treatment regimens, including administration of opioids, the role of off-label prescribing, and the potential of deprescribing to improve patients’ quality of life. 

ASCO updates Guidelines on Palliative Care Hematology Adviosor; by Jen Smith; 5/30/24 The American Society of Clinical Oncology (ASCO) has released an update to its guidelines on palliative care for cancer patients. The guidelines and related information were published in the Journal of Clinical Oncology and JCO Oncology Practice. To develop updated recommendations for integrating palliative care into cancer care, an expert panel reviewed randomized controlled trials, systematic reviews, and meta-analyses published during 2015-2023. Based on their findings, the experts recommend that patients with advanced cancer be referred to specialized interdisciplinary palliative care teams soon after diagnosis, while the patients are still receiving active cancer treatment.

‘We don’t talk about death’: Winston-Salem journalist seeks to help people understand dying, deathbed visions Fox 8 WGHP - High Point, NC; by Bob Buckley; 5/29/24 There may not be anything that fascinates people more than death. It may be the thing many people avoid confronting the most. “In our culture, we’re pretty separated from death. And I don’t know the figures, but the vast majority … take place in hospitals. We don’t talk about death a lot in our culture,” said Phoebe Zerwick, a journalist based in Winston-Salem who recently wrote about deathbed visions for the New York Times Magazine. ... Zerwick became aware of the work of Dr. Christopher Kerr. ... “The biggest difference between hallucinations and these experiences is how the person is made to feel,” Dr. Kerr said. “Most hallucinations leave the person distressed and agitated and would be further confused. These experiences bring comfort. They bring meaning. They’re drawn from life. They really validate the life.” ... “I think the moral of the story is to be present and to be present with people when they are terminally ill. Be present when they’re dying,” Zerwick said.