Literature Review

AI could play role in preventing prescribing of unnecessary drugs in older adults McKnights Senior Living, by Kristen Fischer; 4/22/24 A new study finds that artificial intelligence could encourage doctors to stop prescribing drugs that aren’t necessary — especially in older adults, who tend to be on multiple medications. The report was published 4/18 in the Journal of Medical Systems. More than 40% of older adults are taking five or more prescription medications, a rate that raises their risk for potentially harmful drug interactions. ... AI isn’t a perfect tool compared with having an actual doctor. For instance, it tended not to pay much attention to a person’s pain level, suggesting that the patient stop taking pain medications but not others for clinical ailments such as high cholesterol or high blood pressure, the authors reported.

Comparative effectiveness of acupuncture vs massage for relieving pain in patients with advanced cancer The ASCO Post; by Jun J. Mao, MD, MSCE and Andrew S. Epstein, MD; 4/17/24... The IMPACT study was conducted at Memorial Sloan Kettering Cancer Center and regional sites in New York, New Jersey, and Florida to evaluate the long-term comparative effectiveness of acupuncture vs massage for pain in patients with advanced cancer. ... The primary outcome—change in worst pain intensity score from baseline to 26 weeks—was measured using the Brief Pain Inventory (BPI ranging from 0–10; higher numbers indicate worse pain intensity or interference). The secondary outcomes included fatigue, insomnia, and quality of life. ... To use these therapies, it is important to seek credentialed practitioners who have training or experience in working with patients who have cancer. 

‘We’re the telescope looking forward’: Medical ethicists ask tough questions as part of $66 million research project CU Department of Medicine, by Mark Harden; 4/5/24 In the original “Jurassic Park” movie, after the process of bringing dinosaurs back to life is explained to a team of consultants, one of them voices a warning: “Your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should.” University of Colorado Department of Medicine faculty members will be asking the “should” question years before there’s an answer to “could.” They’ve joined in a nationwide study of whether tiny, battery-powered electric devices and genetic material, swallowed in capsule form, could one day replace surgery or injections as treatments for metabolic diseases such as diabetes and obesity.

Cancer patients often want ‘one more round.’ Should doctors say no? The Washington Post, by Mikkael A. Sekeres, MD; 3/31/24 My patient was in his early 30s and his leukemia had returned again following yet another round of treatment. He was a poster child for the recently reported rise in cancer rates in the young, and had just asked me what chemotherapy cocktail I could devise for him next, to try to rid him of his cancer. I hesitated before answering. Oncologists are notorious for always being willing to recommend to our patients one more course of treatment, even when the chances of success are negligible.  

Expanding the use of continuous sedation until death and physician-assisted suicide  The Journal of Medicine & Philosophy: A Forum for Bioethics and Philosophy of Medicine; by Samuel H Lipuma and Joesph P Demarco; 3/27/24 The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. 

Partners In Care sets sights on service diversification, hospice-pharmacy partnership Hospice News, by Jim Parker; 3/22/24 Hospice providers need to evolve with their changing patient populations and the larger health care system, according to Greg Hagfors, CEO of Partners In Care. The Oregon-based hospice, palliative care and home health provider recently celebrated the 45th anniversary of its founding, which preceded the establishment of the Medicare Hospice Benefit. ... Hospice News recently spoke with Hagfors about the ways the industry has changed since Partners In Care came on the scene — and how it is moving towards the future.

Health care utilization and opioid use in patients receiving an integrated palliative care intervention for treatment of head and neck cancer compared to a historical control Elsevier, International Journal of Radiation; by F. Rizwan. C. D'Avella, M. Albert, T. King, B. Egleston, T.J. Galloway, M. Chwistek, C. Fang, A. El-jawahri, J.R. Bauman; online access for 4/1/24 release Patients receiving chemoradiation therapy (CRT) for head and neck cancer (HNC) can develop significant symptomology (odynophagia, malnutrition) resulting in frequent hospitalizations and decreased quality of life (QOL) and continue to have chronic symptoms such as dysphagia and/or pain. The integration of a palliative care (PC) team during CRT has the potential to address the high symptom burden and improve QOL.

Preventing adverse drug events in hospice care Hospice News, by Holly Vossel; 3/15/24 Documentation errors and a fragmented health system pose the greatest risks for adverse drug events among hospices. ... Evaluating these risks involves having solid medication reconciliation processes in place — both at the time of a patient’s admission and throughout their end-of life care experience, according to Mary Lynn McPherson, professor and executive program director of advanced post-graduate education in palliative care at the University of Maryland’s School of Pharmacy. McPherson also serves on the board of the American Academy of Hospice and Palliative Medicine (AAHPM).

ACC updates HFrEF Decision Pathway, reinforcing the Four Pillars of Therapy

Pharmacy associations join forces to advocate for pharmacists during change healthcare outageNewswire Press Release; 3/3/24 Association executives from the American Pharmacists Association (APhA), the National Community Pharmacists Association (NCPA), the National Alliance of State Pharmacy Associations (NASPA), and the American Society of Consultant Pharmacists (ASCP) released an open letter to pharmacy benefit manager (PBM) executives and other insurance payers whose systems may have been impacted by the Change Healthcare outage. Pharmacists and pharmacies are asking for assurances that claims fulfilled during this outage will be paid, and paid in a timely manner, considering the challenges faced by pharmacies and pharmacists with predicting co-payments and determining eligibility and coverage. 

Reimagining end-of-life care: Balancing polypharmacy, treatment modification, and quality of life in advanced cancer patientsBNN, by Mahnoor Jehangir; 2/15/24In a recent groundbreaking study, researchers have illuminated the complexities surrounding polypharmacy and the prescription of potentially inappropriate medications (PIMs) to patients at the end of their lives, particularly those battling advanced cancer. This investigation, involving a cohort of 265 older adults, sheds light on the nuanced challenges and critical decisions faced by healthcare providers in managing the delicate balance between treatment efficacy and quality of life for terminally ill patients. 

Palliative care’s psychedelic futuretruthdig, by Jane C. Hu; 2/14/24In Oregon, hospice doctors are expanding the menu of treatments for end-of-life anxiety and depression.

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.