Literature Review

Center for Hospice Care's BreatheEazy Program supports patients with respiratory issues LaporteCounty.Life; by Garrett Spoor; 2/13/25 One of the toughest health challenges a person can face is the trouble of breathing. Center for Hospice Care comes across a lot of patients who experience this issue and encourages many of them to become a part of their BreatheEazy program. Dr. Karissa Misner, medical director at Center for Hospice Care, considers the BreatheEazy program to be a monumental boost for patients who might have respiratory issues. “This is a specialized pulmonary program for our patients with chronic obstructive pulmonary disease,” Misner said. “It can also be used for many other terminal diagnoses that affect the lungs. Whenever there is any type of illness that causes difficulty in breathing, we can utilize this program.”

Opioid painkillers less available to people of color HealthDay News / Coastal Breeze News, Marco Island, FL; 1/30/25 People of color now have less access to prescription opioid painkillers than white patients, an unintended consequence of efforts to stem America’s opioid epidemic. Communities of color have a 40% to 45% lower distribution of commonly prescribed opioids, compared to majority white communities, researchers reported in a study published Jan. 23 in the journal Pain. This could prevent opioid painkillers from reaching those in true need of them, like cancer patients, researchers said. 

DEA proposed telemedicine prescribing rule could burden hospice physicians and hospice operations Morgan Lewis, Washington, DC; by Howard J. Young, Jacob J. Harper, and Roshni Edalur; 1/27/25 Signaling a possible future approach to regulating Schedule II-V prescribing via telemedicine in lieu of in-person examinations, on January 17 the DEA issued a notice of proposed rulemaking regarding its next iteration of controlled substance prescribing controls. With comments due March 18, 2025, the Proposed Rule is not subject to the Trump administration’s executive order freeze on new proposed regulations. [Click on the title's link to continue reading.]

Transforming care: Spencer Health Solutions and Pharmerica partner to simplify medication management and improve lives The MarCom Journal, Morrisville, NC; by Leigh White, PharMerica and Daphne Earley, Spencer Health Solutions; 1/21/25In a move set to redefine how medication is managed, Spencer Health Solutions (SHS), a leader in innovative healthcare technology, and PharMerica, one of the nation’s largest and most trusted long-term care pharmacy services provider, are joining forces. This transformative partnership aims to make managing medications easier and more reliable for individuals with complex medication needs, senior living communities, and payers nationwide. ... Spencer Health Solutions (SHS) is dedicated to transforming medication management through innovative healthcare technology. ... PharMerica ... serves the long-term care, senior living, hospital, home infusion, hospice, behavioral, specialty and oncology pharmacy markets. 

Lobbying groups unite to form US Cannabis Roundtable MJBiz; by MJBizDaily Staff; 1/16/25 The National Cannabis Roundtable and the U.S. Cannabis Council – two large lobbying groups that advocate on behalf of the state-regulated marijuana industry in Washington, D.C. – are merging to form the US Cannabis Roundtable. The unified group represents marijuana multistate operators such as Cresco Labs, Curaleaf Holdings, Green Thumb Industries, Trulieve Cannabis Corp. and Verano Holdings as well as single-state operators, according to a [recent] news release. 

Methadone in cancer-related neuropathic pain: A narrative reviewCurrent Oncology; Faten Ragaban, Om Purohit, Egidio Del Fabbro; 12/24The unique mechanisms of action and preliminary clinical trials support methadone's status as the first opioid to consider for CRNP [cancer-related neuropathic pain] when non-opioid first-line treatments have failed to alleviate patient symptoms. Methadone can also be considered as a first-line opioid in patients with mixed nociceptive-neuropathic pain and any of the following features: renal dysfunction; administration of opioids through a feeding tube; a lack of financial resources/insurance; and a switch from another high-dose opioid. More research is needed regarding methadone for CRNP and methadone's preferential use in specific sub-groups of patients.

[KY] Attorney General Russell Coleman files lawsuit against Optum Rx for role in opioid epidemic Northern Kentucky Tribune - Kentucky Center for Public Service Journalism; 12/1/24 The Kentucky Attorney General’s Office has announced its latest lawsuit against a corporation behind the worst man-made epidemic in modern medical history. Attorney General Russell Coleman added Optum Rx and its affiliates to the list of those responsible for the opioid crisis. ... According to the Attorney General’s lawsuit, Optum Rx played a central role in the reckless promotion, dispensing, and oversupply of opioids. ... “Defendants have hidden their conduct through non-transparent business practices and by requiring each entity with whom they conduct business, such as opioid manufacturers, to enter into confidentiality agreements or otherwise keep their agreements confidential,” said the lawsuit. “No state has been harder hit by the drug crisis than Kentucky. Last year alone, nearly 2,000 Kentuckians died of a drug overdose,” Attorney General Coleman said. “These groups pushed a profit-fueled agenda at the expense of Kentucky families, who are left with empty seats at the dinner table. Our Office will continue to hold those behind the drug crisis accountable for their devastating actions.”

The power of collaboration: Pharmacists and nurses partner to enhance patient care American Society of Health-System Pharmacists (ASHP) News Center; by Karen Blum; 9/23/24 Pharmacists and nurses work together on today's most pressing health challenges - from managing heart failure to deprescribing in palliative care to tackling obesity in pre-transplant patients. The Collaborative Care Grant for Nurses and Pharmacists from the ASHP Foundation and American Nurses Foundation recognizes the potential impact of this interdisciplinary teamwork on improving healthcare outcomes. At UPMC Presbyterian Hospital, the grant program helped fund the creation of a medication optimization clinic (MOC) for those with heart failure with reduced ejection fraction. “It made a lot of sense to bring together our collective expertise to manage these patients to get them on more optimal medications,” said James Coons, a clinical pharmacist in cardiology at UPMC Presbyterian Hospital. Coons, an ASHP member and professor at the University of Pittsburgh School of Pharmacy, worked with nurse practitioner and longtime collaborator, Jennifer Kliner, on the project.

Novel drug treatments for pain in advanced cancer and serious illness: a focus on neuropathic pain and chemotherapy-induced peripheral neuropathyPalliative Care and Social Practice; by Mellar P Davis; 7/24This review will discuss haloperidol, miragabalin, palmitoylethanolamide (PEA), and clonidine as adjuvant analgesics or analgesics. Haloperidol [demonstrates] ... only low-grade evidence that [it] improves pain when combined with morphine, methadone, or tramadol in patients who have cancer, pain from fibrosis, radiation necrosis, or neuropathic pain. Miragabalin is a gabapentinoid approved for the treatment of neuropathic pain ... [and] in randomized trials, patients with diabetic neuropathy have responded to miragabalin. Multiple randomized trials and meta-analyses have demonstrated PEA's effectiveness in reducing pain severity arising from diverse pain phenotypes. Intravenous clonidine has been used in terminally ill patients with poorly controlled symptoms, in particular pain and agitation.

Integration of palliative pharmacists to elevate oncologic care Pharmacy Times; by Alexis Beachy, PharmD and Jessica Geiger, PharmD, MS, BCPS; 8/20/24... Conclusion: This case demonstrates several aspects of care palliative pharmacists can assist with, though it is certainly not all-encompassing. All things considered, pharmacists are an essential asset of the palliative team. Their experience further enriches the interdisciplinary team and grants all patients and families many benefits. Specifically, patients receiving oncologic care benefit from collaboration with a palliative care pharmacist. In addition to offering a more individualized and holistic approach to care, palliative pharmacists can also provide patients with quicker and improved symptom management, which often improves quality of life and may also increase survival rates.Editor's Note: This article provides excellent history, definitions, and descriptions of the pharmacist's significant role in providing expert palliative and hospice care.

Pain patients aren’t 'drug users': Exposing a dangerous myth American Council on Science and Health; by Cameron English; 7/18/24 Chronic pain patients who take opioids under medical supervision are fundamentally different from recreational users who take drugs to get high. In their bid to destigmatize and legalize drugs, some drug policy reformers have attempted to blur this clear distinction. [Read case study of a hospice patient who was denied pain meds for longterm conditions, and was put on an opioid for which she had informed the hospice that she could not tolerate. Access to talking with her physician was denied. Result: She changed to a different hospice.]

Pain management in the wake of the opioid crisis Forbes; by Web Golinkin; 7/15/24 Pain is the single most frequent reason for patient visits in the United States. An estimated 20 percent of adults experience chronic pain, and nearly seven percent experience a level of chronic pain that limits their daily activities. However, most doctors and other healthcare professionals have very little education in pain management, according to Scott Fishman, MD, an internationally recognized expert in pain management, ... This lack of education was one of the main causes of the Opioid Crisis, Fishman says ... of the part of the crisis that was caused by the over-prescribing of opioids, many clinicians have become so wary of the medical-legal issues surrounding pain management that they have gone from an overly liberal approach to a restrictive one in which some prescribers are effectively abandoning patients who need to have their symptoms treated. Both extremes are frequently fueled by lack of knowledge and training, according to Fishman. ... The solution is to close the education gap ...

Aligning pill burden and palliative care needs in late-stage CVD: AHA TCTMD - Cardiovascular Research Foundation; by L.A. McKeown; 7/2/24 The first scientific statement from the American Heart Association (AHA) that focuses specifically on pharmacotherapy considerations in the palliative management of patients with CVD [cardiovascular diesease] urges a patient-centered, compassionate approach to de-escalating and deprescribing. ... In addition to shedding light on how and when to start deprescribing and de-escalating common cardiovascular drugs, the statement discusses palliative drugs for pain, shortness of breath, and appetite in the context of CVD, which [Katherine E.] Di Palo [PharmD (Montefoiore Medical Center, NY)] said the committee identified as a gap in knowledge given that much of the evidence for these drugs comes from patients with serious illnesses like cancer. ... Important Takeaways: Di Palo and colleagues note that palliative care complements cardiovascular care in several important ways, including reducing physical symptom burden, managing emotional and spiritual distress, providing sufficient support for caregivers, and helping patients choose treatment in line with their goals for care. Editor's Note: Click here for the American Heart Association's statement, which we posted on 7/2/24.