Literature Review

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).

Description 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.

Subcutaneous 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.

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. 

Study testing new strategy for spotting, managing pain in dementia patients McKnights Long-Term Care News, by Kimberly Marselas; 2/1/24Up to 80% of dementia patients living in nursing homes also experience pain, but many struggle to communicate their symptoms. A new, $2.1 million study aims to test recently revised guidelines for staff members tasked with detecting and managing that pain. ... Barbara Resnick, PhD, RN, professor and associate dean for research at the University of Maryland School of Nursing, will lead the project at 12 nursing homes over the next five years.

A pathophysiological approach for selecting medications to treat nociceptive and neuropathic pain in servicemembersMil Med, by Khan Thi Nguyen, Daniel W Beauchamp, Reginald B O'Hara; 1/31/24The prevalence of chronic pain of service members (SMs) in the U.S. is estimated to be higher (roughly 31-44%) compared to that of civilian population (26%). This higher prevalence is likely due to the high physical demands related combat and training injuries that are not immediately resolved and worsen over time. Mental Health America reports that chronic pain can lead to other mental health conditions such as severe anxiety, depression, bipolar disorder, and post-traumatic stress disorder.

Alternative therapies for pain management in senior careMedCity News, by Bent Philipson; by 1/30/24Chronic pain, an enduring concern for many older adults, is no longer confined to the traditional realm of pharmaceuticals. While traditional pain management methods like medication were once the go-to approach, alternative therapies are emerging as a viable and holistic approach to addressing this issue.

Ethical issues in pain and palliationCurr Opin Anaesthesiol, by Marco Cascella, Alessandro Laudani, Giuliana Scarpati, Ornella Piazza; 1/30/24Summary: Palliative care in the ICU should involve a multidisciplinary team, to mitigate patients suffering and futility. Providing spiritual support in the ICU is an important aspect of holistic patient care too. Increasingly sophisticated tools for diagnosing and treating pain, as those involving artificial intelligence, might favour disparities in access, cause informed consent problems, and surely, they need prudence and reproducibility. Pain clinicians worldwide continue to face the ethical dilemma of prescribing opioids for patients with chronic noncancer pain. Balancing the need for effective pain relief with the risk of opioid misuse, addiction, and overdose is a very controversial task.

Washington State reaches a nearly $150 million settlement with Johnson & Johnson over opioid crisisAP, by Manuel Valdes and Hallie Golden; 1/24/24The Washington state attorney general announced a $149.5 million settlement Wednesday with drugmaker Johnson & Johnson, more than four years after the state sued the company over its role in the opioid addiction crisis. “They knew what the harm was. They did it anyway,” Attorney General Bob Ferguson told reporters Wednesday. 

New research challenges the commonly held view that opioids are the most powerful pain relieversSciTechDaily, by University of Sydney; 1/21/24A University of Sydney-led study challenges the prevailing view of opioids as the most effective pain relievers for cancer, revealing significant evidence gaps and suggesting NSAIDs as a potential alternative. This research advocates for more informed choices in cancer pain management, emphasizing patient empowerment and the consideration of non-opioid options.

Northwestern researchers find significant racial disparities in pediatric health careThe Daily Northwestern, by Isaiah Steinberg; 1/21/24Despite controlling for health insurance status, researchers found vast disparities in health care quality in several pediatric specialties such as neonatal care, emergency medicine and palliative care. ... Researchers saw greatest disparity in care occurred in pain management, with non-white children less likely to be prescribed painkillers for serious medical conditions.