Literature Review

Place of care in the last three years of life for Medicare beneficiariesBMC Geriatrics, by Haiqun Lin, Irina B. Grafova, Anum Zafar, Soko Setoguchi, Jason Roy, Fred A. Kobylarz, Ethan A. Halm & Olga F. Jarrín; 1/25/24Most older adults prefer aging in place; however, patients with advanced illness often need institutional care. Understanding place of care trajectory patterns may inform patient-centered care planning and health policy decisions. The purpose of this study was to characterize place of care trajectories during the last three years of life.

Specialist palliative care use and end-of-life care in patients with metastatic cancerJournal of Pain and Symptom Management, by May Hua MD, MS; Ling Guo MS; Caleb Ing MD, MS; Deven Lackraj MPH; Shuang Wang PhD; R. Sean Morrison MD; 1/24/24For patients with advanced cancer, high intensity treatment at the end of life is measured as a reflection of the quality of care. Use of specialist palliative care has been promoted to improve care quality, but whether its use is associated with decreased treatment intensity on a population-level is unknown. On a population-level, use of specialist palliative care was associated with improved metrics for quality end-of-life care for patients dying with metastatic cancer, underscoring the importance of its integration into cancer care.

Healthcare contact days among older adults living with dementiaJournal of the American Geriatrics Society, by Emma D. Chant PhD; Christine S. Ritchie MD, MSPH; E. John Orav PhD; Ishani Ganguli MD, MPH; 1/23/24For older adults with dementia and their care partners, accessing health care outside the home involves substantial time, direct and indirect costs, and other burdens. While prior studies have estimated days spent by these individuals in or out of hospitals and nursing homes, ambulatory care burdens are likely substantial yet poorly understand. Therefore, we characterized “health care contact days”—days spent receiving ambulatory or institutional care—in this population. Older adults with dementia spent 31 days a year accessing care which was mostly ambulatory.Publisher's note: Also see Health care contact days among older adults in Traditional Medicare.

Saturday NewslettersResearch literature is the focus of Saturday newsletters - enjoy!

Criteria for enrollment of patients with COPD in palliative care trials: A systematic reviewJ Pain Symptom Manage, by Natalia Smirnova, Allison V Lange, Amanda Glickman, Kristen Desanto, Cara L McDermott , Donald R Sullivan, David B Bekelman, Dio Kavalieratos; 1/25/24Context: Use of palliative care interventions in chronic obstructive pulmonary disease (COPD) has increased in recent years and inclusion criteria used to identify patients with COPD appropriate for palliative care vary widely. We evaluated the inclusion criteria to identify ways to improve enrollment opportunities for patients with COPD.

Groundbreaking research by PFF scholarsPulminary Fibrosis Foundation; 1/22/24The Pulmonary Fibrosis Foundation (PFF), the nation’s leading pulmonary fibrosis research, advocacy, and education organization has announced five awardees for the 2023 cycle of PFF Scholars who will receive funding for their cutting-edge research. ... “The most recent PFF Scholars class is tackling some of the most urgent questions about pulmonary fibrosis,” said Scott Staszak, PFF Chief Operating Officer. “Our goal is to accelerate the Scholars’ research and support them in securing more substantial grants for their impactful work.”

The Better Care Plan: a blueprint for improving America's healthcare systemHealth Affairs Scholar, by Stephen M Shortell, John S Toussaint, George C Halvorson, Jon M Kingsdale, Richard M Scheffler, Allyson Y Schwartz, Peter A Wadsworth, Gail Wilensky; 7/23The United States falls far short of its potential for delivering care that is effective, efficient, safe, timely, patient-centered, and equitable. We put forward the Better Care Plan, an overarching blueprint to address the flaws in our current system. The plan calls for continuously improving care, moving all payers to risk-adjusted prospective payment, and creating national entities for collecting, analyzing, and reporting patient safety and quality-of-care outcomes data. A number of recommendations are made to achieve these goals.Publisher note: From "The Best of Health Affairs Scholar 2023".

Navigating stress in the Pediatric Intensive Care Unit among parents of children with severe neurological impairmentJ Pain Symptom Manage, by Jori F. Bogetz, MD; Justin Yu, MD, MS; Ellie Oslin, BA; Krysta S. Barton, PhD, MPH; Joyce P. Yi-Frazier, PhD; Robert Scott Watson, MD, MPH; Abby R. Rosenberg, MD, MA, MS; 12/23This qualitative study of 15 parents of children with severe neurological impairment highlights various ways parents and family caregivers navigate stress in the pediatric intensive care unit, including both self-activation and letting go, with the most reported practices being advocating for their child and being supported by compassionate clinicians.

Grief training in palliative care fellowshipsJournal of Pain & Symptom Management, by Sara A. Barlow, MD; Meghan Price, MD; Christopher A. Jones, MD; Carl Pieper, DrPH; Anthony N. Galanos, MD; 1/24No prior study has assessed grief and bereavement curriculum in Hospice and Palliative Medicine (HPM) fellowship programs in the United States. ... Most palliative care programs were academic (74%) and had four or fewer fellows (85%). 90% devoted a minority (0%–10%) of their curriculum to grief and bereavement training. Most programs reported at least some program-led grief and bereavement programming (69%); however, 53% endorsed that fellows are not very or not at all involved in this programming. 

Saturday NewslettersResearch literature is the focus of Saturday newsletters - enjoy!

Journal of Aid-in-Dying MedicineAmerican Clinicians Academy on Medical Aid in Dying has begun a new journal; 12/23.The Journal of Aid-in-Dying Medicine is an independent, peer-reviewed journal focused on the clinical aspects of aid-in-dying care in the United States. Articles published in the Journal cover a wide range - from academically-detailed investigations to editorials and review articles, from poetry to photography/art. Authors will include clinicians ranging from doctors to doulas, pharmacists to chaplains, nurses to trained end-of-life volunteers.

Improving the value of serious illness careInnov Aging, by Brystana Kaufman; 12/23My Health and Aging Policy Fellowship placement with CMMI provides an opportunity to learn about the current policies impacting palliative care payment and process for developing new models. Palliative and hospice care has been one of the fasting growing health services in the U.S. and the VA over the past decade. Although Medicare’s hospice benefit requires a 6-months life expectancy, palliative care may be appropriate for seriously ill individuals depending on their clinical and psychosocial needs...

Mobile application–based communication facilitation platform for family members of critically ill patients: A randomized clinical trialJAMA Network, by Christopher E. Cox, MD, MPH; Deepshikha C. Ashana, MD, MBA, MS; Isaretta L. Riley, MD, MPH; Maren K. Olsen, PhD; David Casarett, MD; Krista L. Haines, DO; Yasmin Ali O’Keefe, MD; Mashael Al-Hegelan, MD, MBA; Robert W. Harrison, MD; Colleen Naglee, MD; Jason N. Katz, MD, MHS; Hongqiu Yang, PhD; Elias H. Pratt, MD; Jessie Gu, MD; Katelyn Dempsey, MPH; Sharron L. Docherty, RN, PNP, PhD; Kimberly S. Johnson, MD; 1/24Can a mobile application–based primary palliative care intervention targeting intensive care unit (ICU) physicians and family members improve unmet palliative care needs overall, and are there different outcomes by race? Findings suggest that a mobile application is a promising primary palliative care intervention for ICU clinicians that directly addresses the limited supply of palliative care specialists.