Literature Review

Palliative medicine fellows’ discussions, perceptions, and training regarding medical cannabisJournal of Pain and Sympotom Management, by Dylan R. Sherry MD, Rushad Patell MD, Harry J. Han MD, Laura E. Dodge ScD MPH, Ilana M. Braun MD, Mary K. Buss MD MPH; 2/27/24Medical cannabis is increasingly considered for palliation of pain, nausea/vomiting, anorexia, and other symptoms. We aimed to determine whether training in hospice and palliative medicine (HPM) adequately prepares fellows to counsel patients about medical cannabis.

Ethics at the end of life in the newborn intensive care unit: Conversations and decisionsSeminars in Fetal and Neonatal Medicine, by Mark R. Mercurio, Lynn Gillam; 6/23The unexpected birth of a critically ill baby raises many ethical questions for neonatologists. Some of these are obviously ethical questions, about whether to attempt resuscitation, and, if the baby is resuscitated and survives, whether to continue life sustaining interventions. Other ethical decisions are more related to what to say rather than what to do. Although less obvious, they are equally as important, and may also have far-reaching ramifications... This may serve as a helpful guide for ethical deliberation, and helpful scripting for parental discussion, in similar cases.

What aspects of quality of life are important from palliative care patients’ perspectives? A framework analysis to inform preference‑based measures for palliative and end‑of-life settingsThe Patient - Patient-Centered Outcomes Research, by Nikki McCaffrey, Julie Ratcliffe, David Currow, Lidia Engel, Claire Hutchinson; 11/23Existing, popular, preference-based outcome measures such as the EQ-5D do not incorporate the most important, patient-valued, quality-of-life domains in the palliative and end-of-life settings. Development of a new, more relevant and comprehensive preference-based outcome measure could improve the allocation of resources to patient-valued services and have wide applicability internationally.

Drugs, delirium, and ethics at the end of lifeJournal of the American Geriatric Society, by Columba Thomas, MD; Yesne Alici, MD; William Breitbart, MD; Eduardo Bruera, MD; Liz Blackler, MBE, LCSW-R; Daniel P. Sulmasy MD, PhD; 1/24For older persons with delirium at the end of life, treatment involves complextrade-offs and highly value-sensitive decisions. The principles of beneficence,nonmaleficence, respect for autonomy, and justice establish important parametersbut lack the structure necessary to guide clinicians in the optimal management ofthese patients. We propose a set of ethical rules to guide therapeutics—the canonsof therapy—as a toolset to help clinicians deliberate about the competing concernsinvolved in the management of older patients with delirium at the end of life.

Disparities in the geographic distribution of palliative care specialists in 2022Journal of General Internal Medicine, by Julia L Frydman, Karen McKendrick, Yingtong Chen, Jonathan Wun, Nathan E Goldstein, R Sean Morrison, Laura P Gelfman; 2/12/24In 2022, the number of HPM board-certified clinicians was 8,935 (6,448 = physicians (72.2%); 2,487 = NPs (27.8%)), which represents 0.7% of the NP workforce and 0.6% of the physician workforce... Our study highlights the uneven geographic distribution of board-certified HPM clinicians, which depends on state, metropolitan status, and area-level SES. 

Kim Mooney-Doyle awarded nearly $500,000 to study communication needs in families of seriously ill childrenThe Elm of the University of Maryland, by Mary Therese Phelan; 2/15/24Kim Mooney-Doyle, PhD, RN, CPNP-AC, assistant professor at the University of Maryland School of Nursing (UMSON), has been awarded a two-year R21 grant of $460,000 from the National Institute of Nursing Research (NINR) to research how understanding family communication during serious pediatric illness, from the perspective of adolescent siblings and parents, provides opportunities to prevent long-term distress.

Palliative sedation: ethics in clinical practice guidelines - systematic reviewBJM Supportive & Palliative Care, by Martyna Tomczyk, Cécile Jaques, Ralf J Jox; 8/23Effective cooperation between palliative care clinicians and ethicists should be encouraged, in order to integrate in particular the crucial ethical issues of continuous deep sedation until death when developing or updating clinical practice guidelines on palliative sedation.

Perspectives on transfusions for hospice patients with blood cancers: A survey of hospice providersJournal of Pain and Symptom Management, by Helen P Knight, Caitlin Brennan, Susan Lysaght Hurley, Anna J Tidswell, Melissa D Aldridge, Kimberly S Johnson, Edo Banach, James A Tulsky, Gregory A Abel, Oreofe O Odejide; 1/24We received 113 completed surveys (response rate = 23.5%). Of the cohort, 2.7% reported that their agency always offers transfusions, 40.7% reported sometimes offering transfusions, and 54.9% reported never offering transfusions... Most respondents (76.6%) identified lack of transfusion access in hospice as a barrier to hospice enrollment for blood cancer patients. The top intervention considered as "very helpful" for increasing enrollment was additional reimbursement for transfusions (72.1%).

Alzheimer's Disease and Related Dementias: Caregiver perspectives on hospice re-enrollment following a hospice live dischargeJournal of Palliative Medicine, by Stephanie P Wladkowski, Susan Enguídanos; 10/23Three-quarters of participants (n = 16) would consider re-enrolling their loved one in hospice. However, some believed they would have to wait for a medical crisis (n = 6) to re-enroll, while others (n = 10) questioned the appropriateness of hospice for patients with Alzheimer's disease and related dementias if they cannot remain in hospice care until death.

Patient Focus: When Should People With Heart Failure Who Were Admitted to the Hospital Think About Palliative or Hospice Care? An Explanation of “Factors Associated with Mortality and Hospice Use Among Medicare Beneficiaries With Heart Failure Who Received Home Health Services”Journal of Cardiac Failure, by Spencer Carter, MD; Jennifer T. Thibodeau, MD, MSCS; 12/23Hospital stays for patients with heart failure are serious events that mean that the heart may be sicker. Some people with heart failure who are in the hospital are at higher risk of dying within 6 months after their hospital stay. This study describes differing characteristics of people who might be at higher risk of death and who may benefit from palliative or hospice care to better support them.Publisher's note: Also see https://onlinejcf.com/article/S1071-9164(23)00922-3/abstract. 

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

Are hospice Google ratings correlated with patient experience scores? Evidence from a national hospice studyAmerican Journal of Hopsice and Palliative Care, by Ganisher Davlyatov, Mengying He, Gregory Orewa, Haiyan Qu, Robert Weech-Maldonado; 2/22Choosing hospice care for your loved ones is often challenging. Online ratings such as Google rating has become a go-to source for most consumers. Hospice Google ratings were highly correlated with patients' and families' experience scores as measured by the CAHPS survey.

Participant safety in multisite, randomized, double-blind, placebo-controlled clinical trials in hospice/palliative care: Data from the contracted studies of the Australian National Palliative Care Clinical Studies CollaborativeJournal of Palliative Medicine, by David C. Currow, Belinda Fazekas, Linda Brown, Slavica Kochovska, Katherine Clark, Meera R. Agar; 1/24Controversies surround conduct of phase III clinical trials in palliative care... These studies are safe for participants and generate knowledge to support informed patient decision making.