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American Journal of Hospice & Palliative Care

Muni Rubens, Venkataraghavan Ramamoorthy, Anshul Saxena, Sankalp Das, Sandeep Appunni, Sagar Rana, Brittany Puebla, Deborah T Suarez, Mariana Khawand-Azoulai, Suleyki Medina, Ana Viamonte-Ros
BACKGROUND: Although palliative care services are increasing in the United States, disparities exist in access and utilization. Hence, we explored these factors in hospitalized patients with advanced cancers using the National Inpatient Sample (NIS). METHODS: This was a retrospective analysis of NIS data, 2005 to 2014, and included patients ≥18 years with advanced cancers with and without palliative care consultations. Both χ2 and independent t tests were used for categorical and continuous variables...
November 1, 2018: American Journal of Hospice & Palliative Care
Emma Nicholson, Tara Murphy, Philip Larkin, Charles Normand, Suzanne Guerin
BACKGROUND: Effective palliative care requires a strong evidence base to advance clinical practice and policy-making. Calls for more collaborative and strategic approaches to research have resulted in the development of research networks at national and wider regional levels. AIM: The aim was to synthesize the learning arising from the activities of the Palliative Care Research Network from the island of Ireland, in order to identify the overarching messages from these activities...
October 25, 2018: American Journal of Hospice & Palliative Care
Jan Tse Liu, Iris Kovar-Gough, Nabila Farabi, Frank Animikwam, Sarah Beth Weers, Julie Phillips
BACKGROUND: Primary care physicians (PCPs) frequently have long-term relationships with patients as well as their families. As such they are well positioned to care for their patients at the end of their lives. As the number of patients in need of end-of-life care continues to grow, it is critical to understand how PCPs can fulfill that need. The purpose of our study is to perform a narrative review of the literature and develop a theoretical model delineating the overarching roles played by PCPs in caring for patients at the end of life...
October 24, 2018: American Journal of Hospice & Palliative Care
Jennifer Gabbard, Allison Jordan, Julie Mitchell, Mark Corbett, Patrick White, Julie Childers
The current opioid crisis in the United States is a major problem facing health-care providers, even at the end of life. Opioids continue to be the mainstay treatment for pain at the end of life, with the prevalence of pain reported in up to 80% of patients and tends to increase as one gets closer toward the end of life. In the past year, 20.2 million Americans had a substance use disorder (SUD) and SUDs are disabling disorders that largely go untreated. In addition, the coexistence of both a mental health and SUD is very common with the use of opioids often as a means of chemical coping...
October 23, 2018: American Journal of Hospice & Palliative Care
Hyejin Kim, Eliza M Park, Carrie Henry, Sandra E Ward, Mi-Kyung Song
BACKGROUND: Determining intervention efficacy depends as much on the control group as on the intervention, but little attention has been given to the control condition in psychoeducational trials in palliative care. OBJECTIVES: To examine (1) research practice regarding control conditions that are neither usual care nor no-treatment controls in randomized trials of psychoeducational palliative care interventions and (2) the rationale and completeness of the descriptions of control conditions in trial reports...
October 21, 2018: American Journal of Hospice & Palliative Care
Annelieke Damen, Dirk Labuschagne, Laura Fosler, Sean O'Mahony, Stacie Levine, George Fitchett
It is well accepted that attention to spiritual concerns is a core dimension of palliative care. It is similarly well accepted that chaplains are the spiritual care specialists who should address such concerns. However, what chaplains do when they provide care for patients and families is often poorly understood by their palliative care colleagues. Having a clear understanding of what chaplains do is important because it contributes to improved utilization of the spiritual care and other resources of the palliative care team and thereby to better care for patients and families...
October 18, 2018: American Journal of Hospice & Palliative Care
Giovanna Sirianni, Giulia Perri, Jeannie Callum, Sandra Gardner, Anna Berall, Debbie Selby
BACKGROUND: There remains limited data in the literature on the frequency, clinical utility and effectiveness of transfusions in palliative care, with no randomized controlled trials or clinical practice guidelines on this topic. There are no routinely accepted practices in place for the appropriate transfusion of blood products in this setting. AIM: The aim of this study was to retrospectively review all transfusions in the palliative care units of 2, tertiary care hospitals in Canada...
October 18, 2018: American Journal of Hospice & Palliative Care
Shelli L Feder, Janet P Tate, Kathleen M Akgün, Julie A Womack, Sangchoon Jeon, Marjorie Funk, Roger J Bedimo, Matthew J Budoff, Adeel A Butt, Kristina Crothers, Nancy S Redeker
BACKGROUND: The number of adults with heart failure (HF) and HIV infection is increasing. These patients may benefit from palliative care (PC). OBJECTIVES: Determine the association between HIV infection, other HIV characteristics, and PC among hospitalized patients with HF in the Veterans Health Administration (VHA). DESIGN: Nested case-control study of patients with HF hospitalized from 2003 to 2015 and enrolled in the Veterans Aging Cohort Study...
October 10, 2018: American Journal of Hospice & Palliative Care
Nai-Ching Chi, Soojeong Han, Emelia Barani, Debra Parker Oliver, Karla T Washington, Frances Marcus Lewis, Amy Walker, George Demiris
BACKGROUND: Family caregivers encounter many barriers to managing patients' pain in the home hospice setting. However, there are limited clinically applicable resources for hospice providers to help family caregivers identify and address these barriers. AIM: To develop a pain management manual for hospice providers to support family caregivers and conduct a preliminary providers' evaluation of the manual. DESIGN AND PARTICIPANTS: A pain management manual was developed and structured into 3 parts: (1) 5 common pain management case scenarios based on a secondary data analysis of a hospice clinical trial; (2) a list of suggested assessment questions and strategies for each case scenario was developed based on a caregiver framework; and (3) pain educational material was included from established clinical guidelines...
October 10, 2018: American Journal of Hospice & Palliative Care
Ariel Shalev, Veerawat Phongtankuel, M Carrington Reid, Sara J Czaja, Ritchell Dignam, Rosemary Baughn, Matthew Newmark, Holly G Prigerson, Jeanne Teresi, Ronald D Adelman
BACKGROUND: Although home hospice organizations provide essential care for and support to terminally ill patients, many day-to-day caregiving responsibilities fall to informal (ie, unpaid) caregivers. Studies have shown that caregivers value receiving clear information about end-of-life (EoL) care. Meeting the information needs of this group is critical in improving their experience in hospice. OBJECTIVES: To identify the information needs of informal home hospice caregivers...
October 9, 2018: American Journal of Hospice & Palliative Care
Katherine R Miller, Jai N Patel, James T Symanowski, Connie A Edelen, Declan Walsh
OBJECTIVE: Studies suggest acupuncture improves cancer-related symptoms; however, it is unclear whether patient characteristics predict pain response. This study determined acupuncture's effect on cancer-related pain and identified variables associated with pain response. METHODS: A retrospective chart review included adult patients with cancer referred to palliative medicine and received acupuncture for pain management. Paired t tests compared differences in pain scores from pre- to postacupuncture...
October 4, 2018: American Journal of Hospice & Palliative Care
Debra L Wiegand, Jooyoung Cheon, Giora Netzer
Withdrawal of life-sustaining therapy at the end of life is a complex phenomenon. Intensive care nurses and physicians are faced with caring for patients and supporting families, as these difficult decisions are made. The purpose of this study was to explore and describe the experience of critical care nurses and physicians participating in the process of withdrawal of life-sustaining therapy. A hermeneutic phenomenological approach was used to guide this qualitative investigation. Interviews were conducted with critical care nurses and physicians from 2 medical centers...
September 24, 2018: American Journal of Hospice & Palliative Care
Talal Hilal
No abstract text is available yet for this article.
September 19, 2018: American Journal of Hospice & Palliative Care
Anne Williams, Leah Sera, Mary Lynn McPherson
BACKGROUND: End-of-life (EOL) patients with dementia have an increased risk for anticholinergic toxicities due to age-related pharmacokinetic and physiologic changes in conjunction with an increased susceptibility to drug-induced cognitive impairments. Despite this well-documented risk, the use of drugs with anticholinergic properties (DAPs) remains prevalent in EOL patients with dementia. OBJECTIVE: The aims of this study were to describe prescribing patterns and characterize anticholinergic burden among hospice patients with dementia, as measured by the Anticholinergic Cognitive Burden (ACB) scale...
September 13, 2018: American Journal of Hospice & Palliative Care
Christopher Lemon, Michael De Ridder, Mohamed Khadra
BACKGROUND: Documentation rates of advance directives (ADs) remain low. Using electronic medical records (EMRs) could help, but a synthesis of evidence is currently lacking. OBJECTIVES: To evaluate the evidence for using EMRs in documenting ADs and its implications for overcoming challenges associated with their use. DESIGN: Systematic review of articles in English, published from inception of databases to December 2017. DATA SOURCES: PubMed, PsycINFO, EMBASE, and CINAHL...
August 30, 2018: American Journal of Hospice & Palliative Care
Leanna R Jaward, Thomas A O'Neil, Adam Marks, Michael A Smith
BACKGROUND: Corticosteroids are frequently utilized in the palliative care setting to combat symptoms such as fatigue, dyspnea, pain, weakness, anorexia, cachexia, nausea, and vomiting. Often times, adverse effects arise with corticosteroid use, and it is unclear whether switching to another corticosteroid would reduce the risk of specific adverse effects or what measures can be taken to alleviate the adverse effects. OBJECTIVE: This article aims to review the differentiating pharmacokinetics, potency, and adverse effect profiles of corticosteroids and summarize their clinical applicability...
August 30, 2018: American Journal of Hospice & Palliative Care
Brijesh Patel, Paul Secheresiu, Mahek Shah, Lekha Racharla, Ahmad B Alsalem, Manyoo Agarwal, Byomesh Tripathi, Naveen Sablani, Lohit Garg, Shantanu Patil, Nauman Islam, Daniel Ray, Modele O Ogunniyi, Ron Freudenberger
OBJECTIVE: To determine the rate and predictors of palliative care referral (PCR) in hospitalized patients with acute heart failure (AHF). INTRODUCTION: The PCR is commonly utilized in terminal conditions such as metastatic cancers. There is no data on trends and predictors from large-scale registry of general population regarding PCR in patients with AHF. METHODS: For this retrospective study, data were obtained from National Inpatient Sample Database from 2010 to 2014...
August 29, 2018: American Journal of Hospice & Palliative Care
Nabeel Chauhan, Syed F Ali, Yousef Hannawi, Archana Hinduja
BACKGROUND: A significant percentage of terminally ill patients are discharged to hospice care following a devastating stroke. OBJECTIVE: We sought to determine the factors associated with hospital discharge to hospice care in a large cohort of patients with stroke. METHODS: Using the institutional Get With The Guidelines-Stroke database, all consecutive patients with acute ischemic stroke (AIS) who were alive at discharge, from January 2009 until July 2015, were analyzed...
August 28, 2018: American Journal of Hospice & Palliative Care
Michael W Rabow, Marilyn McGowan, Rebecca Small, Redwing Keyssar, Hope S Rugo
BACKGROUND: Engaging patients in advance care planning (ACP) is challenging but crucial to improving the quality of end-of-life care. Group visits and multiple patient-clinician interactions may promote advance directive (AD) completion. OBJECTIVE: Facilitate ACP discussions with patients and caregivers and the creation of notarized AD's at a comprehensive cancer center. DESIGN: Two-session, nurse-led ACP workshops for patients and their family caregivers...
August 28, 2018: American Journal of Hospice & Palliative Care
Alexia M Torke, Susan E Hickman, Bernard Hammes, Steven R Counsell, Lev Inger, James E Slaven, Dawn Butler
BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) form is an advance care planning tool designed for seriously ill patients. The discussions needed for high-quality POLST decision-making are time intensive and often do not occur in the outpatient setting. OBJECTIVE: We conducted a single-arm feasibility study of POLST facilitation by nonphysicians using Respecting Choices Last Steps, a standardized, structured approach to facilitation of POLST conversations...
August 28, 2018: American Journal of Hospice & Palliative Care
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