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Journal of Palliative Medicine

Megan Johnson Shen, Holly G Prigerson, Ana I Tergas, Paul K Maciejewski
BACKGROUND: Little is known about disparities in end-of-life (EoL) care between U.S. immigrants and nonimmigrants. OBJECTIVE: To determine immigrant/nonimmigrant advanced cancer patient differences in receipt of values-inconsistent aggressive medical care near the EoL. DESIGN: Analysis of data from Coping with Cancer, a federally funded, prospective, multi-institutional cohort study of advanced cancer patients with limited life expectancies recruited from 2002 to 2008...
September 12, 2018: Journal of Palliative Medicine
Maya Katz, Yuika Goto, Benzi M Kluger, Nicholas B Galifianakis, Janis M Miyasaki, Jean S Kutner, Christopher A Jones, Steve Z Pantilat
Parkinson's disease (PD) affects 1%-2% of individuals older than 60 years and is the 14th leading cause of death in the United States. People with PD, across all stages of the disease, suffer from a significant symptom burden that includes many nonmotor symptoms (such as depression, fatigue, pain, and dementia), and most will ultimately die from complications of this degenerative and incurable illness. Even at diagnosis, a palliative care (PC) approach can help the patient adjust to his or her diagnosis and maintain an optimal quality of life...
September 11, 2018: Journal of Palliative Medicine
Asmaa Janah, Dominique Rey, Anne-Déborah Bouhnik, Julien Mancini, Aline Sarradon-Eck, Pierre Verger, Patrick Peretti-Watel, Marc-Karim Bendiane
BACKGROUND: Pain management, especially at the end of life, varies depending on the prescriber's characteristics and attitudes. Little is known about the practices of general practitioners (GPs) regarding end-of-life management for patients with cancer. OBJECTIVES: To provide an overview of the characteristics associated with GPs' attitudes and practices regarding opioids prescribing and to explore GPs' perceived role and difficulties in managing end-of-life care for patients with cancer...
September 7, 2018: Journal of Palliative Medicine
Viktoria Manukyan, Brigitte N Durieux, Cailin J Gramling, Laurence A Clarfeld, Donna M Rizzo, Margaret J Eppstein, Robert Gramling
OBJECTIVE: Automating conversation analysis in the natural clinical setting is essential to scale serious illness communication research to samples that are large enough for traditional epidemiological studies. Our objective is to automate the identification of pauses in conversations because these are important linguistic targets for evaluating dynamics of speaker involvement and turn-taking, listening and human connection, or distraction and disengagement. DESIGN: We used 354 audio recordings of serious illness conversations from the multisite Palliative Care Communication Research Initiative cohort study...
September 5, 2018: Journal of Palliative Medicine
Hideaki Hasuo, Kenji Kanbara, Hiroko Sakuma, Kazuki Uchitani, Mikihiko Fukunaga
BACKGROUND: Self-care systems for early-stage specialist palliative care for cancer patients and their family caregivers have received much attention recently. Resonant breathing is an established method for maximizing heart rate variability (HRV), but it has not been implemented for home self-care. OBJECTIVE: We aimed to examine the usefulness and ease of implementation for family caregivers to administer resonant breathing using a portable device at home. DESIGN: We divided caregivers into two groups-a home self-care group and a control group-and we conducted a randomized open-label study, with rate of change in HRV being the primary outcome...
September 5, 2018: Journal of Palliative Medicine
Betty R Ferrell, Martha L Twaddle, Amy Melnick, Diane E Meier
BACKGROUND: The goal of the 4th edition of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care (NCP Guidelines) is to improve access to quality palliative care for all people with serious illness regardless of setting, diagnosis, prognosis, or age. OBJECTIVE: The NCP Guidelines are intended to encourage and guide healthcare organizations and clinicians (including nonpalliative care specialists) across the care continuum to integrate palliative care principles and best practices into their routine assessment and care of all seriously ill patients and their family caregivers...
September 4, 2018: Journal of Palliative Medicine
Dustin Liebling, Neel Mehta, Amitabh Gulati
BACKGROUND: Despite the growing use of opioids to treat cancer pain and the probability of opioid aberrancy in the cancer setting, clinical practice guidelines (CPGs) or recommendations for active screening and monitoring of opioid compliance are lacking. OBJECTIVES: To evaluate the current practices and attitudes clinicians have toward monitoring and prescribing opioids in patients with cancer; to describe the current practice of screening and monitoring opioid compliance in the cancer setting; to provide insight into the role that CPGs may have in addressing opioid aberrancy in the oncologic population...
August 28, 2018: Journal of Palliative Medicine
R Sean Morrison, Melissa D Aldridge, James Block, Lily Chiu, Catherine Maroney, Corey A Morrison, Diane E Meier
BACKGROUND: The evidence base to support high-quality clinical care and number of scientists available to develop this evidence base are inadequate. OBJECTIVE: To describe the first 10 years of the National Palliative Care Research Center's (NPCRC) programs and their outcomes. DESIGN: Established in 2005, NPCRC was created in direct response to the recommendations of the Institute of Medicine. Specifically, NPCRC was created to expand the palliative care evidence-based needed for both health policy and clinical practice by supporting research scientists, stimulating research and innovation, and creating a community of researchers focused on the needs of persons with serious illness and their families...
August 23, 2018: Journal of Palliative Medicine
J Nicholas Dionne-Odom, Deborah Ejem, Andres Azuero, Richard A Taylor, Gabrielle B Rocque, Yasemin Turkman, Moneka A Thompson, Sara J Knight, Michelle Y Martin, Marie A Bakitas
BACKGROUND: Improving family caregiver preparation for surrogate decision making is a critical priority. OBJECTIVE: Determine a parsimonious set of intrapersonal factors associated with family caregivers' confidence in making future medical decisions for their relatives with cancer. METHODS: Cross-sectional mail survey. Family caregivers of Medicare beneficiaries with pancreatic, lung, brain, ovarian, head and neck, hematologic, and stage IV cancers from communities of eight U...
August 21, 2018: Journal of Palliative Medicine
Yoshinobu Matsuda, Tatsuya Morita, Tempei Miyaji, Tomoko Ogawa, Kuniko Kato, Takashi Kawaguchi, Akihiro Tokoro, Satoru Iwase, Takuhiro Yamaguchi, Yoshikazu Inoue
BACKGROUND: Dyspnea is common in interstitial lung disease (ILD) patients and often refractory to conventional treatment. Little is known regarding the safety of systemic morphine in ILD patients. OBJECTIVE: The objective of this study is to evaluate the safety of a single subcutaneous morphine injection and to determine the recommended dose of morphine for alleviating dyspnea in ILD patients. DESIGN: We conducted a dose-escalation Phase I study for investigating the recommended dose of a single subcutaneous morphine injection to alleviate dyspnea in ILD patients...
August 21, 2018: Journal of Palliative Medicine
Dulce M Cruz-Oliver, Martha Abshire, Oscar Cepeda, Patricia Burhanna, Jennifer Johnson, David Vera Velazquez, Jennifer Chen, Karim Diab, Kara Christopher, Miriam Rodin
BACKGROUND: Benefits of palliative care have been extensively described; however, reports on adherence to national quality indicators are limited. OBJECTIVES: This study focuses on describing the characteristics of patients who were seen at an urban academic hospital and their care team's adherence to 5 out of 10 Measuring What Matters (MWM) quality indicators. DESIGN: Retrospective chart review Setting/Subjects: Patients seen by inpatient palliative care service from January 2014 to December 2015 in an urban academic hospital...
August 21, 2018: Journal of Palliative Medicine
Jinfeng Ding, Claire E Johnson, Angus Cook
BACKGROUND: The majority of end-of-life (EOL) care occurs in general practice. However, we still have little knowledge about how this care is delivered or how it can be assessed and supported. AIM: (i) To review the existing evaluation tools used for assessment of the delivery of EOL care from the perspective of general practice; (ii) To describe how EOL care is provided in general practice; (iii) To identify major areas of concern in providing EOL care in this context...
August 21, 2018: Journal of Palliative Medicine
Dawon Baik, David Russell, Lizeyka Jordan, Frances Dooley, Kathryn H Bowles, Ruth M Masterson Creber
BACKGROUND: The Palliative Performance Scale (PPS) has been widely used for survival prediction among patients with cancer; however, few studies have reviewed PPS scores in heterogeneous palliative care populations across multiple care settings. OBJECTIVE: The aim of this systematic review was to determine how the PPS tool has been used to estimate survival at the end of life. METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
August 21, 2018: Journal of Palliative Medicine
Daniel David, Deborah E Barnes, Ryan D McMahan, Ying Shi, Mary T Katen, Rebecca L Sudore
BACKGROUND: Patient activation-or knowledge, confidence, and skill managing overall health-is associated with improved health behaviors such as exercise; it is unknown whether it is associated with advance care planning (ACP). OBJECTIVE: To determine whether patient activation is associated with ACP. DESIGN: This is a cross-sectional study. SETTING/SUBJECTS: A total of 414 veterans (≥60 years) with serious and chronic illness enrolled in an ACP trial...
August 21, 2018: Journal of Palliative Medicine
Susann Strang, Mirela Osmanovic, Charlotta Hallberg, Peter Strang
BACKGROUND: Due to severe symptoms and poor prognosis in advanced cases, chronic obstructive pulmonary disease (COPD) is today seen as a palliative diagnosis. The everyday lives of patients as well as their relatives are restricted and affected by significant psychosocial problems. OBJECTIVE: To obtain detailed knowledge about people's experiences, for example, transitions in relationships, responsibility, and possible changes in communication, caused by the illness...
August 17, 2018: Journal of Palliative Medicine
Domenica Disalvo, Tim Luckett, Georgina Luscombe, Alexandra Bennett, Patricia Davidson, Lynnette Chenoweth, Geoffrey Mitchell, Dimity Pond, Jane Phillips, Elizabeth Beattie, Stephen Goodall, Meera Agar
BACKGROUND: Prescribing medications for nursing home residents with advanced dementia should focus on optimizing function and comfort, reducing unnecessary harms and aligning care goals with a palliative approach. OBJECTIVE: The aim of the study was to estimate the proportion of Australian nursing home residents with advanced dementia receiving potentially inappropriate medications, and identify those most commonly prescribed and factors associated with their use...
August 14, 2018: Journal of Palliative Medicine
Claire E O'Hanlon, Anne M Walling, Edward Okeke, Sharon Stevenson, Neil S Wenger
BACKGROUND: Advance care planning (ACP) is fundamental to guiding medical care at the end of life. Understanding the economic impact of ACP is critical to implementation, but most economic evaluations of ACP focus on only a few actors, such as hospitals. OBJECTIVE: To develop a framework for understanding and quantifying the economic effects of ACP, particularly its distributional consequences, for use in economic evaluations. DESIGN: Literature review of economic analyses of ACP and related costs to estimate magnitude and direction of costs and benefits for each actor and how data on these costs and benefits could be obtained or estimated...
August 10, 2018: Journal of Palliative Medicine
Joshua Wales, Sarina R Isenberg, Pete Wegier, Jennifer Shapiro, Victor Cellarius, Sandy Buchman, Amna Husain, Narges Khoshnood
BACKGROUND: Medical Assistance in Dying (MAiD) was legalized in Canada in June 2016. There are no documented experiences of MAiD provision within a home palliative care program. The majority of palliative care physicians in Canada object to MAiD. As one of the largest home-based palliative care providers in Canada, the Temmy Latner Centre for Palliative Care (TLCPC) developed processes to implement MAiD provision within a home palliative care team with diverse attitudes toward MAiD. OBJECTIVE: To demonstrate the feasibility of providing MAiD within a home palliative care setting and describe the population that received MAiD in the first year of legalization...
August 10, 2018: Journal of Palliative Medicine
Ambereen K Mehta, Salim Najjar, Natalie May, Binit Shah, Leslie Blackhall
BACKGROUND: Palliative care (PC) needs in patients with neurological diseases are becoming more recognized by neurologists and PC physicians. OBJECTIVE: To qualify and quantify the PC education available in the United States adult neurology programs since the Accreditation Council for Graduate Medical Education (ACGME) published updated mandates in 2009. DESIGN: A 22-question survey was electronically distributed to each neurology residency program in the United States...
August 8, 2018: Journal of Palliative Medicine
Rachael Price Seddighzadeh, Kathryn Lawrence, Tyler Hamby, Alice Hoeft
BACKGROUND: Literature in adult palliative care (PC) boasts fewer invasive procedures, shorter lengths of stay, and decreased cost of care. Benefits of pediatric PC are under-researched and are important to identify to optimize care. OBJECTIVE: Our aim was to estimate the influence and utilization of PC on pediatric patient care. DESIGN: We evaluated the electronic medical record of 43 patients at Cook Children's Medical Center (CCMC) with complex chronic conditions, who died between January 1, 2013, and December 31, 2014, comparing the length and frequency of hospitalizations, number of medications administered and procedures performed, and established limits of resuscitation between patients who received PC and those who did not...
August 2, 2018: Journal of Palliative Medicine
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