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"Advanced Care Planning"

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https://www.readbyqxmd.com/read/28196448/provider-perspectives-on-advance-care-planning-documentation-in-the-electronic-health-record
#1
Ellis Dillon, Judith Chuang, Atul Gupta, Sharon Tapper, Steve Lai, Peter Yu, Christine Ritchie, Ming Tai-Seale
CONTEXT: Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic. OBJECTIVES: In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28182261/improving-the-electronic-capture-of-advance-care-directives-in-a-healthcare-delivery-system
#2
Norifumi Kamo, Barbara L Williams, Donna L Smith, C Craig Blackmore
OBJECTIVES: To determine the effectiveness of a multifaceted quality improvement intervention in outpatient clinics at an integrated healthcare delivery system on capture rate of advance directives (ADs) in the electronic medical record (EMR). DESIGN: Interrupted time series analysis with control groups between January 2010 and June 2015. SETTING: Oncology, nephrology, and primary care outpatient clinics in an integrated healthcare delivery system...
February 9, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28176900/the-view-of-pulmonologists-on-palliative-care-for-patients-with-copd-a-survey-study
#3
R G Duenk, C Verhagen, Pnr Dekhuijzen, Kcp Vissers, Y Engels, Y Heijdra
INTRODUCTION: Early palliative care is not a common practice for patients with COPD. Important barriers are the identification of patients for palliative care and the organization of such care in this patient group. OBJECTIVE: Pulmonologists have a central role in providing good quality palliative care for patients with COPD. To guide future research and develop services, their view on palliative care for these patients was explored. METHODS: A survey study was performed by the members of the Netherlands Association of Physicians for Lung Diseases and Tuberculosis...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28173885/cultural-influences-upon-advance-care-planning-in-a-family-centric-society
#4
Keson Tay, Rachel Jia Yu Lee, Shin Wei Sim, Sumytra Menon, Ravindran Kanesvaran, Lalit Kumar Radha Krishna
OBJECTIVE: Advanced care plans (ACPs) are designed to convey the wishes of patients with regards to their care in the event of incapacity. There are a number of prerequisites for creation of an effective ACP. First, the patient must be aware of their condition, their prognosis, the likely trajectory of the illness, and the potential treatment options available to them. Second, patient input into ACP must be free of any coercive factors. Third, the patient must be able to remain involved in adapting their ACP as their condition evolves...
February 8, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28171836/content-of-advance-care-planning-among-japanese-elderly-people-living-at-home-a-qualitative-study
#5
Yoshihisa Hirakawa, Chifa Chiang, Esayas Haregot Hilawe, Atsuko Aoyama
PURPOSE OF STUDY: Elderly peoples' values and preferences for end-of-life care have not yet known in details. The aim of the present study was to investigate the end-of-life wishes and decision making among Japanese elderly people who required home care services. The study was designed to qualitative research strategies, using face to face interview data recorded in nursing care records, with a focus on advance care planning. DESIGN AND METHODS: A total of 102 elderly people (47 males, 55 females) of 6 home care support offices in Hyogo prefecture participated...
January 31, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28166857/palliative-care-discussions-in-multiple-system-atrophy-a-retrospective-review
#6
Anita M Dayal, Mary E Jenkins, Mandar S Jog, Kurt Kimpinski, Penny MacDonald, Teneille E Gofton
OBJECTIVE: Multiple system atrophy (MSA) is an incurable neurodegenerative illness in which progressive symptoms, including stridor and acute laryngeal obstruction, occur. Advanced care planning and palliative care discussions in people living with MSA are not well defined. The aim of the present study is to evaluate advanced care planning and current practices in palliative care in MSA to identify opportunities for improving quality of care. METHODS: The study is a retrospective chart review assessing the focus and timing of palliative care discussions in people living with MSA...
February 7, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28158737/does-religiosity-account-for-lower-rates-of-advance-care-planning-by-older-african-americans
#7
Catheryn S Koss
No abstract text is available yet for this article.
February 1, 2017: Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
https://www.readbyqxmd.com/read/28156660/attitudes-of-radiation-oncologists-toward-palliative-and-supportive-care-in-the-united-states-report-on-national-membership-survey-by-the-american-society-for-radiation-oncology-astro
#8
James B Yu, Malcolm Mattes, Adrienne Thrasher, Hui-Kuo George Shu, Jennifer F De Los Santos, Harald Paganetti, Bridget F Koontz, Christopher Abraham, Tracy A Balboni
: 105 Background: Radiation oncologists are frequently involved in providing palliative and supportive care (PSC) for patients with advanced cancers through delivery of palliative radiation. Whether they are confident in their ability to assess and initiate treatments for pain, non-pain, and psychosocial distress is unknown. The American Society for Radiation Oncology (ASTRO) surveyed its practicing members in the United States on self-assessment of their primary PSC skills, and access to continuing medical education on PSC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156659/novel-tool-utilized-as-a-trigger-for-advance-care-planning-in-hospitalized-oncology-patients
#9
Sandhya Rao, Diane Sarnacki, Alexandra Dobie, Karla Damus, Gretchen Gignac
: 22 Background: Study Purpose: reduce inpatient oncology readmissions; determine if there is a need to standardize trigger for Advance Care Planning in the inpatient oncology population. METHODS: Investigational Quality Improvement Study January-June 2014. Retrospective chart review of oncology readmissions on the BMC Hematology and Oncology service during a 6 month period, January-June 2013 (N = 68). Data abstracted included: demographics (age, race/ethnicity, primary language, education, marital status, ECOG); type and stage of cancer; type of consults (palliative, spiritual, social services, integrative, PT/OT, hospice, visiting nurse)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156656/systematic-review-of-interventions-to-facilitate-advance-care-planning-acp-in-cancer-patients
#10
Hao-Wen Sim, Camilla Zimmermann, Monika K Krzyzanowska
: 21 Background: ACP refers to the process of consideration, documentation and communication of preferences for future care. ACP is crucial for patients (pts) with advanced cancer as it can guide substitute decision makers (SDM) and health care providers (HCP) to align care with preferences, thus improving quality of end-of-life care. METHODS: We performed a systematic review of MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane (Systematic Review and Clinical Trial) databases (1995 to 2015) to identify interventions that facilitate ACP for cancer pts (documentation or discussion of advance directives, SDM or code status)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156632/end-of-life-care-for-glioblastoma-multiforme-gbm-patients-at-a-large-academic-center
#11
Xiao Wang, Jiangxia Wang, Anne Evans, W Anthony Riley, Thomas J Smith
: 56 Background: GBM is a uniformly fatal disease with average survival of < 3 years and universal cognitive problems, making advance care planning paramount. End of life (EOL) patterns of GBM care in the US have not been studied. We examined care in a cohort of GBM and brain tumor (BT) patients as part of a program to provide individual provider feedback about EOL care. METHODS: We reviewed the care of all GBM patients over 3 years with a random sample of 100, and a 5-yr subset of 45 who received their care at Gilchrist Hospice (GH), our largest provider...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156629/a-whole-greater-than-the-sum-of-the-parts-close-collaboration-between-palliative-care-and-clinical-ethics
#12
(no author information available yet)
: 53 Background: The disciplines of palliative care (PC) and clinical ethics (CE) share common content but also important distinctions in method, skill set, and clinical role in a given patient encounter. Particularly in cases of advance care planning, complex decision-making, and clarifying goals oncology teams may be challenged to know which consultation service to involve. METHODS: Case report and commentary. RESULTS: A 60 year-old man with a 3-year history of glioblastoma multiforme presented with sudden onset right-sided weakness and altered mental status...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156626/effect-of-a-communication-skills-intervention-on-resident-comfort-and-knowledge-of-discussing-goals-of-care-and-advance-care-planning
#13
Elizabeth Golding, Aaron Lampkin, Mary Walker Larach, Lawrence Klima
: 50 Background: Inpatient providers are sometimes challenged with advanced care planning for their patients. At a teaching hospital, resident physicians find themselves tasked with this responsibility for inpatients they may have only just met, as well as in their assigned outpatient panel. Education on communication skills though has been shown to improve resident comfort level and knowledge of discussing goals of care and advance care planning. METHODS: Internal medicine categorical residents (n = 15) and preliminary (n = 3) residents at a university-affiliated, community hospital learned the fundamentals of discussing goals of care and advance care planning using selected modules from the Center for Advancing Palliative Care's (CAPC) online curriculum in communication skills during their outpatient clinic rotation from February through June 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156602/integration-of-palliative-care-for-patients-with-solid-tumors-on-phase-i-clinical-trials
#14
Vincent M Chung, Marianna Koczywas, Anna Cathy Williams, Arti Hurria, Tami R Borneman, Rhonda Cooper, Louise Knight, Patricia Fischer, Denise Gallagher, Thomas J Smith
: 138 Background: Cancer patients receiving Phase I clinical trials are a population with advanced disease, high symptom burden, and with multiple QOL concerns including use of advance directives. METHODS: An NCI funded R01 is currently in progress (2014-2019) as a randomized clinical trial to test a palliative care intervention (PCI) in this population. The PCI includes comprehensive patient assessment, goals of care communication, interdisciplinary care planning and patient teaching...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156601/what-s-in-the-special-sauce-of-protocol-driven-outpatient-palliative-care-consultations
#15
Marie Bakitas, J Nicholas Dionne-Odom, Jennifer Frost, Margaret Plunkett, Lisa A Lisa A Stephens, Peggy Bishop
: 139 Background: Initial outpatient palliative care consultations (OPCC) in clinics are usually requested for uncontrolled symptoms. The purpose of this substudy was to determine the nature of recommendations made in early PC (EPC) protocol-driven OPCC. METHODS: Using a standardized tool, we conducted a content analysis on the assessment and plan components of protocol-driven OPCCs. OPCCs were conducted as a component of the ENABLE [Educate, Nurture, Advise, Before Life Ends] RCT (10/2010-9/2013) consisting of an OPCC and 6 structured weekly telephone coaching sessions and monthly follow up either at study entry (early) or 12 weeks later (delayed)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156575/using-a-values-assessment-as-a-bridge-to-advance-care-planning-results-of-1286-patient-reports
#16
Cynthia Taniguchi, Kathryn J Eagye, Susan Ash-Lee, Angela Kalisiak, Sabrina Q Mikan, Nicole Hartung
: 12 Background: Recent studies have shown that formal Palliative Care (PC) improves care at the end of life for cancer patients. The role of communication in PC is not defined. Other studies have shown that communication alone can be associated with better end of life outcomes. The US Oncology Network developed and tested a Values Assessment (VA) instrument for routinely broaching difficult topics to facilitate more formal advance care planning (ACP). The results of the first 28 months of the program on over 1200 patients are reported here...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156564/advance-care-planning-and-specialty-palliative-care-utilization-for-patients-with-hematologic-malignancies-who-undergo-allogeneic-hematopoietic-cell-transplant
#17
Lisa M McNey, Erik Eckhert, Derek Galligan, Gabriel N Mannis
: 18 Background: Unlike most metastatic solid tumors, many advanced hematologic malignancies are treated with curative intent. Accordingly, aggressive interventions often continue until late in the disease course because it can be difficult to discern when cure is no longer possible. This is particularly true for recipients of allogeneic hematopoietic cell transplant (alloHCT). We hypothesized that alloHCT recipients and their providers would be less likely to utilize specialty Palliative Care (PC) services or to engage in early communication regarding advance care planning...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156563/barriers-and-facilitators-of-navigator-led-advance-care-planning-conversations-in-older-patients-with-cancer
#18
Chao-Hui Huang, Soumya J Niranjan, J Nicholas Dionne-Odom, Kelly Kenzik, Kerri S Bevis, Gabrielle Betty Rocque
: 17 Background: National guidelines and most individuals endorse advance care planning (ACP) as essential; however, few individuals engage in such planning. Little is known about the role of lay navigators in supporting ACP. We sought to understand facilitators and barriers of successful implementation of ACP conducted by lay cancer navigators. METHODS: Semi-structured interviews were conducted with 26 lay navigators at 11 sites across the Southeast who were engaged in ACP implementation using Respecting Choices©...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156562/addressing-resource-allocation-for-advance-care-planning-discussions-in-hospital
#19
(no author information available yet)
: 16 Background: Advance care planning (ACP) is fundamental in quality palliative care. There is no data detailing the demand for ACP discussions in hospitals, nor any standard objective criteria to decide urgency of such discussions. This cross-sectional study addresses this by comparing the ability of two commonly used instruments to detect palliative patients, and to predict death in the current admission. METHODS: All inpatients were censored from the largest tertiary hospital in the state on a single inpatient day...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156561/a-qualitative-investigation-of-mindfulness-practice-to-support-advance-care-planning-acp
#20
Ann H Cottingham, Kathleen A Beck-Coon, Paul R Helft
: 15 Background: Despite ongoing attempts to increase ACP in the U.S, a national longitudinal study of patients with cancer found no significant change in participation in end-of-life (EOL) discussions or living will completion between 2000-2012. A key barrier to ACP includes emotional discomfort talking about EOL care preferences. Mindfulness practices facilitate emotional regulation through present-centered awareness and non-reactive coping. In this pilot, an intervention combining mindfulness training, mindful communication skill development, and information about ACP was hypothesized to increase ACP in patients with cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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