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Early intervention of palliative care

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https://www.readbyqxmd.com/read/28209067/barriers-to-nausea-management-end-of-life-conversations-early-palliative-care-interventions-and-patient-education
#1
Charles B Simone
No abstract text is available yet for this article.
January 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28208923/long-term-outcome-in-patients-with-esophageal-stenting-for-cancer-esophagus-our-experience-at-a-rural-hospital-of-punjab-india
#2
Parvinder Singh, Abhitesh Singh, Anantbir Singh, Ghansham Sharma, Parmod Kumar Bhatia, Amarjeet Singh Grover
INTRODUCTION: Cancer of the esophagus is among the leading cause of cancer deaths in Punjab, India. Patients generally present with dysphagia as their first symptom and more often they have advanced disease at the time of presentation to a tertiary care centre. Palliative procedures have important roles in this setting. Stenting is the best option to palliate the symptoms of dysphagia, from which patient is suffering the most. AIM: To know the success rate, early and long term complications and mortality in esophageal stenting, when it was done in malignant esophageal stricture patients...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28166798/identifying-and-characterising-health-policy-and-system-relevant-documents-in-uganda-a-scoping-review-to-develop-a-framework-for-the-development-of-a-one-stop-shop
#3
Boniface Mutatina, Robert Basaza, Ekwaro Obuku, John N Lavis, Nelson Sewankambo
BACKGROUND: Health policymakers in low- and middle-income countries continue to face difficulties in accessing and using research evidence for decision-making. This study aimed to identify and provide a refined categorisation of the policy documents necessary for building the content of a one-stop shop for documents relevant to health policy and systems in Uganda. The on-line resource is to facilitate timely access to well-packaged evidence for decision-making. METHODS: We conducted a scoping review of Uganda-specific, health policy, and systems-relevant documents produced between 2000 and 2014...
February 6, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28156634/randomized-trial-of-early-integrated-palliative-and-oncology-care
#4
Areej El-Jawahri, William F Pirl, Vicki A Jackson, Elyse R Park, Anthony Back, Alona Muzikansky, Mihir Kamdar, Simone Rinaldi, Juliet Jacobsen, Emily R Gallagher, Joel Fishbein, Justin Eusebio, Harry VanDusen, Jennifer S Temel
: 104 Background: Early palliative care (PC) improves outcomes in patients with newly diagnosed metastatic non-small cell lung cancer (NSCLC) and in patients identified by clinicians as having poor prognosis, advanced cancer. We evaluated the impact of early, integrated palliative and oncology care in patients with newly diagnosed lung and gastrointestinal (GI) cancer. METHODS: Between 5/2/11 and 7/20/15, we randomly assigned patients with newly diagnosed incurable lung (NSCLC, small cell, mesothelioma) or GI (pancreas, hepatobiliary, gastric, esophageal) cancer to PC integrated with oncology care (monthly visits with PC) or usual oncology care...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156582/a-model-of-early-integration-of-palliative-care-into-oncology-care-for-patients-with-metastatic-colorectal-cancer
#5
Laura Cantino, Ingrid Maravilla, Nicole Thompson, Chloe Evelyn Atreya, Kara Bischoff
: 142 Background: Current NCCN guidelines recommend that "institutions should develop processes for integrating palliative care into cancer care." However, it is not clear what the best method is for implementing this integrated care. Palliative care needs specific to patients with metastatic colorectal cancer (mCRC) and best practices for integration of outpatient palliative and oncologic care in mCRC are not well understood. METHODS: We conducted a pre-post prospective cohort study to evaluate the palliative care needs of mCRC patients and the implementation of an integrated palliative care program...
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
#6
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/28156557/a-pilot-trial-of-early-specialty-palliative-care-for-patients-with-advanced-pancreatic-cancer-challenges-encountered-and-lessons-learned
#7
Nathan Bahary, Rene Claxton, Julie Childers, Dio Kavalieratos, Linda King, Barry C Lembersky, Seo Young Park, Greer A Tiver, Robert Arnold
: 110 Background: Palliative care trials face implementation barriers. We describe challenges encountered in a pilot trial of early specialty palliative care for patients with pancreatic cancer. METHODS: We conducted a mixed-methods pilot randomized controlled trial of early specialty physician-led palliative care in advanced pancreatic cancer. Recently diagnosed patients with borderline, locally-advanced, or metastatic pancreatic cancer and their caregivers (total N=60) were recruited from clinic at a comprehensive cancer center and randomized (2:1) to receive monthly specialty palliative care visits for 3 months in addition to standard oncology care vs...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156551/effect-of-early-integrated-palliative-care-on-family-caregivers-fc-outcomes-for-patients-with-gastrointestinal-and-lung-cancer
#8
Vicki A Jackson, Joseph A Greer, William F Pirl, Elyse R Park, Anthony Back, Alona Muzikansky, Mihir Kamdar, Simone Rinaldi, Juliet Jacobsen, Joel Fishbein, Justin Eusebio, Harry VanDusen, Ryan David Nipp, David P Ryan, Jennifer S Temel
: 234 Background: Patients with newly diagnosed advanced cancers who receive early palliative care (PC) integrated with oncology care report improvement in their quality of life (QOL) and mood. While a telephone-based psycho-educational intervention for FC decrease depression, the impact of early, integrated outpatient PC models on FC outcomes remains unknown. METHODS: We conducted a randomized trial of early PC integrated with oncology care versus oncology care alone for newly diagnosed patients with incurable lung and gastrointestinal cancers and their FC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156543/oncology-patients-in-the-health-care-safety-net-is-it-too-late-for-early-palliative-care
#9
Anne Kinderman, Leslie Safier
: 128 Background: Studies have suggested that uninsured and Medicaid patients are more likely to present with late-stage cancer than Medicare patients, and may be more likely to be admitted urgently or emergently. However, studies of palliative care interventions for cancer patients suggest that the greatest impact can be achieved if these services begin "early" (≥ 90 days prior to death). In our urban public hospital, we examined where patients receive their initial cancer diagnosis, and at what stage they are diagnosed, in order to determine how to best implement community-based palliative care services...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156522/patient-family-member-and-clinician-perspectives-on-advance-care-planning-acp-in-hematology-and-hematopoietic-stem-cell-transplantation-hsct
#10
Jessica Simon, Shelley Raffin Bouchal
: 7 Background: Studies have found that ACP engagement remains low in patients undergoing HSCT in spite of the high risks of treatment-related morbidity and mortality. METHODS: This qualitative study used Thorne's Interpretive Description methodology. Participants were accrued from hematological malignancy outpatient clinics at a tertiary oncology center and underwent audio-recorded semi-structured interviews. Analysis involved meticulous review of interview transcripts...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156502/symptom-distress-and-patterns-of-palliative-care-referral-among-oncology-outpatients
#11
Craig D Blinderman
: 185 Background: The early implementation of palliative care services is recognized as an important aspect of oncologic care. However, rates of referral to palliative care services among oncology patients are still low, and the decision to refer is frequently at the discretion of the treating oncologist or by patient request. We sought to better identify the patterns of referral to outpatient palliative care, as well as patient symptom burden in an effort to target early and high-yield palliative care interventions...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156499/palliative-treatment-directives-for-bone-metastases-a-quality-directed-approach-to-guiding-institutional-practice
#12
Lucille Lee, Petrina Zuvic, Isabella Bingchan Zhang, Louis Potters, Beatrice Bloom
: 188 Background: The efficacy of single fraction (fx) radiation treatment (RT) has proven to have equipoise for palliation of bone metastases when compared to courses of 10 fx or more. Despite these data, there has been a slow adoption of this practice in the US and worldwide. Examination of our multicenter practice from 2004 - 2016 showed that single fx RT utilization has remained at 17% and hypofractionationed (HFX) courses (1 or 5 fx) have remained at 71% since 2009. We hypothesized that evidence-based, treatment-guiding directives could improve HFX utilization in this population...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156490/the-impact-of-very-early-referral-on-the-effectiveness-of-specialty-cancer-care-management-services-for-oncology-patients-in-active-treatment
#13
Melissa Lindholm, Arthur H Rossof, Richard B Weininger, Margaret Rausa, Pamela Schumacker, Steven Hartley, Diane Richards, David Spangler, Debra Stern, J Scott Reid
: 157 Background: Many patients receiving treatment for cancer experience high levels of morbidity and reduction in quality of life. Proactive specialty cancer care management programs can be offered to patients experiencing these challenges. These patients are most often self-identified, referred by a physician, or identified by claims from a commercial or government insurer or vendor. While earlier intervention of case management or palliative care services has been shown to improve outcomes for cancer patients, a variety of logistic challenges frequently interfere with early referral...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156485/palliative-care-interventions-and-end-of-life-care-outcomes-for-hepatocellular-patients-pts-at-two-veterans-affairs-va-medical-centers
#14
Sarah Lee, Sejal Kothadia, Yucai Wang, Victor Tsu-Shih Chang, Yeun-Hee Anna Park, Ellen Olson, David Klein, Fengming Zhong
: 164 Background: Palliative care interventions and their effect on EOL outcomes for liver cancer pts have not been described. We investigated the association between palliative care intervention and EOL care outcomes. METHODS: We reviewed the charts of pts with hepatocellular carcinoma and who were seen by palliative care at 2 VA medical centers from 2006 to 2012. We investigated the association between EOL outcomes (number of ER visits, ICU visits, chemotherapy, place of death, number of hospitalizations during their last 30 days), and interventions such as early referral (within 30 days of diagnosis), defined goals of care, holding a family meeting, and symptom assessment and management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156482/implementing-an-emergency-department-emr-trigger-tool-for-palliative-medicine-consultation-and-its-effect-on-length-of-stay-and-health-care-costs-a-retrospective-study
#15
Felix Rivera, Wendy Edwards
: 167 Background: Several studies have shown that palliative medicine consultation can improve multiple patient-centered outcomes, especially when provided early. Our goal is to show that our electronic health record (EHR) trigger tool is a cost-effective way for hospitals to identify patients who may benefit from early consultation, improving outcomes such as hospital length of stay and facilitating appropriate disposition for patients with metastatic cancer. METHODS: Retrospective chart review of 721 patients at an urban community hospital who were identified by a trigger system integrated into the Emergency Department (ED) EHR...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156434/earlier-access-to-palliative-medicine-an-experience-of-integration-into-a-community-oncology-practice
#16
Jacqueline Matthews
: 92 Background: A growing body of evidence supports the integration of palliative care as a standard for comprehensive cancer care. Through our experience as an inpatient palliative care provider, with 50% of our population having advanced cancer, we recognized the value proposition to provide continuity in the outpatient setting. Innovative Care Solutions developed a partnership with a large, community oncology program late 2015 for a palliative care multidisciplinary team to be embedded into one location of their practice...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156192/cost-analysis-of-a-prospective-multi-site-cohort-study-of-palliative-care-consultation-teams-for-adults-with-advanced-cancer-where-do-cost-savings-come-from
#17
Peter May, Melissa M Garrido, J Brian Cassel, Amy S Kelley, Diane E Meier, Charles Normand, Thomas J Smith, R Sean Morrison
BACKGROUND: Studies report cost-savings from hospital-based palliative care consultation teams compared to usual care only, but drivers of observed differences are unclear. AIM: To analyse cost-differences associated with palliative care consultation teams using two research questions: (Q1) What is the association between early palliative care consultation team intervention, and intensity of services and length of stay, compared to usual care only? (Q2) What is the association between early palliative care consultation team intervention and day-to-day hospital costs, compared to a later intervention? DESIGN: Prospective multi-site cohort study (2007-2011)...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28154913/right-ventricle-to-pulmonary-artery-shunt-in-pulmonary-atresia-with-a-ventricular-septal-defect-a-word-of-caution
#18
Kwang Ho Choi, Si Chan Sung, Hyungtae Kim, Hyoung Doo Lee, Gil Ho Ban, Geena Kim, Hoon Ko
The management of pulmonary atresia with a ventricular septal defect (PA/VSD) depends on the anatomy of the pulmonary artery or on the surgical strategy used at individual institutions. In our institution, we adopted a right ventricle-to-pulmonary artery (RV-PA) shunt in 2011 as a palliative procedure for PA/VSD to overcome the disadvantages of a Blalock-Taussig shunt. We evaluated the results of the RV-PA shunt as initial palliative surgery for PA/VSD. Thirteen patients with ductus-dependent PA/VSD from August 2011 to August 2015 were enrolled...
February 3, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28152867/regional-engagement-to-define-report-and-use-quality-metrics-to-improve-palliative-care-in-oncology
#19
Karma Kreizenbeck, Catherine R Fedorenko, Bernardo Goulart, Veena Shankaran, J Randall Curtis, Gary H Lyman, Csaba Mera, Bruce Smith, Scott David Ramsey
: 282 Background: Palliative care in oncology encompasses a wide array of care, and optimal performance metrics remain uncertain. To address this issue we held a regional meeting that included patient advocates, clinicians, private and public payers and researchers to identify quality indicators for palliative care, discuss palliative care (PC) quality measurement in the region, review preliminary results and metrics for PC, and identify opportunities to improve care. METHODS: Regional experts facilitated discussions...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152833/understanding-total-cost-of-cancer-care-to-determine-strategic-interventions-to-improve-value
#20
Salimah Velji, Kavita Patel, Basit Chaudhry, Sonia Grizzle, Catherine A Lyons, Rogerio Lilenbaum
: 3 Background: Cancer centers across the country are largely unprepared to move toward value-based payment. Total cost of care data is not readily available and centers do not know how much of their patients' care is received at other hospitals, when in the trajectory of illness greatest cost is incurred, or the elements of care that present the greatest opportunity for savings. A previous examination of practice patterns Smilow Cancer Hospital (SCH) demonstrated that our patients had high rates of ED visits, hospital admissions and ICU use in their last month of life...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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