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https://www.readbyqxmd.com/read/29771351/burn-surgeon-and-palliative-care-physician-attitudes-regarding-goals-of-care-delineation-for-burned-geriatric-patients
#1
Holly B Cunningham, Shannon A Scielzo, Paul A Nakonezny, Brandon R Bruns, Karen J Brasel, Kenji Inaba, Scott C Brakenridge, Jeffrey D Kerby, Bellal A Joseph, M J Mohler, Joseph Cuschieri, Mary E Paulk, Akpofure P Ekeh, Tarik D Madni, Luis R Taveras, Jonathan B Imran, Steven E Wolf, Herb A Phelan
Objective: Palliative care specialists and burn surgeons were surveyed regarding: 1) importance of goals of care conversations for burned seniors; 2) confidence in their own specialty's ability to conduct these conversations; and 3) confidence in the ability of the other specialty to do so. Methods: A 13-item survey was developed by the steering committee of a multi-center consortium dedicated to palliative care in the injured geriatric patient and beta-tested by burn surgeons and palliative care specialists unaffiliated with the consortium...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29757869/end-of-life-care-for-patients-with-advanced-ovarian-cancer-is-aggressive-despite-hospice-intervention-a-population-based-study
#2
Jui-Kun Chiang, Chun-Shuo Hsu, Chih-Wen Lin, Yee-Hsin Kao
OBJECTIVE: To date, few studies have examined end-of-life (EOL) care and healthcare costs for patients with ovarian cancer. We evaluated the effects of hospice care on the quality of EOL care and healthcare costs for patients with ovarian cancer in the final month of life. MATERIALS AND METHODS: We conducted a population-based study and analyzed data from Taiwan's Longitudinal Health Insurance Database, which contains claims information for medical records of patients, healthcare costs, and insurance system exit dates: our proxy for death between 1997 and 2011...
May 11, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29710217/association-between-hospice-length-of-stay-health-care-utilization-and-medicare-costs-at-the-end-of-life-among-patients-who-received-maintenance-hemodialysis
#3
Melissa W Wachterman, Susan M Hailpern, Nancy L Keating, Manjula Kurella Tamura, Ann M O'Hare
Importance: Patients with end-stage renal disease are less likely to use hospice services than other patients with advanced chronic illness. Little is known about the timing of hospice referral in this population and its association with health care utilization and costs. Objective: To examine the association between hospice length of stay and health care utilization and costs at the end of life among Medicare beneficiaries who had received maintenance hemodialysis...
April 30, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29579318/increased-resource-use-in-men-with-metastatic-prostate-cancer-does-not-result-in-improved-survival-or-quality-of-care-at-the-end-of-life
#4
Ron Golan, Adrien N Bernstein, Xiangmei Gu, Brian A Dinerman, Art Sedrakyan, Jim C Hu
BACKGROUND: Cancer care and end-of-life (EOL) care contribute substantially to health care expenditures. Outside of clinical trials, to our knowledge there exists no standardized protocol to monitor disease progression in men with metastatic prostate cancer (mPCa). The objective of the current study was to evaluate the factors and outcomes associated with increased imaging and serum prostate-specific antigen use in men with mPCa. METHODS: Using Surveillance, Epidemiology, and End Results-Medicare data from 2004 to 2012, the authors identified men diagnosed with mPCa with at least 6 months of follow-up...
March 26, 2018: Cancer
https://www.readbyqxmd.com/read/29341836/a-cohort-study-of-patient-reported-outcomes-and-healthcare-utilization-in-acute-myeloid-leukemia-patients-receiving-active-cancer-therapy-in-the-last-six-months-of-life
#5
Jared R Lowe, Yinxi Yu, Steven Wolf, Greg Samsa, Thomas W LeBlanc
BACKGROUND: Evidence about the unique palliative care needs of patients with acute myeloid leukemia (AML) is limited. Improving the care of these patients will require a better understanding of their unmet needs, including symptom burden at the end of life, and patterns of healthcare utilization. OBJECTIVE: To describe AML patients' experiences in the last six months of life regarding symptom burden, blood product utilization, and use of palliative care services...
January 17, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29218773/illness-and-end-of-life-experiences-of-children-with-cancer-who-receive-palliative-care
#6
Erica C Kaye, Courtney A Gushue, Samantha DeMarsh, Jonathan Jerkins, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
BACKGROUND: The field of pediatric palliative oncology is newly emerging. Little is known about the characteristics and illness experiences of children with cancer who receive palliative care (PC). METHODS: A retrospective cohort study of 321 pediatric oncology patients enrolled in PC who died between 2011 and 2015 was conducted at a large academic pediatric cancer center using a comprehensive standardized data extraction tool. RESULTS: The majority of pediatric palliative oncology patients received experimental therapy (79...
April 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29121480/palliative-care-planner-a-pilot-study-to-evaluate-acceptability-and-usability-of-an-electronic-health-records-system-integrated-needs-targeted-app-platform
#7
Christopher E Cox, Derek M Jones, Wen Reagan, Mary D Key, Vinca Chow, Jessica McFarlin, David Casarett, Claire J Creutzfeldt, Sharron L Docherty
RATIONALE: The quality and patient-centeredness of intensive care unit (ICU)-based palliative care delivery is highly variable. OBJECTIVE: To develop and pilot an app platform for clinicians and ICU patients and their family members that enhances the delivery of needs-targeted palliative care. METHODS: In the development phase of the study, we developed an electronic health record (EHR) system-integrated mobile web app system prototype, PCplanner (Palliative Care Planner)...
January 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29066257/disparity-of-end-of-life-care-in-cancer-patients-with-and-without-schizophrenia-a-nationwide-population-based-cohort-study
#8
Huei-Kai Huang, Ying-Wei Wang, Jyh-Gang Hsieh, Chia-Jung Hsieh
BACKGROUND: Cancer patients with schizophrenia may face disparities in end-of life care, and it is unclear whether schizophrenia affects their medical care and treatment. METHODS: We conducted a nationwide population-based cohort study based on the National Health Insurance Research Database of Taiwan. The study population included patients >20years old who were newly diagnosed as having one of six common cancers between 2000 and 2012 (schizophrenia cohort: 1911 patients with both cancer and schizophrenia; non-schizophrenia cohort: 7644 cancer patients without schizophrenia)...
October 21, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/29056563/impact-of-targeted-therapy-on-the-quality-of-end-of-life-care-for-patients-with-non-small-cell-lung-cancer-a-population-based-study-in-taiwan
#9
Hsin-Yun Tsai, Kuo-Piao Chung, Raymond Nien-Chen Kuo
CONTEXT: Targeted therapies with epidermal growth factor receptor tyrosine kinase inhibitors have been widely used in the treatment of advanced non-small-cell lung cancer (NSCLC). However, little research has focused on the use of targeted therapies at the end of life (EOL). OBJECTIVES: This study investigated the determinants of receiving targeted therapy during the last month of life and how targeted therapies affect the quality of EOL care. METHODS: We conducted a retrospective population-based study using a cancer registry and National Health Insurance claims data among 42,678 Taiwanese NSCLC decedents in 2005-2012...
March 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28834888/trend-analysis-of-end-of-life-care-between-hospice-and-nonhospice-groups-of-cancer-patients-in-taiwan-for-2002-11
#10
Jui-Kun Chiang, Yang-Cheng Lee, Yee-Hsin Kao
The aim of the study is to examine the effect of hospice care on quality of end-of-life (EOL) care for patients with advanced cancer in Taiwan between 2002 and 2011.It is a population-based longitudinal study following National Health Insurance medical care claims of hospice and nonhospice patients with advanced cancer in their last month of life.Utilization of hospice service doubled from 10.5% to 21.5% over the study period. Of 12,682 patients identified as having advanced cancer, 7975 (62.88%) were found to have 1 or more quality indicators (QIs) of poor EOL cancer care...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28796559/improvements-in-patient-and-health-system-outcomes-using-an-integrated-oncology-and-palliative-medicine-approach-on-a-solid-tumor-inpatient-service
#11
Richard F Riedel, Kim Slusser, Steve Power, Christopher A Jones, Thomas W LeBlanc, Arif H Kamal, Devi Desai, Deborah Allen, Yinxi Yu, Steven Wolf, Anthony N Galanos
PURPOSE: Early palliative care (PC) improves outcomes for outpatients with advanced cancer. Its effect on hospitalized patients with cancer is unknown. Herein, we report on the influence of a novel, fully integrated inpatient medical oncology and PC partnership at a tertiary medical center during its first year of implementation. METHODS: We conducted a retrospective, longitudinal, pre- and postintervention cohort study at Duke University Hospital. Pre- and postintervention cohorts were defined as all patients admitted to the solid tumor inpatient service from September 1, 2009, to June 30, 2010, and September 1, 2011 to June 30, 2012, respectively...
September 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28737996/integrating-palliative-and-oncology-care-for-patients-with-advanced-cancer-a-quality-improvement-intervention
#12
Laura C Hanson, Frances Collichio, Stephen A Bernard, William A Wood, Matt Milowsky, Erin Burgess, Crista J Creedle, Summer Cheek, Lydia Chang, Bhisham Chera, Alexandra Fox, Feng-Chang Lin
BACKGROUND: Practice guidelines recommend palliative care for patients with advanced cancer, but gaps in access and quality of care persist. OBJECTIVE: To increase goals-of-care (GOC) communication for hospitalized patients with Stage IV cancer. METHODS: An interdisciplinary team designed a quality improvement intervention to enhance oncology palliative care, including training in communication skills and triggers for palliative care consults...
December 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28590150/impact-of-home-based-patient-centered-support-for-people-with-advanced-illness-in-an-open-health-system-a-retrospective-claims-analysis-of-health-expenditures-utilization-and-quality-of-care-at-end-of-life
#13
Sylvia Ek Sudat, Anjali Franco, Alice R Pressman, Kenneth Rosenfeld, Elizabeth Gornet, Walter Stewart
BACKGROUND: Home-based care coordination and support programs for people with advanced illness work alongside usual care to promote personal care goals, which usually include a preference for home-based end-of-life care. More research is needed to confirm the efficacy of these programs, especially when disseminated on a large scale. Advanced Illness Management is one such program, implemented within a large open health system in northern California, USA. AIM: To evaluate the impact of Advanced Illness Management on end-of-life resource utilization, cost of care, and care quality, as indicators of program success in supporting patient care goals...
February 2018: Palliative Medicine
https://www.readbyqxmd.com/read/28375994/translating-research-to-practice-providing-critically-ill-children-the-opportunity-to-go-home-or-to-hospice-for-end-of-life-care
#14
Harriett Nelson, Sandra Mott
BACKGROUND: A freestanding quaternary pediatric hospital in New England has been facilitating parents' requests to take their child home or to a hospice facility from an Intensive Care Unit at end of life for the withdrawal of life sustaining measures for the past 16 years. However, knowledge of the aftermath of this decision was very limited. Before responding to a growing interest in making this service more available, an exploratory study was done to learn about the parents' perceptions of the experience over time...
May 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28350476/initial-experience-with-honoring-choices-wisconsin-implementation-of-an-advance-care-planning-pilot-in-a-tertiary-care-setting
#15
Wendy L Peltier, Faiz Gani, Jennifer Blissitt, Katherine Walczak, Kristi Opper, Arthur R Derse, Fabian M Johnston
BACKGROUND: Although previous research on advance care planning (ACP) has associated ACP with improved quality of care at the end of life, the appropriate use of ACP remains limited. OBJECTIVE: To evaluate the impact of a pilot program using the "Honoring Choices Wisconsin" (HCW) model for ACP in a tertiary care setting, and to understand barriers to system-wide implementation. DESIGN: Retrospective review of prospectively collected data. SETTING/SUBJECTS: Patients who received medical or surgical oncology care at Froedtert and the Medical College of Wisconsin...
March 28, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28220023/early-palliative-care-reduces-end-of-life-intensive-care-unit-icu-use-but-not-icu-course-in-patients-with-advanced-cancer
#16
Andrew M Romano, Kristine E Gade, Gradon Nielsen, Robert Havard, James H Harrison, Josh Barclay, George J Stukenborg, Paul W Read, Leslie J Blackhall, Patrick M Dillon
BACKGROUND: Early palliative care for advanced cancer patients improves quality of life and survival, but less is known about its effect on intensive care unit (ICU) use at the end of life. This analysis assessed the effect of a comprehensive early palliative care program on ICU use and other outcomes among patients with advanced cancer. PATIENTS AND METHODS: A retrospective cohort of patients with advanced cancer enrolled in an early palliative care program ( n  = 275) was compared with a concurrent control group of patients receiving standard care ( n  = 195) during the same time period by using multivariable logistic regression analysis...
March 2017: Oncologist
https://www.readbyqxmd.com/read/28185893/u-s-clergy-religious-values-and-relationships-to-end-of-life-discussions-and-care
#17
Michael J Balboni, Adam Sullivan, Andrea C Enzinger, Patrick T Smith, Christine Mitchell, John R Peteet, James A Tulsky, Tyler VanderWeele, Tracy A Balboni
CONTEXT: Although clergy interact with approximately half of U.S. patients facing end-of-life medical decisions, little is known about clergy-congregant interactions or clergy influence on end-of-life decisions. OBJECTIVE: The objective was to conduct a nationally representative survey of clergy beliefs and practices. METHODS: A mailed survey to a nationally representative sample of clergy completed in March 2015 with 1005 of 1665 responding (60% response rate)...
June 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28169946/differences-in-utilization-of-life-support-and-end-of-life-care-for-medical-icu-patients-with-versus-without-cancer
#18
COMPARATIVE STUDY
Geoffrey Koff, Urvashi Vaid, Edward Len, Albert Crawford, David A Oxman
OBJECTIVES: To explore differences in the utilization of life support and end-of-life care between patients dying in the medical ICU with cancer compared with those without cancer. DESIGN: Retrospective review of 403 deaths or hospice transfers in the medical ICU from January 1, 2012, to June 30, 2013. SETTING: Urban tertiary care university hospital. PATIENTS: Consecutive medical ICU deaths or hospice transfers over an 18-month period...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28158232/the-effects-of-hospice-shared-care-for-gastric-cancer-patients
#19
Kun-Siang Huang, Shih-Ho Wang, Seng-Kee Chuah, Kun-Ming Rau, Yu-Hung Lin, Meng-Che Hsieh, Li-Hsueh Shih, Yen-Hao Chen
BACKGROUND: Hospice care has been proved to result in changes to the medical behaviors of terminally ill patients. The aim of this study was to evaluate the effects and medical behavior changes of hospice-shared care intervention among terminally ill gastric cancer patients. METHODS: A total of 174 patients who died of gastric cancer between 2012 and 2014 were identified. These patients were divided into two groups: a hospice-shared care group (n = 93) and a control group (n = 81)...
2017: PloS One
https://www.readbyqxmd.com/read/28156629/a-whole-greater-than-the-sum-of-the-parts-close-collaboration-between-palliative-care-and-clinical-ethics
#20
(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
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