Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2019
QTc Interval Prolongation in Pediatric and Young Adult Patients on Methadone for Cancer Related Pain.
Methadone has been reported to prolong the corrected QT (QTc) interval and increase the risk of torsades de pointes. ⋯ Clinically significant prolongation of the QTc interval occurred only in one patient who had a history of prolonged QTc. Prolonged QTc is rare in this population.
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J Pain Symptom Manage · Oct 2019
Observational StudyPaying for Palliative Care in Medicare: Evidence from the Four Seasons/Duke CMMI Demonstration.
Palliative care improves patient and family outcomes and may reduce the cost of care, but this service is underutilized among Medicare beneficiaries. ⋯ Expansion of community palliative care programs into multiple enrollment settings is feasible. It may improve hospice utilization among enrollees. Heterogeneous program participation by program setting pose challenges to a standardizing reimbursement policy.
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J Pain Symptom Manage · Oct 2019
Comfort Measures Orders and Hospital Transfers: Insights from the OPTIMISTIC Demonstration Project.
Nursing facility residents and their families may identify "comfort measures" as their overall goal of care, yet some hospital transfers still occur. ⋯ Most transfers of residents with comfort measures orders were considered unavoidable. Nonetheless, we identified several opportunities for improving care processes, including communication and addressing acute changes in status.