Journal of pain and symptom management
-
J Pain Symptom Manage · Apr 2023
Standard Naloxone Prescribing for Palliative Care Cancer Patients on Opioid Therapy: A Single-Site Quality Improvement Pilot to Assess Attitudes and Access.
Limited data exist on when to offer naloxone to cancer patients on opioid therapy. ⋯ Opioid safety education and naloxone prescribing can be done quickly and is well-received by clinicians and patients.
-
J Pain Symptom Manage · Apr 2023
Just-in-Time Decision Making: Preliminary Findings of a Goals of Care Rapid Response Team.
The COVID-19 pandemic placed the issue of resource utilization front and center. Our comprehensive cancer center developed a Goals of Care Rapid Response Team (GOC RRT) to optimize resource utilization balanced with goal-concordant patient care. ⋯ GOC RRT consultations were feasible and associated with care limitation. Adherence to core team participation was fair.
-
J Pain Symptom Manage · Apr 2023
Racial Disparities in Health Beliefs and Advance Care Planning Among Patients Receiving Maintenance Dialysis.
Among people receiving maintenance dialysis, little is known about racial disparities in the occurrence of prognostic discussions, beliefs about future health, and completion of advance care planning (ACP) documents. ⋯ We found no significant difference in the frequency of prognostic discussions between Black (11.9%) versus White patients (7%) (P=0.15). However, Black patients (19%) had lower odds of believing that their health would worsen over the next 12 months (OR 0.22, CI 0.12, 0.44) and reporting completion of any ACP-related document (OR 0.5, CI 0.32, 0.81) compared to White patients CONCLUSION: Racial differences exist in beliefs about future health and completion of ACP-related documents. Systemic efforts to investigate differences in health beliefs and address racial disparities in the completion of ACP-related documents are needed.
-
J Pain Symptom Manage · Apr 2023
A world of maximalist medicine: physician perspectives on palliative care and end-of-life for patients with pulmonary arterial hypertension.
Physicians who specialize in pulmonary arterial hypertension (PAH) care for patients facing a serious, life-limiting illness. Palliative care is underutilized in patients with PAH, and little is known about how best to provide palliative care to this patient population. ⋯ PAH physicians are open to palliative care for their patients and are willing to partner with palliative care clinicians to implement this effectively and in the right setting. Areas for targeted improvement in enhancing palliative care for patients with PAH exist, especially enhancing collaboration between PAH physicians and palliative care specialists and navigating barriers in health systems.