Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2023
ReviewPsychiatric Comorbidities and Outcomes in Palliative and End-of-Life Care: A Systematic Review.
Although psychiatric comorbidities are common among individuals at end of life, their impact on outcomes is poorly understood. ⋯ Psychiatric comorbidity is associated with significant differences in care utilization and clinical outcome among patients at end of life. In particular, patients with psychiatric comorbidity and serious illness are at high risk of poor quality of life and high symptom burden. Our finding that psychiatric comorbidity is associated with increased utilization of palliative care likely reflects the complexity and clinical needs of patients with serious illness and mental health needs. These data suggest that greater integration of mental health and palliative care services may enhance quality-of-life among patients at end of life.
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J Pain Symptom Manage · Jul 2023
Randomized Controlled TrialEffect of an Artificial Intelligence Decision Support Tool on Palliative Care Referral in Hospitalized Patients: A Randomized Clinical Trial.
Palliative care services are commonly provided to hospitalized patients, but accurately predicting who needs them remains a challenge. ⋯ A decision support tool integrated into palliative care practice and leveraging AI/ML demonstrated an increased palliative care consultation rate among hospitalized patients and reductions in hospitalizations.
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J Pain Symptom Manage · Jul 2023
Observational StudyDecisional-regret trajectories from end-of-life decision making through bereavement.
Regret plays a central role in surrogate decision making. Research on decisional regret in family surrogates is scarce and lacks longitudinal studies to illustrate the heterogenous, dynamic evolution of decisional regret. ⋯ Surrogates heterogeneously suffered decisional regret from EOL decision making through bereavement as evident by four identified distinct decisional-regret trajectories. Early identification and prevention of increasing/prolonged decisional-regret trajectories is warranted.