Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2024
Case ReportsDiscrepancies between the electronic medical record and website access to the prescription drug monitoring program.
The US opioid crisis has affected many patients across the age spectrum. Yet little has been reported on the effects of this crisis on cancer patients. ⋯ We present a case of missing opioid prescriptions on EMR integrated PDMP versus the web based PDMP. A full review of PDMP integration is needed to identify gaps as these pose a significant patient safety issue.
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J Pain Symptom Manage · Mar 2024
Pilot Implementation of the Responding to Urgency of Need in Palliative Care (RUN-PC) Triage Tool.
Specialist palliative care services must balance provision of needs-based care within resource restraints. The Responding to Urgency of Need in Palliative Care (RUN-PC) Triage Tool is a novel, evidence-based, 7-item prioritization tool, with recommended response times for any given score. ⋯ The RUN-PC Triage Tool is feasible to implement, with high clinician acceptability and virtually no additional time required. The recommended response times are feasible and highlight target areas for improvement. Implementation of the tool enables palliative care services to better characterize their referral population and, in turn, improve transparency around access to care.
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The symptoms associated with the excessive fluid accumulation of ascites or pleural effusions can be intractable to medical management and can have a significant negative impact on quality of life of hospice patients. Hospice of the Valley, a community-based, nonprofit hospice agency has historically referred patients to outpatient providers for paracentesis, thoracentesis, and placement of tunneled drainage catheters. ⋯ An in-house program of tunneled catheter placement is a feasible option for hospice providers with low-cost exposure and high potential for improved quality of life and symptom relief for selected patients.
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J Pain Symptom Manage · Mar 2024
Questionnaires about the End of Life for Cancer Patients - Is the Response Burden Acceptable?
Research about the end of life with the help of patient-reported outcomes in vulnerable populations such as cancer patients is needed but is potentially burdensome and can therefore raise concerns. ⋯ The reported response burden seems acceptable since it was generally low. However, a subgroup did report some burden. Minimising burden and enhancing participants' benefits without compromising the research quality should further influence study designs in this field.
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J Pain Symptom Manage · Mar 2024
Effects of primary care-led, integrated palliative care for Medicare patients in a value-based model.
Faced with a projected shortage of specialized palliative care physicians, scalable palliative solutions are required to better meet the aging population's needs. ⋯ A primary care-led, integrated approach of delivering palliative care within a full-risk model can be an effective care delivery mechanism to meet the healthcare needs of an aging population by impacting patient outcomes and reducing avoidable utilization and cost at the end of life. These findings demonstrate that PCPs in a scaled, full-risk model can simultaneously improve care for patients while reducing costs to the healthcare system.