Journal of pain and symptom management
-
J Pain Symptom Manage · Jun 2024
Factors associated with hospital admission in the last month: A retrospective single center analysis.
Driven by concerns about care quality, patient experience, and national metrics, health systems are increasingly focusing on identifying risk factors for patients who are hospitalized in the last month of life. ⋯ As patients with heart or liver disease or metastatic cancer had the highest odds of admission in the last month, collaborative interventions between primary, palliative, and specialty care may improve quality of care at the end of life.
-
J Pain Symptom Manage · Jun 2024
US Medicare Hospice and Palliative Medicine Physician Workforce and Service Delivery in 2008-2020.
Despite clinical benefits of early palliative care, little is known about Medicare physician workforce specialized in Hospice and Palliative Medicine (HPM) and their service delivery settings. ⋯ Despite growth in Medicare HPM physician workforce, access is disproportionately concentrated in metropolitan and inpatient settings. This may limit receipt of early outpatient specialized palliative care, especially in nonmetropolitan areas.
-
J Pain Symptom Manage · Jun 2024
Palliative Medicine Fellows' Discussions, Perceptions, and Training Regarding Medical Cannabis.
Medical cannabis is increasingly considered for palliation of pain, nausea/vomiting, anorexia, and other symptoms. ⋯ Most HPM fellows report formal training in the use of medical cannabis. Over half of trainees reported discussing medical cannabis with patients, but few considered themselves sufficiently informed to make cannabis-related clinical recommendations. These results suggest both a need for expanded high-quality evidence for medical cannabis in palliative care and for improved formal education for HPM fellows.
-
J Pain Symptom Manage · Jun 2024
Interprofessional Post-Graduate Training Model for Nurse Practitioners and Physician Trainees.
People living with serious illness and their care partners rely on team-based specialty hospice and palliative care (HPC) in order to achieve high quality end of life outcomes. In HPC, physician and nurse practitioner (NP) scope of practice has significant overlap so training together may offer benefits to clinicians and patients. ⋯ Assessing an IPE post-graduate training program in HPC was possible using a shared clinical competency framework, and revealed similar clinical gains for NPs and physicians enrolled in the program.
-
J Pain Symptom Manage · Jun 2024
Effects of Prognostic Communication Strategies on Prognostic Perceptions, Treatment Decisions and End-Of-Life Anticipation in Advanced Cancer: An Experimental Study among Analogue Patients.
Evidence-based guidance for oncologists on how to communicate prognosis is scarce. ⋯ If and how oncologists discuss prognosis can influence how individuals perceive prognosis, which treatment they prefer, and how they feel about treatment decisions. Communicating numerical estimates may stimulate prognostic understanding and informed treatment decision-making.