Journal of palliative medicine
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Palliative care improves outcomes, yet rural residents often lack adequate and equitable access. This study provides practical tips to address palliative care (PC)-related challenges in rural communities. ⋯ Despite complex barriers to access, providers can tailor PC to be patient-centered, respect local values, and bridge gaps. The "Top 10" format emphasizes the relevant issues to enable clinicians to provide optimal care for people from rural areas.
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Objective: The electronic health record (EHR) has emerged as a fundamental tool but has focused on physical care delivery. Psychosocial screenings and interventions are central to palliative care that supports whole person care models; however, EHR innovations to capture psychosocial care have not been optimized. Material and Methods: A narrative review was conducted from 2009 to March 2023. ⋯ Recommendations highlight the importance of shared priorities and collaboration with key stakeholders to fully execute on the clinical utility of EHRs. Future work will continue to evaluate data collection tools and systematic approaches to capture psychological needs and social environment and its impact on health outcomes and quality of life. Conclusion: This review will expand on opportunities for automated reporting of psychosocial care in the context of seriously ill.
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Background: Physical pain is highly prevalent and impacts the well-being of patients with advanced oncologic disease. Although myofascial pain syndrome (MPS) can be one of the components of pain in cancer patients on palliative care (PC), so far there is no evidence about the benefit of treatment with 1% lidocaine needling. Objectives: To evaluate the efficacy of MPS treatment with injection of 1% lidocaine on the reduction of pain in cancer patients on PC. ⋯ After 72 hours, there was a reduction in referred pain intensity (p < 0.001) and an increase in pressure threshold (p = 0.007) in the intervention group (IG), with no difference in the control. The frequency of individuals who reduced the doses and/or classes of pain medications was higher in the IG (p = 0.011). Conclusion: One percent lidocaine needling in TPs was an effective therapy for pain reduction in MPS.
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Background: Gaps remain in our understanding of the intensity and timing of specialty palliative care (SPC) exposure on end-of-life (EOL) outcomes. Objective: Examine the association between intensity and timing of SPC and hospice (HO) exposure on EOL care outcomes. Design, Settings, Participants: Data for this cohort study were drawn from 2021 adult decedents from Kaiser Permanente Southern California and Colorado (n = 26,251). ⋯ Caregivers of patients in the HO-only (aRR: 1.27 [95% CI: 0.98-1.63], p = 0.07) and SPC-HO cohorts (aRR: 1.19 [95% CI: 0.93-1.52], p = 0.18) tended to report more positive care experience compared to the no SPC or HO cohort. Conclusion: Earlier exposure to SPC was important in reducing potentially burdensome treatments and death in the hospital for decedents who did not enroll in HO. Increasing availability and access to community-based SPC is needed.