Journal of palliative medicine最新文献

{"title":"Nonmedical Stimulant Use and Stimulant Use Disorders in Palliative Care #522.","authors":"Gabrielle Langmann, Cari Low","doi":"10.1177/10966218251383705","DOIUrl":"https://doi.org/10.1177/10966218251383705","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand-Foot Syndrome (Palmar-Plantar Erythrodysesthesia) #520.","authors":"Philip Chang, Arpit Arora","doi":"10.1177/10966218251384017","DOIUrl":"https://doi.org/10.1177/10966218251384017","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"0"},"PeriodicalIF":2.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative Care Practices in Gynecological Cancers in Asian Countries-A Cross-Sectional Survey by the Federation of Asian Organizations for Radiation Oncology.","authors":"Bhavana Rai, Ankita Gupta, Srinivasa G Y, Ekkasit Tharavichitkul, Chairat Lowanichkiattikul, Aung Khine, Ye Myint Aung, Christine Sagpao, Arie Munandar, Angela Giselvania, Hajera Jabeen, Tatsuya Ohno, Joo Young Kim, Unurjargal Bayasgalan, Shyam Kishore Srivastava, Imjai Chitapanarux, Supriya Chopra","doi":"10.1177/10966218251382355","DOIUrl":"https://doi.org/10.1177/10966218251382355","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This survey was conducted to assess the current palliative care practices in advanced gynecological cancers among radiation oncologists across the Federation of Asian Organizations for Radiation Oncology (FARO) region. <b><i>Materials and Methods:</i></b> A web-based survey comprising of a 23-item questionnaire was sent to the members of the FARO research committee, FARO council officers, and members representing the national radiation oncology organizations (<i>N</i> = 36) that are a part of FARO. <b><i>Results:</i></b> All members (100%) responded to the questionnaire. While a majority (76%) of the respondents had both inpatient and outpatient services available for palliative care at their center, only 22% reported having access to specialist palliative care or an attached hospice facility. Among gynecological cancers, cervical cancer was the most common malignancy referred for palliative care (89%), followed by ovarian (64%) and uterine cancer (40%). A combination of palliative radiation and drug therapy (89%) was the most frequently employed treatment modality. Nearly 65% of the respondents reported prescribing strong opioids such as morphine, while 8.3% cited limited or no access to strong opioids. More than 60% of the respondents believed that palliative care was underutilized at their center, and oncologists' lack of time was cited as the most common barrier (47%) limiting its utilization. Formal training in palliative care for all radiation oncologists (75%), development of palliative care infrastructure (66.7%), and improved access to specialist palliative care (55.6%) were cited as the most important measures that need to be undertaken to facilitate palliative care in the region. <b><i>Conclusions:</i></b> This survey has identified notable gaps in palliative care practices for gynecological cancers in the FARO region. To effectively integrate comprehensive palliative care into the oncology workflows, efforts must focus on increased training, strengthening the existing infrastructure, and developing research models tailored to the region's needs.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Humor in Palliative Care: Bridging Evidence and Practice.","authors":"Cuervo Pinna","doi":"10.1177/10966218251383839","DOIUrl":"https://doi.org/10.1177/10966218251383839","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Using AI-Generated Media of Children with Medical Conditions to Fundraise for a Pediatric Hospice.","authors":"Gregorio Zuniga-Villanueva, Muhammed Mukadam, David Lawrence Lysecki","doi":"10.1177/10966218251382730","DOIUrl":"https://doi.org/10.1177/10966218251382730","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulse Check: Status Update on Pediatric Palliative and Hospice Community-Based Coverage.","authors":"Meaghann S Weaver, Alix Ware, Deborah Fisher, Betsy Hawley, Holly Davis, Lisa C Lindley, Steven M Smith, Conrad S P Williams, Tej Chana, Christy Torkildson","doi":"10.1177/10966218251381999","DOIUrl":"https://doi.org/10.1177/10966218251381999","url":null,"abstract":"<p><p><b><i>Background:</i></b> The pediatric literature describes reliance on community-based palliative and hospice organizations in extending the reach of care for children. <b><i>Objective:</i></b> To provide an updated post-pandemic snapshot of pediatric palliative and hospice services and staffing offered by community-based organizations in the United States. <b><i>Design and Subjects:</i></b> This study utilized an online survey distributed to organizational members of the National Alliance for Care at Home in the United States. <b><i>Results:</i></b> A total of 295 palliative and hospice organizations from 50 states and Washington, DC, responded. Half (49%) of organizations reported increasing the number of pediatric patients accepted into their care over the past five years. A total of 6% of responding programs newly started to accept pediatric patients between 2020 and the current survey completion. Programs are less likely to include perinatal (61%) patients compared to infants through young adults (94%). Trauma increased as a reason for pediatric enrollment. Nonmetro geographies are less likely to provide services for children. The pediatric palliative average annual census was 271, and the pediatric hospice average annual census was 74. The pediatric patient's average length of stay for palliative care was 154 days and for hospice was 96 days. Medicaid (47%) is the most common form of reimbursement. Lack of trained personnel, low referrals, and funding were depicted as the most common barriers. <b><i>Conclusions:</i></b> Children remain underrepresented in the extension of care offered through community-based hospice organizations, with the gap widening in nonmetro settings. Further research into training, staffing, and funding models may improve care reach.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Gaps in Care Quality for Seriously Ill Medicare Advantage Enrollees.","authors":"Rebecca Anhang Price, Anagha Tolpadi, Melissa A Bradley, Maria DeYoreo, Marc N Elliott, Joan M Teno, William Brodnitzki, Jason X Chen, Anna Gosline, Stephanie Chan","doi":"10.1177/10966218251381011","DOIUrl":"https://doi.org/10.1177/10966218251381011","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Increasingly, seriously ill Americans are ensured by Medicare Advantage (MA). However, standardized assessments of MA care quality do not highlight their unique experiences and needs. We adapted a previously validated survey to describe care experiences of seriously ill MA enrollees and highlight areas of unmet need for quality improvement. <b><i>Study Design:</i></b> This is a cross-sectional study. <b><i>Methods:</i></b> We sampled 3500 MA enrollees with the highest Hierarchical Condition Category (HCC) scores within one MA organization and administered a validated patient Serious Illness Survey for Home-Based Programs assessing communication, care coordination, symptom management, and planning for care in July and August 2023. We calculated top-box scores for all respondents and used linear regressions to calculate adjusted scores for subgroups of respondents meeting alternate serious illness definitions. <b><i>Results:</i></b> Of 1412 respondents, 84.6% had three or more chronic conditions. Responses indicated substantial room for improvement across quality measures assessed, with just 59.6% and 56.9% of respondents reporting that their communication and care coordination needs were met, respectively; 52.8% reporting that they \"definitely\" got the help they wanted for their symptoms; and 38.8% indicating that they had \"definitely\" discussed planning for care with their health care professionals. Respondents with HCC risk scores of ≥3 plus recent health care utilization also reported considerable unmet needs. <b><i>Conclusions:</i></b> Seriously ill MA enrollees have important unmet needs for care planning, care coordination, communication, and symptom management that are not highlighted by existing quality measures, but can be addressed through evidence-based interventions. Assessing care quality for seriously ill enrollees using standardized, survey-based measures can help to identify actionable improvement targets for this high-need, high-cost group.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Sitting when Caring for Patients with Serious Illness #514.","authors":"Sean Marks, Jonathan Gully, James Deming","doi":"10.1177/10966218251383718","DOIUrl":"https://doi.org/10.1177/10966218251383718","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Affordable Care Act on Palliative and Hospice Care Utilization Among Patients with Gastrointestinal Cancers: An Interrupted Time Series Analysis.","authors":"Eshetu Worku, Selamawit Woldesenbet, Mujtaba Khalil, Timothy M Pawlik","doi":"10.1177/10966218251377179","DOIUrl":"https://doi.org/10.1177/10966218251377179","url":null,"abstract":"<p><p><b><i>Background:</i></b> The Affordable Care Act (ACA) aimed to expand insurance coverage, improve health outcomes, and reduce costs. We assessed the impact of the ACA on hospice or palliative care utilization among patients with stage IV gastrointestinal (GI) cancer. <b><i>Methods:</i></b> Individuals diagnosed with stage IV GI cancer between 2007 and 2019 were identified from the Medicare database. An interrupted time series analysis (ITS) examined the impact of ACA on palliative care utilization. Entropy balancing and gamma regression were used to assess the cost implications of not utilizing palliative care. <b><i>Results:</i></b> Among the 26,227 stage IV GI cancer Medicare beneficiaries, approximately half (53.9%) were male. Overall, 80.5% of patients used palliative care before death. Utilization increased from 54.3% in 2007 to 84% in 2013 pre-ACA (slope: +0.009; 95% confidence interval [CI]: 0.005-0.012) and from 84.5% in Q1 2014 to 89.7% in Q4 2019 post-ACA (slope: +0.004; 95% CI: 0.0007-0.007), indicating slow progress in palliative care uptake. The ITS model demonstrated that ACA implementation did not affect palliative care utilization (slope: -0.006; 95% CI: -0.017 to +0.004). Patients from minority racial groups (odds ratio [OR]: 0.79; 95% CI: 0.74-0.86) and those in moderate (OR: 0.86; 95% CI: 0.80-0.94) and high (OR: 0.68; 95% CI: 0.62-0.74) Social Vulnerability Index (SVI) counties were less likely to use palliative care in both pre- and post-ACA eras. Palliative care use was associated with $2,633 lower total expenditure. <b><i>Conclusion:</i></b> ACA implementation did not improve palliative care utilization for racial minorities and high SVI groups. Targeted efforts are needed to improve access to equitable end-of-life care.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Communication: Closing the Gap Between Parental Preference and Provider Practice.","authors":"Alison J Liu, Eleanor M Frechette, Christina K Ullrich","doi":"10.1177/10966218251381942","DOIUrl":"https://doi.org/10.1177/10966218251381942","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}