Journal of palliative medicine最新文献

{"title":"Injectable Opioid Use in Home Palliative Care: A Pilot Survey of Multidisciplinary Role Sharing and Readiness.","authors":"Shinya Kajiura, Tomohiko Hayashi, Makoto Hirano, Shiro Koseki, Nozomu Murakami, Ryuji Hayashi","doi":"10.1177/10966218261460945","DOIUrl":"10.1177/10966218261460945","url":null,"abstract":"<p><strong>Background/objectives: </strong>Injectable opioid use in home palliative care requires multiprofessional coordination, but regional implementation data are limited. We conducted a pilot survey to describe experience, task sharing, difficulties, and future willingness.</p><p><strong>Methods: </strong>We performed an anonymous web-based cross-sectional survey of multidisciplinary professionals involved in community-based palliative care in a Japanese regional health care area.</p><p><strong>Results: </strong>Among 159 respondents, 117 (73.6%) had prior opioid experience for cancer pain, and 73/117 (62.4%) had prior injectable opioid experience. Initiation was mainly attributed to hospital physicians, maintenance dose management to hospital and clinic/home care physicians, and solution or cassette exchange to nurses. Difficulties when starting or modifying injectable opioids were reported by 27/73 respondents (37.0%). Future willingness was higher with prior experience (41/72, 56.9%) than without prior experience (7/83, 8.4%).</p><p><strong>Conclusion: </strong>This pilot survey suggests that home injectable opioid practice is a multidisciplinary workflow with an experience-related readiness gap, supporting broader regional evaluation and implementation-focused support.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1444-1447"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277739","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":"Communicating with Patients and Families with Limited English Proficiency in the Home Hospice Setting: A National Survey of U.S. Hospice Providers.","authors":"Milagros D Silva, Ronald D Adelman, Irina Mindlis, Angela L Novas, Amy S Tucci, M Carrington Reid","doi":"10.1177/10966218261456825","DOIUrl":"10.1177/10966218261456825","url":null,"abstract":"<p><strong>Background: </strong>Language barriers lead to disparities at the end of life (EOL). How providers work with medical interpreters and meet the needs of patients and families with limited English proficiency (LEP) enrolled in hospice remains poorly understood.</p><p><strong>Objectives: </strong>To investigate home hospice providers' experiences when communicating with patients and families with LEP, report the frequency of use of medical interpretation, and ascertain the strategies utilized by respondents to communicate with patients and families with LEP.</p><p><strong>Design: </strong>Cross-sectional survey of U.S. based home hospice providers delivering home hospice care.</p><p><strong>Results: </strong>A total of 138 surveys were collected. The response rate could not be calculated due to the survey dissemination method. On average 22% of the respondents reported caring for patients/families with LEP. Over-the-phone interpreting (OPI) was the most frequent professional interpreter modality utilized to communicate with patients/families with LEP (81%). Adult family members and hospice staff, who spoke the same language as the patient, were also commonly utilized by respondents (83% and 66%, respectively). Provision of video remote interpreting written hospice and bereavement materials in various non-English languages was viewed as a beneficial interventions for this patient population.</p><p><strong>Conclusion: </strong>OPI was most frequently utilized by home hospice providers. Having bilingual hospice staff and non-English language bereavement materials was viewed as an important strategy to support patients and families with LEP.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1387-1393"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301793","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":"Hawaii's CMS-Approved Community-Based Palliative Care Benefit: A Model for State Medicaid Innovation.","authors":"Irwin James Chapman, Rae S Seitz","doi":"10.1177/10966218261452785","DOIUrl":"10.1177/10966218261452785","url":null,"abstract":"<p><strong>Background: </strong>Hawaii implemented a statewide Community Palliative Care benefit in 2025 under its Section 1115 Medicaid Demonstration waiver to expand access to interdisciplinary palliative care for Medicaid beneficiaries with serious illnesses.</p><p><strong>Methods: </strong>This policy analysis synthesizes federal and state policy documents, implementation guidance, and relevant literature to describe the development, operational design, and implementation strategy of the benefit.</p><p><strong>Results: </strong>The benefit establishes standardized eligibility criteria, interdisciplinary staffing expectations, unified documentation standards, and a blended reimbursement model. Development incorporated extensive stakeholder engagement, including clinicians, managed care organizations, hospice programs, and community organizations.</p><p><strong>Conclusions: </strong>Hawaii's model provides a structured statewide framework for Medicaid-covered community-based palliative care and offers lessons for other states seeking to expand access to serious illness care.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1375-1378"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015892","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":"Prescription Inquiries From Community Pharmacies Regarding Outpatient Opioid Prescriptions: A Retrospective Analysis of Content and Clinical Significance.","authors":"Keito Ikou, Yuma Shibutani, Shinya Suzuki, Sayaka Nakajima, Akiko Hashimoto, Azumi Sakou, Yasuaki Ryushima, Naoko Kumazawa, Masahito Yonemura, Naoki Kondo","doi":"10.1177/10966218261460520","DOIUrl":"10.1177/10966218261460520","url":null,"abstract":"<p><strong>Background: </strong>Opioids are widely used for cancer-related pain but are associated with serious adverse events, making appropriate prescription auditing essential. In Japan, most outpatient opioid prescriptions are dispensed at community pharmacies, where pharmacists play a key role. However, the content and clinical significance of opioid-related prescription audits have not been fully elucidated.</p><p><strong>Objectives: </strong>To evaluate the content, clinical significance, and impact of prescription inquiries by community pharmacists on outpatient opioid prescriptions.</p><p><strong>Designs: </strong>This single-center retrospective cohort study analyzed prescription inquiries related to outpatient opioid prescriptions issued by the National Cancer Center Hospital East between September 2023 and March 2025. Inquiry contents were classified according to drug therapy problems related to efficacy and safety.</p><p><strong>Measurement: </strong>Pharmacist interventions were evaluated using established rating instruments for medication-order error severity and clinical value.</p><p><strong>Results: </strong>During the study period, 184,688 prescriptions were issued; 10,153 (5.4%) involved inquiries from community pharmacies, including 391 (0.2%) related to opioids, of which 341 (87%) resulted in prescription modifications. Inquiries related to efficacy and safety accounted for 48%, with dosage errors (23%) and treatment duration errors (23%) most common. Overall, 180 cases (46%) were classified as potentially lethal, serious, or significant medication-order errors, and 46% of pharmacist interventions were rated as significant or higher, most frequently involving dosage errors with high severity and clinical value.</p><p><strong>Conclusions: </strong>These findings highlight the critical role of community pharmacists in ensuring safe and appropriate opioid therapy and underscore the importance of collaboration between hospital and community pharmacists in outpatient cancer care.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1419-1424"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376091","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 Special Sauce: Lessons in Leadership Development from the Sojourns Scholar Leadership Program.","authors":"Steven Z Pantilat, Barbara L Jones, Patricia M Davidson, Lynn F Reinke, Jean S Kutner, Diane Meier, Corey L Kennard, Edo Banach, Betty Ferrell","doi":"10.1177/10966218261466834","DOIUrl":"10.1177/10966218261466834","url":null,"abstract":"<p><p>In 2014 the Cambia Health Foundation launched the Sojourns Scholar Leadership Program to promote, support, grow, and nurture a new generation of leaders in palliative care. As the program winds down after recruiting 108 scholars comprised of 10 cohorts of 10-12 professionals from across disciplines in our field, the members of its advisory board share the \"secret sauce,\" three aspects of the program that we believe were the keys to success-recruit great people, provide strong program leadership and mentorship, and create and sustain a supportive, engaged community-to guide future initiatives in leadership development. Palliative care needs visionary leaders to address the challenges in health care and meet the demand for quality palliative care. We strongly encourage other organizations committed to improving the care of people with serious illness to use these lessons to invest in the development of new generations of leaders.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1363-1366"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405151","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":"Responding to Common Patient Concerns for The Fentanyl Patch #535.","authors":"Zaheera Lukman, Ravindra Maharaj, Sean Marks, Michael J Schuh","doi":"10.1177/10966218261460513","DOIUrl":"10.1177/10966218261460513","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1476-1477"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148226129","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":"Body Image Considerations in Patients with Serious Illness #534.","authors":"Julia Myerson, Yue-Liang Brewerton, Sean Z Hutchinson","doi":"10.1177/10966218261450282","DOIUrl":"10.1177/10966218261450282","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1473-1475"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015966","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":"Geographic Access to Hospices with High Quality Ratings.","authors":"Jacob Whitman, Harsheni Sudakar, Lindsay Sabik, Yael Schenker","doi":"10.1177/10966218261457198","DOIUrl":"10.1177/10966218261457198","url":null,"abstract":"<p><strong>Objective: </strong>Recent growth in hospice has raised concerns about variability in access and quality. This study examines U.S. county-level presence of hospice providers.</p><p><strong>Methods: </strong>Quality was assessed using 2023 Centers for Medicare & Medicaid Services Consumer Assessment of Healthcare Providers and Systems Hospice Survey Star Ratings. County-level sociodemographic characteristics were obtained from the U.S. Census Bureau's American Community Survey 2023 five-year sample.</p><p><strong>Results: </strong>Of 7024 hospice providers, 29.2% had publicly available ratings, of which 55.3% were high quality (>3 stars). Of 3222 counties, at least one hospice provider was located in 41.4%, and a high-quality provider was present in 23.6%. Counties with high-quality providers tend to be urban and have higher income, larger populations, higher education, and lower poverty and uninsurance rates.</p><p><strong>Conclusions: </strong>Many U.S. counties have no hospice providers. The presence of high-quality care is markedly lower in rural and poor counties. Missing star ratings limit the utility of public quality data for patient and family decision-making.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1425-1430"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317674","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":"Integrating Artificial Intelligence-Based Simulation into Serious Illness Conversation Training: A Pilot Medical Student Intervention.","authors":"Lori A Herbst, Daniel Kadden, Danielle E Weber, Seth Overla, Laurah Turner","doi":"10.1177/10966218261457791","DOIUrl":"10.1177/10966218261457791","url":null,"abstract":"<p><strong>Background: </strong>Serious illness conversations (SICs) are an important part of medical care, yet trainees continue to express discomfort. Educational opportunities are time and resource-intensive. This pilot study's aim was to explore the experience of artificial intelligence (AI) technology deployed for SIC practice and feedback.</p><p><strong>Methods: </strong>2-Sigma, an AI-based simulation platform, was deployed as a tool for medical students to practice SICs utilizing skills taught through a dedicated Advance Care Planning (ACP) curriculum. Eleven medical students completed 27 cases and full transcripts were reviewed to describe (1) student interactions with AI, (2) AI responses, and (3) AI-provided feedback.</p><p><strong>Results: </strong>Students interacted with AI utilizing skills taught in the ACP curriculum. AI responses displayed emotion, however, quickly resolved negative feelings. Feedback addressed important components of SICs but varied in its specificity.</p><p><strong>Conclusion: </strong>AI technology represents a potential tool for practicing skills necessary for SICs.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1431-1437"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211568","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":"Daffodils.","authors":"April Butler","doi":"10.1177/10966218251401417","DOIUrl":"10.1177/10966218251401417","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1478"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145634929","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}