Journal of palliative medicine最新文献_第6页

The Pharmacology of Aid in Dying: From Database Analyses to Evidence-Based Best Practices.

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-28 DOI: 10.1089/jpm.2024.0379

Patrick Macmillan, Susan Hughes, Angelique Loscar, Lonny Shavelson

{"title":"The Pharmacology of Aid in Dying: From Database Analyses to Evidence-Based Best Practices.","authors":"Patrick Macmillan, Susan Hughes, Angelique Loscar, Lonny Shavelson","doi":"10.1089/jpm.2024.0379","DOIUrl":"https://doi.org/10.1089/jpm.2024.0379","url":null,"abstract":"Background: Medical aid in dying is legal in 10 states plus Washington DC, covering 22% of the U.S. population. Much has been written about the ethics of aid in dying, but little about evidence-based care, especially the medications used. We investigated the efficacy of four commonly used aid-in-dying medication protocols-using the time to sleep and time to death as proxies for efficacy. Methods: We performed an independent, secondary analysis on deidentified data from four organizations, comparing four different medication protocols. Descriptive statistics for time to sleep and time to death for the different medication protocols were calculated. Medication protocols included one sedative and three sedative/cardiotoxin combinations. Results: We analyzed data from 3332 death reports covering 2009 to 2023, comparing a single sedative medication protocol with three different sedative/cardiotoxin combinations. The sedative alone yielded the most rapid median time to death of 0.4 hours, but with days-long outliers. Two of the sedative/cardiotoxin combinations yielded median times to death of 0.8 hours. But from 2018 to 2023, as the medication combinations shifted, the mean time to death declined while the median remained relatively steady-confirming that these combinations reduced the incidence of longer deaths (especially extreme outliers). Conclusion: This first-time analysis of aid-in-dying medication protocols showed that while a sedative alone had the best median time to death, the most recent sedative/cardiotoxin protocol had an acceptable median time to death of 0.8 hours, but with fewer prolonged-death outliers.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058178","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}

引用次数: 0

Orexin Receptor Antagonists for Insomnia in Patients with Serious Illness #496.

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-28 DOI: 10.1089/jpm.2024.0521

Hana Yu, Brooke Cline

引用次数: 0

Management of Behavioral Disturbances in Dementia: Part 1 Non-Pharmacologic #498.

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-24 DOI: 10.1089/jpm.2024.0560

Emma Bradley, Stephanie Teachout, Joshua Borris, Tyler Gentile, Paul Noufi

引用次数: 0

Ketamine and Ketamine-Assisted Psychotherapy for Psychiatric and Existential Distress in Patients with Serious Medical Illness: A Narrative Review. 氯胺酮及氯胺酮辅助心理治疗治疗严重内科疾病患者的精神和存在性困扰：叙述性综述。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-22 DOI: 10.1089/jpm.2024.0346

Roxanne Sholevar, William Kromka, Yvan Beaussant

{"title":"Ketamine and Ketamine-Assisted Psychotherapy for Psychiatric and Existential Distress in Patients with Serious Medical Illness: A Narrative Review.","authors":"Roxanne Sholevar, William Kromka, Yvan Beaussant","doi":"10.1089/jpm.2024.0346","DOIUrl":"https://doi.org/10.1089/jpm.2024.0346","url":null,"abstract":"Context: Psychiatric and existential distress are common and difficult-to-treat symptoms that are frequently encountered in the palliative care setting; current treatment options are limited in efficacy and tolerability. Psychedelic-assisted therapies (PAT) have gained public and scientific interest in their potential to induce rapid and effective reductions in psychiatric and existential distress in patients with serious medical illness, but remain available only in the research setting. Ketamine as a pharmacologic agent has a large body of evidence in the treatment of refractory depression. Objectives: To review the evidence that exists for use of ketamine or ketamine-assisted psychotherapy (KAP) for psychiatric and existential distress in patients with serious medical illness, aiming to identify therapeutic signals and gaps in research. Methods: A literature search identified publications of (1) ketamine or KAP, (2) psychiatric or existential distress, and (3) palliative care or patients with serious medical illness. Identified reports were carefully reviewed with attention to population and treatment-related factors, which were described in a narrative and aggregate format. Results: Nine studies and 12 case reports were identified that reported positive results and a good safety profile. There was significant variation in patient population, setting, route of administration, dosing schedule, and concurrent treatments. Most reports were of ketamine as a pharmacologic agent for symptoms of psychiatric distress. Conclusion: Evidence suggests that ketamine may induce rapid and transient improvements in psychiatric symptoms in patients with serious medical illness. A large gap in research exists for KAP and symptoms of existential distress. There is a signal that suggests ketamine could be used in a psychedelic therapy model with potential benefits over classical psychedelics.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007127","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}

引用次数: 0

Top Ten Tips Palliative Care Clinicians Should Know About Rheumatology. 关于风湿病，姑息治疗临床医生应该知道的十大提示。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-22 DOI: 10.1089/jpm.2024.0520

Shannon Herndon, Jack Kimball, Laura Ross, Sarah Homann, Maya N Faison, Yu-Lin Amy Lee, Adam Marks, Sophia C Weinmann, Mithu Maheswaranathan, David Leverenz, Christopher A Jones

引用次数: 0

Palliative Care Needs in Adult Patients with Acute Leukemia: A Prospective Observational Study. 成年急性白血病患者的姑息治疗需求：一项前瞻性观察研究。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-22 DOI: 10.1089/jpm.2024.0381

Jyothsna Kuriakose, Jayita K Deodhar, Hasmukh Jain, Manju Sengar, Alok Shetty, Prasun P, Prarthna Jayaseelan

{"title":"Palliative Care Needs in Adult Patients with Acute Leukemia: A Prospective Observational Study.","authors":"Jyothsna Kuriakose, Jayita K Deodhar, Hasmukh Jain, Manju Sengar, Alok Shetty, Prasun P, Prarthna Jayaseelan","doi":"10.1089/jpm.2024.0381","DOIUrl":"https://doi.org/10.1089/jpm.2024.0381","url":null,"abstract":"Background: Acute leukemia (AL) affects patients' well-being and inflicts substantial symptom burden. We evaluated palliative care needs and symptom burden in adult patients with AL from diagnosis through fourth week of induction chemotherapy. Methods: Newly diagnosed adult patients with AL scheduled for curative-intent treatments, prospectively completed Functional Assessment of Cancer Therapy-Leukemia questionnaire at diagnosis and postinduction therapy. Subscale scores identified domains with major needs, with lower scores signifying higher needs, while Leu-subscale assessed leukemia-specific symptom burden. Results: One hundred patients were enrolled. Upon diagnosis and four weeks into induction phase, respectively, patients exhibited the lowest scores in physical (17 ± 8.75; 16 ± 11; p < 0.05), functional (16.5 ± 10.75; 11 ± 12.2; p < 0.05), and leukemia-specific (43 ± 16.75; 41.48 ± 11.68; p > 0.05) domains. Predominant symptoms were \"getting tired easily\" (91%) at diagnosis and \"unable to do usual activities\" (92.3%) after induction. Conclusion: Patients with AL demonstrated substantial physical, functional, and leukemia-specific symptom needs at diagnosis, which intensified postinduction, highlighting the necessity for palliative care integration from diagnosis.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007128","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}

引用次数: 0

Is It in You?… (to be a Spiritual Care Champion). 它在你身上吗？（成为精神关怀冠军）。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-17 DOI: 10.1089/jpm.2024.0558

Paul Galchutt, Betty R Ferrell

引用次数: 0

Utilizing Simulated Telemedicine Encounters to Conduct Nationwide Studies of Physician Communication Practices. 利用模拟远程医疗接触进行医师沟通实践的全国研究。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-17 DOI: 10.1089/jpm.2024.0342

Michael C Matthews, Monica A Patel, Rachel A Rodenbach, Winifred Commers, Toby C Campbell

{"title":"Utilizing Simulated Telemedicine Encounters to Conduct Nationwide Studies of Physician Communication Practices.","authors":"Michael C Matthews, Monica A Patel, Rachel A Rodenbach, Winifred Commers, Toby C Campbell","doi":"10.1089/jpm.2024.0342","DOIUrl":"https://doi.org/10.1089/jpm.2024.0342","url":null,"abstract":"Introduction: High-quality communication and shared decision making (SDM) are crucial elements of effective patient care. SDM conversations are intimate and logistically challenging to capture. Evaluating alternative methods to effectively observe how physicians conduct these conversations may improve research efforts in this core discipline of medicine. Methods: In two distinct qualitative studies (A and B), subspecialist physicians participated in a telemedicine encounter with a simulated patient facing a high-stakes treatment decision. Results: Thirty-seven transplant hematologists (A) and 21 medical oncologists (B) from across the United States successfully completed a telemedicine encounter with a trained actor, allowing for qualitative analysis of their SDM conversations. Discussion: Simulated telemedicine encounters are a feasible method for studying how a broad sample of subspecialty physicians conduct difficult conversations, such as emotionally fraught SDM conversations. This model could improve understanding of the current practice of SDM, identify opportunities for improvement, and serve as a framework for ongoing research of physician communication practices.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007142","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}

引用次数: 0

Palliative Care, Advance Care Planning, and Craftsmanship: What He Taught Me Through End-of-Life Care. 缓和疗护、预先疗护计划与工艺：他透过临终疗护教给我的。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-16 DOI: 10.1089/jpm.2024.0512

Tadashi Nishimura, Megumi Nakamura, Jun Kako, Hajime Fujimoto

引用次数: 0

Fast Facts and Concepts #497: What Would You Do if It Were Your Child? 快速事实和概念#497：如果是你的孩子，你会怎么做？

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-01-14 DOI: 10.1089/jpm.2024.0538

Katherine F Guttmann, Renee D Boss, Cardinale B Smith, Robert M Arnold

引用次数: 0