Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2019
Randomized Controlled TrialCOMPASS: A Pilot Trial of an Early Palliative Care Intervention for Patients with End Stage Liver Disease.
Palliative care interventions have shown promise in improving quality of life and reducing health-care utilization among patients with chronic organ failure. ⋯ Logistical obstacles hindered completion of the trial as originally designed. Nevertheless, a preemptive palliative care intervention resulted in increased time to first readmission and more days alive outside the hospital in the first six months after study entry.
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J Pain Symptom Manage · Oct 2019
Observational StudyPaying for Palliative Care in Medicare: Evidence from the Four Seasons/Duke CMMI Demonstration.
Palliative care improves patient and family outcomes and may reduce the cost of care, but this service is underutilized among Medicare beneficiaries. ⋯ Expansion of community palliative care programs into multiple enrollment settings is feasible. It may improve hospice utilization among enrollees. Heterogeneous program participation by program setting pose challenges to a standardizing reimbursement policy.
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J Pain Symptom Manage · Oct 2019
Randomized Controlled TrialAcceptance and Commitment Therapy for Symptom Interference in Advanced Lung Cancer and Caregiver Distress: A Pilot Randomized Trial.
Advanced lung cancer patients typically have a poor prognosis and many symptoms that interfere with functioning, contributing to high rates of emotional distress in both patients and family caregivers. There remains a need for evidence-based interventions to improve functional outcomes and distress in this population. ⋯ Findings suggest that telephone-based ACT is feasible for many advanced lung cancer patients and caregivers, but may not substantially reduce symptom interference and distress. Low baseline levels of certain symptoms may have contributed to null findings. Next steps include applying ACT to specific, clinically meaningful symptom interference and varying intervention dose and modality.