Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2021
A National Survey of Challenges Faced by Hospices during the Opioid Crisis: Estimates of Pain Medication Shortages, Missing Medications, and Opioids Left in the Home Post-Death.
No national data exist on hospice medication shortages, the frequency that opioid medications go missing, and drug disposal practices. ⋯ Hospices face numerous challenges during the national opioid crisis. Interventions are needed to ensure access to needed treatments, mitigation of diversion, and safe medication disposal.
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J Pain Symptom Manage · Oct 2021
An Exploratory Study of Demographics and Outcomes for Patients Seen by Specialist Palliative Care Social Work in the Inpatient Setting at an Academic Medical Center.
Specialist palliative care social work (PCSW) across a four-team palliative care (PC) service in the inpatient setting at a tertiary academic medical center. ⋯ Involvement of PCSW increased dramatically over the study period. Compared to the rest of the PC team, when PCSW was involved, length of stay was longer, whole-person care components were more likely to be addressed, dyspnea was significantly improved, and pain was significantly worse when compared to those consults not seen by PCSW. Other symptoms such as nausea and anxiety as well as discharge characteristics such as death or hospice discharge were not significantly different with involvement of PCSW.
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J Pain Symptom Manage · Oct 2021
Changing Institutional Culture Around Hospice Using LEAN Tools to Improve Hospice Utilization in a Veteran Population.
Longer hospice length of stay improves the palliation of symptoms, quality of life, and the dying process for patients and their caregivers. We used a Lean designed Rapid Improvement Event (RIE) to facilitate earlier entry into hospice. ⋯ LEAN tools can be used successfully to improve end of life outcomes in an inpatient VA setting. The 90-day sustainment period following the RIE uncovers barriers to implementation and allows for adjustments to implementation.
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J Pain Symptom Manage · Oct 2021
Outcomes of Specialty Palliative Care Interventions for Patients with Hematologic Malignancies: A Systematic Review.
The outcomes of specialty palliative care (PC) interventions for patients with hematologic malignancies (HMs) is under-investigated. ⋯ Specialty PC interventions improve healthcare outcomes for patients with HMs and should be implemented early and often. There remains a need for additional studies investigating PC use exclusively in patients with HMs.
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J Pain Symptom Manage · Oct 2021
Navigating the Challenges of Fertility and Reproductive Planning for Terminal Cancer Patients.
Among the many disruptive effects of a terminal cancer diagnosis in young people is its ability to affect reproductive planning and the opportunity for parenthood. While many reproductive-aged cancer patients receive fertility counseling at diagnosis, ongoing guidance often does not occur during the illness course and associated distress may go unrecognized. Using a case-based framework, this palliative care rounds explores the existential, spiritual, ethical, and logistical challenges that complicate reproductive planning for patients and families as they face a terminal cancer diagnosis. We advocate that palliative care providers should seize currently underrecognized opportunities to screen for distress associated with fertility and reproduction at end of life and utilize an interdisciplinary team approach to provide appropriate support and counseling throughout the illness and bereavement experience.