Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2024
Screening for Palliative Care Need in Oncology: Validation of Patient-Reported Outcome Measures.
Leading oncology societies recommend monitoring symptoms and support needs through patient-reported outcome measures (PROMs), but their use for assessing specialist palliative care (SPC) need has not yet been explored. Research on SPC integration has focused on staff-assessed screening tools, which are time-consuming. ⋯ PROMs are useful for identifying SPC need in cancer patients. Their implementation might facilitate timely integration of SPC. Future research should focus on an integrated assessment approach with PROMs that combines the requirements of the different specialties to save patient and staff resources.
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J Pain Symptom Manage · Apr 2024
Economic Hardship at the End of Life for Families of Children with Complex Chronic Conditions.
Many children with complex chronic medical conditions (CCC), though living longer, die prematurely. Little is known about family economic hardship during end of life (EOL), nor associated differences in patterns of care. ⋯ Economic burden on families of children with CCC correlates with higher health care utilization demonstrating the need for ameliorative resources and preventative measures.
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J Pain Symptom Manage · Apr 2024
Influence of Income and Education on Palliative Care in Acute Myeloid Leukemia Using the NCDB.
Palliative care is integral to symptom management, and we examined its relationship with income, education, and Medicaid expansion in acute myeloid leukemia. This was a retrospective cross-sectional study using the National Cancer Database that included patients with acute myeloid and monocytic leukemias > 18 years of age treated at Commission on Cancer facilities from 2004 to 2016. Univariate and multivariate models were adjusted for demographic variables and facility characteristics. ⋯ Residence in states with Medicaid expansion (January 2014 onward) had greater palliative care utilization. Palliative care use was associated with higher education but underutilized with higher incomes. Increased access with Medicaid expansion suggests the importance of public insurance.
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J Pain Symptom Manage · Apr 2024
Predictive models for palliative care needs of advanced cancer patients receiving chemotherapy.
Early palliative care is recommended within eight-week of diagnosing advanced cancer. Although guidelines suggest routine screening to identify cancer patients who could benefit from palliative care, implementing screening can be challenging due to understaffing and time constraints. ⋯ Our models could forecast specialist palliative care needs for advanced cancer patients on chemotherapy. Using five variables as predictors could replace screening tools and has the potential to contribute to earlier palliative care.
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J Pain Symptom Manage · Apr 2024
Discriminatory healthcare experiences and medical mistrust in patients with serious illness.
Though discrimination in healthcare settings is increasingly recognized, the discriminatory experiences of patients with serious illness has not been well studied. ⋯ In this cross-sectional study of patients with serious illness, discriminatory experiences were associated with worse mistrust in the medical system, particularly for Black and NA/AN participants. These findings suggest that race-conscious approaches are needed to address discrimination and mistrust in marginalized patients with serious illness and their families.