Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2023
Hospice and Palliative Medicine Fellowship Training in Mental Health: A Survey of Program Directors.
Psychological and psychiatric care is a core domain of palliative care. Despite a high burden of mental health comorbidity among individuals with serious illness, the Accreditation Council of Graduate Medical Education gives little guidance about training hospice and palliative medicine (HPM) fellows in this domain of care. Currently, there is a lack of empiric data on HPM physician fellowship training in mental health topics. ⋯ Beyond a few commonly identified and taught key topics, there is variability in clinical and didactic exposure to mental health training among HPM fellowships. Standardizing key learning objectives and guiding educators in how to achieve these objectives could improve the preparedness of the physician workforce in HPM to meet the mental health needs of patients with serious illness.
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J Pain Symptom Manage · Oct 2023
Validation of electronic health record-based algorithms to identify specialist palliative care within the Department of Veterans Affairs.
The measurement of specialist palliative care (SPC) across Department of Veterans Affairs (VA) facilities relies on algorithms applied to administrative databases. However, the validity of these algorithms has not been systematically assessed. ⋯ VA algorithms are highly sensitive and specific in identifying SPC and in differentiating outpatient from inpatient encounters. These algorithms can be used with confidence to measure SPC in quality improvement and research across the VA.
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J Pain Symptom Manage · Oct 2023
Switching to intravenous methadone in advanced cancer patients: a retrospective analysis.
Information about opioid switching to intravenous methadone is lacking. ⋯ IV-ME dose titration followed by intravenous infusion allowed a rapid pain control in few minutes in patients with severe pain intensity, not responsive to previous opioids. Conversion to oral route was successful and facilitated home discharge. Further studies should be performed to confirm these preliminary results.
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J Pain Symptom Manage · Oct 2023
Post-Vaccine Era COVID-19 Pandemic-related Distress in Palliative Care Patients with Advanced Cancer.
The COVID-19 pandemic represents a source of distress in patients with advanced cancer; however, few studies have examined the extent of pandemic-related distress in the postvaccine era. ⋯ Patients with advanced cancer continued to experience pandemic-related distress in the postvaccine era. Our findings highlight potential opportunities to support patients.
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J Pain Symptom Manage · Oct 2023
ReviewThe Experience of Black Patients with Serious Illness in the United States: A Scoping Review.
Black patients experience health disparities in access and quality of care. ⋯ More articles focused on establishing evidence of disparities between Black and White patients than on understanding their root causes. Further investigation is warranted to understand how factors at the patient, provider, health system, and society levels interact to remediate disparities.