Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2023
Randomized Controlled TrialSHARING Choices: Lessons Learned from a Primary-Care Focused Advance Care Planning Intervention.
Few advance care planning (ACP) interventions have been scaled in primary care. ⋯ Study findings reinforce the value of adaptable study design; co-designing workflow adaptations with practice staff; adapting implementation processes to fit the unique needs of two health systems; and modifying efforts to meet health system goals and priorities.
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J Pain Symptom Manage · Aug 2023
Functional status changes in patients receiving palliative care consult during COVID-19 pandemic.
Hospitalized patients with functional impairment have higher symptom burden and mortality. Little is known about how increased patient volume and acuity during the coronavirus disease 2019 (COVID-19) pandemic affected access to palliative care among patients with functional impairment. ⋯ As the healthcare system was stressed with high demand and limited resources, palliative care consultation prioritized highest acuity patients by shifting towards those with lower functional status and higher in-hospital mortality. This shift disproportionately affected noncancer patients. Innovative approaches to ensure upstream palliative care consultation during increased resource constraints are needed.
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J Pain Symptom Manage · Aug 2023
Palliative care physicians' perceptions of conditions required to provide early palliative care.
Early palliative care (EPC) is widely recommended but its implementation may be challenging. ⋯ Changes are necessary at the level of palliative care referral systems, providers, resources, and policy to enable implementation of EPC.