Journal of palliative medicine
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Evidence supports palliative care effectiveness. Given workforce constraints and the costs of new services, payers and providers need help to prioritize their investments. They need to know which patients to target, which personnel to hire, and which services best improve outcomes. ⋯ Palliative care improves cancer, CHF, COPD, and dementia outcomes. Effective models include nurses, social workers, and home-based components, and a focus on communication, psychosocial support, and the patient or caregiver experience. High-quality research on intervention costs and cost outcomes in palliative care is limited.
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Live hospice discharges represent a potential vulnerability in the Medicare hospice benefit. Little is known about how live discharges have varied over time. ⋯ Live hospice discharges and burdensome transitions increased between 2000 and 2012. For-profit hospice programs demonstrated larger increases than nonprofit hospice programs.
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Methadone offers many advantages for treating cancer pain. However, its pharmacokinetic profile makes its use as a full-dose opioid challenging. ⋯ A significant reduction in pain can be seen rapidly after the addition of methadone as a coanalgesic, particularly among patients with high pain intensity. More studies are needed to corroborate the efficacy of methadone as an adjunct to opioids.
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Empirical research suggests that the quality of patient care at the end of life (EOL) is influenced by the effectiveness of the collaboration between the general practitioners (GPs) and hospital physicians (HPs). ⋯ The research showed that Swiss GPs were concerned with the quality of their patients' EOL care and the current level of GP/HP collaboration. GPs appealed for greater involvement with EOL care decisions based on their relationship of care and knowledge of patient preferences. These findings require further critical evaluation to explore the potential advantages for patient care. Existing evidence suggests that there are measurable health benefits from successful GP/HP collaborations. A change in the way GPs maintain involvement with their patients during hospitalizations would be warranted if it resulted in a better use of resources, better patient experiences, and better health outcomes.
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Evaluation of the Effects of Music and Poetry in Oncologic Pain Relief: A Randomized Clinical Trial.
Various forms of art therapy have been tested as adjuvants in the treatment of physical and emotional disorders, including music and poetry. ⋯ Both music and poetry produced a similar improvement in the pain intensity. The two therapies also affected depression scores, and only poetry increased hope scores. Further investigation of the effects and comparisons between the two therapies should be performed.