Abstract
Letters to the Editor
Physician aid in dying: I believe it is of critical importance to our profession as healers that clinicians reflect on their own personal beliefs regarding challenging clinical and moral issues BEFORE they are faced with such situations. (page 902)
Brief Reports
Cross-sectional study examining interspecialty differences in physicians' attitudes, beliefs, and reasons for withdrawing or withholding hypercalcemia treatment in terminally ill patients. (page 979)
Fast Facts and Concepts
Thirst in Palliative Care #313 (page 1009) Chemotherapy: Response and Survival Data #99 (page 1011)
Personal Reflection
I know the evidence and textbook pain strategy is to shift to long acting versions; we tried that. Her cancer pain did not read the same textbook; we titrated, fine tuned, and adjusted according to her personal response. Hence, the Rx as requested; now, swiftly, and unsympathetically rejected. (page 1012)
Book and Media Reviews
(page 1016)
Recent Literature
(page 1018)
Mindful Breathing for Stress Reduction
In this randomized controlled trial, five-minute mindful breathing was a quick, easy-to-administer, and effective therapy for rapid reduction of distress among 60 palliative care patients. The authors argue for the need for additional study to establish the long-term efficacy of this therapy. (page 917)
Methadone as Coanalgesic
This retrospective cohort study evaluated the efficacy and safety of low-dose methadone as adjunct to opioids in the treatment of cancer pain in palliative care patients. Almost half of patients qualified as significant responders with a greater than 30% reduction in pain intensity over a median of seven days. (page 972)
Impact of Palliative Care on Inpatient Treatment Intensity
The authors examined the relationship between the presence of palliative care programs and hospitals' average treatment intensity, represented by mean intensive care unit (ICU) length of stay (LOS) and days under Medicare hospice coverage in the last six months of life. They found that hospital-based palliative care programs alone may not be sufficient to impact ICU LOS or hospice length of enrollment for all chronically ill older adults admitted to hospitals. (page 936)
Guidelines on Respiratory Symptoms
The Japanese Society for Palliative Medicine shares its clinical guidelines for the management of respiratory symptoms in cancer patients, as well as its process for developing the guidelines based on best available evidence and expert consensus. (page 925)
Recommended versus Actual Timing of Palliative Care
In this retrospective analysis of older veterans who died from cancer, the authors found a gap between the recommended timing of supportive services from specialty societies and real-world practice of care. Their results suggest that challenges in prognostication are not fully responsible for underuse of hospice. (page 957)
Symptom Management with Music and Poetry
In a randomized trial, researchers evaluated the effects of passive listening to music and poetry on the variation in pain, depression, and hope scores among patients with advanced cancer. Both music and poetry produced similar improvements in pain intensity and depression, but only poetry increased hope scores. (page 943)
Lymphedema in Head and Neck Cancer
The authors found that internal lymphedema correlated with subjective and objective measures of dysphagia among patients with head and neck cancer. (page 949)
Opioid Barriers in Latin America
Researchers looked at the effectiveness of action plans from workshops on eliminating barriers to the availability and accessibility of opioids in 13 Latin American countries. They found that limited access to pain treatment is multifactorial, including restrictive laws and regulations. They conclude that strategies need to be broad and must include clinical and government representatives to be effective. (page 964)