Abstract
Letters to the Editor
Clinical demonstration project conducted with 19 Advance Care Planning (ACP) group visits, called the Conversation Group Medical Visits. Groups of 3–11 patients met to discuss ACP in two 2-hour sessions facilitated by a geriatrician and a social worker. (page 1187)
Brief Reports
Exploring the longitudinal relationship between oral morphine equivalent daily dose and oral diazepam equivalent daily dose in patients receiving palliative care. (page 1274)
Fast Facts and Concepts
Extracorporeal Membrane Oxygenation in Adults #339 (page 1291)
Skeletal Muscle Relaxants #340 (page 1293)
Personal Reflection
“What do I do now, doctor?” He asked.
“Well, let us work on her. There's a waiting area … ” I replied.
His eyes looked directly into mine. “No! You don't understand, doctor. I know she's gone.
What … do … I … do … now?” (page 1296)
Case Discussions in Palliative Medicine
Case reviewing the role of pediatric palliative care teams in the care of patients with complex congenital heart disease. (page 1301)
Book and Media Reviews
(page 1305)
Standardizing and Scaling Community-Based Palliative Care
The authors describe an interdisciplinary palliative care model across all settings at Four Seasons Compassion for Life, a nonprofit hospice and palliative care organization in North Carolina. They offer guidance for risk stratification assessments and mapping of care processes that may help other programs as they develop and improve efficiencies. (page 1237)
Tracking Patients in Community-Based Palliative Care
This article evaluates the tracking of patients' point of entry into the Four Seasons Compassion for Life's Healthcare Innovation Project and their transition outcomes under this model. (page 1231)
Outpatient Methadone Titration
In a retrospective chart review, the authors found that initiation of methadone for analgesia in ambulatory cancer patients was done safely in an outpatient setting using a “start low-go slow” method and was helpful in ∼75% of patients. Discontinuation was more likely due to side effects than for inadequate analgesia. (page 1244)
Burdensome Nursing Home Transitions
This study examined how decisions were made to transfer nursing home residents with advanced dementia to the hospital, from the perspective of nursing home nurses and physicians. (page 1205)
Palliative Care in Europe
The authors share the results of a qualitative survey outlining the barriers and opportunities for effective palliative care integration throughout Europe. (page 1195)
Antithrombotic Therapy in Hospice Care
In this retrospective study, researchers found that hospice patients received prescriptions for antithrombotic therapy infrequently, but often lacked a documented indication. They conclude that further research is needed on the safety and effectiveness of antithrombotic therapy in hospice care. (page 1225)
Population Health Data for Palliative Care
Researchers used health administrative data to identify involvement of specialized pediatric palliative care services for children with cancer and found that the data had good sensitivity but low specificity. They conclude that studies using such data alone are at significant risk of misclassification and potential bias and advocate for the establishment of population-based palliative care databases. (page 1210)
Preferred Places of Care and Death
In this cross-sectional study, researchers found that patients' preferred places of care and death vary by individual choice and less by diagnosis. (page 1217)
Quality of Death in Advanced Cancer
This national survey of bereaved family members found that trust of hospice staff and good coordination of care were associated with improved quality of death for cancer patients at home. (page 1252)