Abstract
Letters to the Editor
With drug delivery proportional to surface area, cutting of matrix fentanyl patches offers an intuitive solution. (page 1311)
Brief Reports
Study to describe the patterns of dose selection at initial rotation to methadone for analgesia and comparison with existing, commonly taught methods of rotation. (page 1385)
Fast Facts and Concepts
Bleeding Management in Hospice Care Settings #341 (page 1405)
Chemotherapy-Related Cognitive Impairment #342 (page 1407)
Personal Reflection
But we came all this way for the most advanced cancer treatments. You are referring my wife to hospice? These are the moments that fly against our deeply held, if unspoken, beliefs about the triumph of medicine over the surety of death. (page 1413)
Case Discussions in Palliative Medicine
Sixty-year-old female with nociceptive and neuropathic pain that, due to comorbidities and her want to continue aggressive life-sustaining therapies, was difficult to treat. Traditional therapies were either ineffective or fraught with side effects; thus, we trialed fosaprepitant. (page 1415)
Book and Media Reviews
(page 1420)
Recent Literature
(page 1421)
Palliative Care in Phase 1 Trials
Betty Ferrell and colleagues report on their multisite, randomized clinical trial, testing concurrent palliative care for advanced cancer patients participating in phase 1 trials. (page 1338)
Characteristics of Inpatients Referred to Palliative Care
In a prospective, multicenter study including >3000 inpatients with advanced cancer, researchers found that only a minority were referred to palliative care. Patients were more likely to be referred if they had high symptom burden at admission. The authors recommend standardized palliative care screening to ensure that advanced cancer patients receive high-quality, evidence-based care. (page 1321)
Hospice Visit Patterns and Service-Intensity Add-On Payments
The authors report that the relative size of the new service-intensity add-on payment to hospices by the Centers for Medicare and Medicaid has the potential to increase nurse and social work visits as well as reduce disparities in visit patterns during the last week of life. (page 1378)
Integrating Palliative Care and Oncology
Laura Hanson and colleagues describe an interdisciplinary quality improvement intervention that effectively increased the number of goals-of-care discussions and palliative care consults for hospitalized patients with stage IV cancer. (page 1366)
Disseminating Palliative Care to Community Practices
Researchers evaluated the dissemination of a previously tested nurse-led palliative care intervention for patients with lung cancer at three Kaiser Permanente Southern California sites. They found that adaptations to local resources, workflow, and culture were key to successful implementation. (page 1327)
Resident Education in Advance Care Planning
The authors describe a novel curriculum to train internal medicine residents in outpatient conversations about advance care planning. (page 1345)
Value of Hospital Chaplains
In a survey, parents of hospitalized children viewed chaplains as members of the healthcare team and felt they played an important role in their family's well-being during the hospital stay. Chaplains also improved parents' overall satisfaction with hospital care. (page 1352)
Analyzing Patient Care Complaints
In a survey of family caregivers of deceased patients, researchers sought to understand the root causes of complaints about patient care. They developed a theoretical model that combines system factors with provision of services and communication to inform quality improvement efforts in end-of-life care. (page 1359)
Palliative Care in Africa
The authors conducted a scoping review of articles on palliative care in Africa as an indicator of program development across the continent, particularly in Anglophone countries. (page 1372)