Abstract
Letters to the Editor
Currently in Japan, opioids available for dyspnea in patients with heart failure are limited to morphine hydrochloride. There is no consensus about the use of opioids for heart failure patients with renal insufficiency. (page 617)
Brief Reports
Neoplastic pericardial effusion (NPE) is a life-threatening condition that can worsen clinical outcome in cancer patients. The optimal management of NPE has yet to be defined because randomized studies are lacking. (page 691)
Fast Facts and Concepts
Immunotherapy-Related Adverse Effects When Treating Cancer #375 (page 724)
Personal Reflection
In that moment, I learned that my “truth” was wrong. It was actually the process of trusting and exploring that better served Angelica and her mother rather than stating my own view. (page 730)
Case Discussions in Palliative Medicine
The majority of active hospice and palliative medicine physicians under the age of 50 are women. This trend has led to discussions of supporting, recruiting, and retaining women physicians, but there is little literature about the effect of women physicians on patients. In particular, little has been written about the effect of a physician's pregnancy. (page 734)
Book and Media Reviews
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Recent Literature
(page 740)
Prognosis in Blood Cancers
In a national survey, a majority of hematologic oncologists reported discussing prognosis with their patients, but one in five reported never readdressing prognosis or only doing so near death. The findings suggest the need for structured interventions to improve prognostic communication for patients with blood cancers. (page 677)
Trends in Hospice Quality Oversight
This national analysis illuminates the current hospice quality oversight process and examines its role alongside other government monitoring and public reporting efforts. (page 670)
Racial Disparities in Hospice
This retrospective cohort study of almost 650,000 Medicare decedents found significant racial and ethnic differences in hospice use and transitions in care at end of life. (page 619)
Benefits of a Palliative Care Pharmacist
This study evaluated the value of a palliative care pharmacist in patient care, with a favorable return on investment. (page 644)
Palliative Care in the Emergency Department
The authors report on an intervention that successfully screened for palliative needs in cancer patients in the emergency department (ED) and improved access to specific palliative care services without increasing ED length of stay. (page 649)
Statewide “Personality” and Access to Palliative Care
Utilizing U.S. Census and Gallup data, researchers found palliative care access was higher in states with older less racially diverse more liberal populations with higher socioeconomic status. (page 628)
Perspectives on Breathlessness
This qualitative study found chronic refractory breathlessness of advanced disease is managed insufficiently for most patients, caregivers, and health care providers. The authors conclude increased knowledge about effective interventions and availability of skills-based trainings would help breathlessness management. (page 656)
Spiritual Pain and Quality of Life
Among >200 cancer patients, spiritual pain was independently associated with reduced quality of life. (page 663)
Unmet Needs in Surgical Patients
In this retrospective analysis, patients with end-stage renal disease admitted for acute abdominal emergency had high risk for mortality and functional dependence. However, few received palliative care and had high utilization of nonbeneficial support at the end of life. (page 635)