Abstract
Letter to the Editor
In this analysis, authors compared social work involvement on the Mount Sinai palliative care unit with oncology and general medical units. The comparison revealed striking differences in both patient population and social work activity. (page 850)
Brief Report
This exploratory pilot suggests palliative care-anchored remote symptom assessment tools such as EMA-PAL may help address gaps in symptom assessment and timelier, patient-centered symptom management in ambulatory palliative care. (page 939)
Fast Facts
#528: Digital Legacy in Palliative Care. (page 986)
#529: Writing a Medical Letter for Expediated Visitor Visas. (page 988)
Personal Reflection
With patient distrust and provider burnout at an all-time high, bringing a camera into the hospital sounds like a recipe for disaster. Is it even ethical to film vulnerable patients in a hospital setting?
It is a fair question. (page 991)
Case Discussions
Case of an 86-year-old woman with end-stage Parkinson’s disease who received home-based palliative care. She suffered from seborrheic dermatitis, constipation, and dyspnea, which significantly impaired her quality of life. Conventional treatments provided limited relief, prompting the integration of acupuncture and herbal medicine as complementary therapies. (page 992)
Book and Media
(page 1000)
Original Article Key Points
This qualitative study of parents/family caregivers of children with severe neurological impairment and clinicians identified themes before and after the creation of photo narratives and their potential impact. Themes highlighted medical/developmental applications, understanding the child’s full life, and catalyzing humanistic care. Photo-based approaches may be a valuable method for improving care. (page 861)
Buprenorphine is an important tool for patients with serious illness but requires active implementation support. This study describes the development, distribution, and testing of a Buprenorphine Pocket Card and Tool Kit. The resources can be readily implemented to increase palliative care clinicians’ buprenorphine knowledge and prescribing confidence. (page 872)
This article describes the collaborative process of bringing an evidence-based palliative care intervention, photo-narratives, through practical user experience design for future real-world implementation at a children’s hospital. (page 880)
Across communication domains, compared to chart review, the large language models (LLMs) achieved sensitivity ranging from 0.43 to 1.0, specificity from 0.32 to 0.99, and accuracy from 0.51 to 0.99. Hallucinations were low. Abstraction of each domain required approximately 7 seconds per note, compared to 5–7 minutes per note with chart review. LLMs can provide feedback to oncologists on communication with patients. (page 887)
The authors prospectively evaluated a longitudinal palliative care curriculum for medical students using the Context Input Process Product model. Results indicated that the curriculum achieved the intended outcomes of acceptance to diverse stakeholders, improved student knowledge and attitudes about palliative care (PC), and increased student engagement in PC. (page 896)
This is the first global cost-effectiveness analysis of prophylactic naldemedine for opioid-induced constipation in patients with cancer. The results suggest that this strategy could be justifiable as an efficient use of finite health care resources. (page 904)
Emergency department health care professionals identified key priorities for improving end-of-life care for patients with dementia. These include raising awareness of dementia among both the public and health care staff, providing structured training, and improving the emergency department environment and care models. (page 912)
Remotely-delivered music therapy is feasible and acceptable for cognitively-impaired children with medical complexity and parents receiving palliative or complex care and shows strong signals for efficacy. Palliative care providers can assist in identifying patients and families most likely to benefit and advocate for home-based services to increase access to music therapy. (page 921)