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Impact of end-of-life planning on surrogate decision-maker anxiety in the US

ALOIAU, April ; BENTON, Melissa J. ; MOUCHAWAR, Alan ; SEGAL, Daniel L.
International Journal of Palliative Nursing, 02/2020, vol.26, n°2, p. 75-82

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Characteristics of hospices providing high-quality care

ANHANG PRICE, Rebecca ; TOLPADI, Anagha ; SCHLANG, Danielle ; BRADLEY, Melissa A. ; PARAST, Layla ; TENO, Joan M. ; ELLIOTT, Marc N.
JOURNAL OF PALLIATIVE MEDICINE, 06/03/2020, Pagination inconnue

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Thème : Santé.

UNITE SOINS PALLIATIFS ; QUALITE SOIN ; ETATS-UNIS ; EVALUATION

Background: The hospice market has changed substantially, shifting from predominately not-for-profit independent entities to for-profit national chains. Little is known about how hospice organizational characteristics are associated with quality of hospice care.
Objective: To examine the association between hospice characteristics and care processes and performance on measures of hospice care quality.
Design: Logistic regression models assessed the association between hospice characteristics and processes and hospices being in the top quartile of quality measure performance.
Setting/Subjects: U.S. hospices with publicly reported measure scores in 2015-2017.
Measurements: Summaries of hospice-level performance on Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey measures (including communication, timely care, symptom management, emotional and spiritual support, respect, training families, overall rating, and willingness to recommend) and Hospice Item Set (HIS) measures (including pain screening and assessment, dyspnea screening and treatment, bowel regimen for patients on opioids, discussion of treatment preferences, and beliefs/values addressed).
Results: Of the 2746 hospices that met public reporting requirements, 5.6% were in the top quartile of both CAHPS and HIS performance. Characteristics associated with being in the top quartile for CAHPS included being a nonprofit and nonchain or government hospice, smaller size (<200 patients per year), and serving a rural area. Characteristics associated with being in the top quartile for HIS included being in a for-profit chain, larger size (91+ patients per year), and having <40% of patients in a nursing home. Providing professional staff visits in the last two days of life to a higher proportion of patients was associated with hospices being in the top quartile of HIS and in the top quartile of CAHPS.
Conclusions: Hospice characteristics associated with strong performance on HIS measures differ from those associated with strong performance on CAHPS measures. Providing professional staff visits in the last two days of life is associated with high performance on both quality domains.

Origine : PubMed

Differences of quality in end-of-life care across settings - results from the U.S. national health and aging trends study of medicare beneficiaries

XU, Shuo ; LIU, Mangdong ; SHIN, Oejin ; PARKER, Vanessa ; HERNANDEZ, Rosalba
JOURNAL OF PALLIATIVE MEDICINE, 09/03/2020, Pagination inconnue

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Palliative care and infection management at end of life in nursing homes - a descriptive survey

TARK, Aluem ; ESTRADA, Leah V. ; TRESGALLO, Mary E. ; QUIGLEY, Denise D. ; STONE, Patricia W. ; AGARWAL, Mansi
PALLIATIVE MEDICINE, 10/03/2020, Pagination inconnue

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Empowering older adults to discuss advance care planning during clinical visits - the PREPARE randomized trial

FREYTAG, Jennifer ; STREET, Richard L. ; BARNES, Deborah E. ; SHI, Ying ; VOLOW, Aiesha M. ; SHIM, Janet K. ; ALEXANDER, Stewart C. ; SUDORE, Rebecca L.
Journal of the American Geriatrics Society, 10/03/2020, Pagination inconnue

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Lack of awareness and common misconceptions about palliative care among adults - insights from a national survey

FLIEGER, Signe Peterson ; CHUI, Kenneth ; KOCH-WESER, Susan
Journal of general internal medicine, 10/03/2020, Pagination inconnue

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Thème : Soins.

CONNAISSANCE ; DEMARCHE PALLIATIVE ; ETATS-UNIS

BACKGROUND: Despite recent growth in palliative care programs palliative care remains underutilized. Studies suggest that patients and providers commonly associate palliative care with end of life, often leading to misconceptions and late referrals.
OBJECTIVE: To characterize self-reported palliative care knowledge and misconceptions about palliative care among US adults and demographic, health, and social role factors associated with knowledge and misconceptions.
DESIGN: We conducted secondary data analysis of nationally representative, self-reported data from the 2018 Health Information National Trends Survey (HINTS) 5, Cycle 2. We examined associations between knowledge and misconceptions about palliative care together with demographics, health care access, health status, and social roles.
PARTICIPANTS: 3504 US adults. 2594 included in the first analysis after omitting missing cases; 683 who reported knowing about palliative care were included in the second analysis.
MAIN MEASURES: Palliative care knowledge was self-reported in response to: "How would you describe your level of knowledge about palliative care?" Level of misconceptions was based on a series of factual and attitudinal statements about palliative care.
KEY RESULTS: Among US adults, 28.8% report knowing about palliative care, but only 12.6% report knowing what palliative care is and hold no misconceptions. Those most likely to report knowing about palliative care are female, college-educated, higher income, have a primary health care provider, or are a caregiver. Among those who report knowing about palliative care, misconceptions were common: 44.4% automatically think of death, 38.0% equate palliative care with hospice, 17.8% believe you must stop other treatments, and 15.9% see palliative care as giving up.
CONCLUSIONS: US adults who have some knowledge of palliative care are most likely to confuse it with hospice but are less likely to see it as requiring forgoing treatment or as giving up. Primary care clinicians should be encouraged to communicate about palliative care with patients.

Origine : PubMed

Religious observance and perceptions of end-of-life care

TARABEIH, Mahdi ; BOKEK-COHEN, Ya'arit ; ABU RAKIA, Riad ; NIR, Tshura ; COOLIDGE, Natalie E. ; AZURI, Pazit
Nursing inquiry, 12/03/2020, Pagination inconnue

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Incidence and predictors of aspirin discontinuation in older adult veteran nursing home residents at end of life

SPRINGER, Sydney P. ; MOR, Maria K. ; SILEANU, Florentina ; ZHAO, Xinhua ; ASPINALL, Sherrie L. ; ERSEK, Mary ; NIZNIK, Joshua D. ; HANLON, Joseph T. ; HUNNICUTT, Jacob ; GELLAD, Walid F. ; SCHLEIDEN, Loren J. ; THORPE, Joshua M. ; THORPE, Carolyn T.
Journal of the American Geriatrics Society, 13/02/2020, Pagination inconnue

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Prevalent statin use in long-stay nursing home residents with life-limiting illness

MACK, Deborah S. ; TJIA, Jennifer ; HUME, Anne L. ; LAPANE, Kate L.
Journal of the American Geriatrics Society, 14/02/2020, Pagination inconnue

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Thème : Médicaments - Pharmacie.

THERAPEUTIQUE MEDICAMENTEUSE ; PREVALENCE ; MAISON RETRAITE ; MALADIE LETALE ; ETATS-UNIS

OBJECTIVES; To evaluate the prevalence and factors associated with statin pharmacotherapy in long-stay nursing home residents with life-limiting illness.
DESIGN: Cross-sectional.
SETTING: US Medicare- and Medicaid-certified nursing home facilities.
PARTICIPANTS: Long-stay nursing home resident Medicare fee-for-service beneficiaries aged 65 years or older with life-limiting illness (n = 424 212).
MEASUREMENTS: Prevalent statin use was estimated as any low-moderate intensity (daily dose low-density lipoprotein-cholesterol [LDL-C] reduction <30%-50%) and high-intensity (daily dose LDL-C reduction >50%) use via Medicare Part D claims for a prescription supply on September 30, 2016, with a 90-day look-back period. Life-limiting illness was operationally defined to capture those near the end of life using evidence-based criteria to identify progressive terminal conditions or limited prognoses (<6 mo). Poisson models provided estimates of adjusted prevalence ratios and 95% confidence intervals for resident factors.
RESULTS: A total of 34% of residents with life-limiting illness were prescribed statins (65--75 y = 44.0%, high intensity = 11.1%; >75 y = 31.1%, high intensity = 5.4%). Prevalence of statins varied by life-limiting illness definition. Of those with a prognosis of less than 6 months, 23% of the 65 to 75 and 12% of the older than 75 age groups were on statins. Factors positively associated with statin use included minority race or ethnicity, use of more than five concurrent medications, and atherosclerotic cardiovascular disease or risk factors.
CONCLUSION: Despite having a life-limiting illness, more than one-third of clinically compromised long-stay nursing home residents remain on statins. Although recent national guidelines have expanded indications for statins, the benefit of continued therapy in an advanced age population near the end of life is questionable. Efforts to deprescribe statins in the nursing home setting may be warranted.

Origine : PubMed

Timing is everything - early do-not-resuscitate orders in the intensive care unit and patient outcomes

OUYANG, Daniel J. ; LIEF, Lindsay ; RUSSELL, David ; XU, Jiehui ; BERLIN, David A. ; GENTZLER, Eliza ; SU, Amanda ; COOPER, Zara R. ; SENGLAUB, Steven S. ; MACIEJEWSKI, Paul K. ; PRIGERSON, Holly G.
Plos one, 2020, vol.15, n°2, p. 1-12

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Trends in place of death for cardiovascular mortality related to heart failure in the United States from 2003 to 2017

CHUZI, Sarah ; MOLSBERRY, Rebecca ; OGUNSEITAN, Adeboye ; WARRAICH, Haider J. ; WILCOX, Jane E. ; GRADY, Kathleen L. ; YANCY, Clyde W. ; KHAN, Sadiya S.
Circulation. Heart failure, 02/2020, vol.13, n°2, Pagination inconnue

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Racial differences in pain management for patients receiving hospice care

BOOKER, Staja Q. ; HERR, Keela A. ; WILSON GARVAN, Cynthia
Oncology nursing forum, 01/03/2020, vol.47, n°2, p. 228-240

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Theory-based development of an implementation intervention utilizing community health workers to increase palliative care use

KUBI, Boateng ; ENUMAH, Zachary O. ; LEE, Kimberley T. ; FREUND, Karen M. ; SMITH, Thomas Joseph ; COOPER, Lisa A. ; OWCZARZAK, Jill T. ; JOHNSTON, Fabian M.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 21/02/2020, Pagination inconnue

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Underutilization of portable orders for life-sustaining treatment at discharge from hospital - observational study at US academic trauma center

RUBINS, Jeffrey B.
Journal of general internal medicine, 10/02/2020, Pagination inconnue

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State of palliative care services at US cancer centers - an updated national survey

HUI, David ; CHEN, Joseph ; DIBAJ, Seyedeh ; DELGADO GUAY, Marvin ; HEUNG, Yvonne ; LIU, Diane ; BRUERA, Eduardo ; DE LA ROSA, Allison
Cancer, 12/02/2020, Pagination inconnue

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Thème : Santé.

DEMARCHE PALLIATIVE ; CANCER ; ETATS-UNIS ; HOSPITALISATION DOMICILE SOINS PALLIATIFS

BACKGROUND: This study examined the changes in outpatient palliative care services at US cancer centers over the past decade.
METHODS: Between April and August 2018, all National Cancer Institute (NCI)-designated cancer centers and a random sample of 1252 non-NCI-designated cancer centers were surveyed. Two surveys used previously in a 2009 national study were sent to each institution: a 22-question cancer center executive survey regarding palliative care infrastructure and attitudes toward palliative care and an 82-question palliative care program leader survey regarding detailed palliative care structures and processes. Survey findings from 2018 were compared with 2009 data from 101 cancer center executives and 96 palliative care program leaders.
RESULTS: The overall response rate was 69% (140 of 203) for the cancer center executive survey and 75% (123 of 164) for the palliative care program leader survey. Among NCI-designated cancer centers, a significant increase in outpatient palliative care clinics was observed between 2009 and 2018 (59% vs 95%; odds ratio, 12.3; 95% confidence interval, 3.2-48.2; P < .001) with no significant changes in inpatient consultation teams (92% vs 90%; P = .71), palliative care units (PCUs; 26% vs 40%; P = .17), or institution-operated hospices (31% vs 18%; P = .14). Among non-NCI-designated cancer centers, there was no significant increase in outpatient palliative care clinics (22% vs 40%; P = .07), inpatient consultation teams (56% vs 68%; P = .27), PCUs (20% vs 18%; P = .76), or institution-operated hospices (42% vs 23%; P = .05). The median interval from outpatient palliative care referral to death increased significantly, particularly for NCI-designated cancer centers (90 vs 180 days; P = 0.01).
CONCLUSIONS: Despite significant growth in outpatient palliative care clinics, there remain opportunities for improvement in the structures and processes of palliative care programs.

Origine : PubMed

Drivers of care costs and quality in the last 3 months of life among older people receiving palliative care - a multinational mortality follow-back survey across England, Ireland and the United States

YI, Deokhee ; JOHNSTON, Bridget M. ; RYAN, Karen ; DAVESON, Barbara A. ; MEIER, Diane E. ; SMITH, Melinda ; McQUILLAN, Regina ; SELMAN, Lucy ; PANTILAT, Steven Z. ; NORMAND, Charles E. ; MORRISON, R. Sean ; HIGGINSON, Irene J.
PALLIATIVE MEDICINE, 03/02/2020, p. 1-11

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Factors associated with elective withdrawal of maintenance hemodialysis - a case-control analysis

WETMORE, James B. ; YAN, Heng ; GILBERTSON, David T. ; LIU, Jiannong
American journal of nephrology, 04/02/2020, p. 1-10

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Geopersonality of preventable death in the United States - anger-prone states and opioid deaths

GERHART, James ; DUBERSTEIN, Paul ; PAULL, Danielle ; O'MAHONY, Sean ; BURNS, John ; DENICOLO, Martin ; HOERGER, Michael
The American journal of hospice and palliative care, 03/02/2020, Pagination inconnue

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Advance care planning among older adults with advanced non–dialysis-dependent CKD and their care partners - perceptions versus reality?

OSKOUI, Tira ; PANDYA, Renuka ; WEINER, Daniel E. ; WONG, John B. ; KOCH-WESER, Susan ; LADIN, Keren
Kidney medicine, 31/01/2020, p. 1-9

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Evaluating for disparities in place of death for head and neck cancer patients in the United States utilizing the CDC WONDER database

STEPHENS, Sarah J. ; CHINO, Fumiko ; WILLIAMSON, Hannah ; NIEDZWIECKI, Donna ; CHINO, Junzo ; MOWERY, Yvonne M.
Oral oncology, 01/03/2020, vol.102, p. 1-6

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