PROP s Disproportionate Influence on U.S. Opioid Policy: The Harms of Intended Consequences
ConclusionDespite being turned back from an effort to bluntly reduce opioid prescribing by the FDA in 2013 based on a lack of scientific evidence for its position (17,18), PROP has had a disproportionate effect on opioid policy in the Untied States for almost a decade. PROP found a willing federal regulatory partner in the CDC, and while PROP may not have secretly written the 2016 CDC Pain Guidelines (75), they certainly enjoyed disproportionate representation on CDCs review panels and Core Expert Group (23-25) in a process that lacked transparency (22, 23, 26, 27). When the CDC admitted that its Pain Guideline had been...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 3, 2021 Category: Palliative Care Tags: CDC health policy kollas opioids pain prop Source Type: blogs

PROP ’s Disproportionate Influence on U.S. Opioid Policy: The Harms of Intended Consequences
ConclusionDespite being turned back from an effort to bluntly reduce opioid prescribing by the FDA in 2013 based on a lack of scientific evidence for its position (17,18), PROP has had a disproportionate effect on opioid policy in the Untied States for almost a decade. PROP found a willing federal regulatory partner in the CDC, and while PROP may not have “secretly written” the 2016 CDC Pain Guidelines (75), they certainly enjoyed disproportionate representation on CDC’s review panels and Core Expert Group (23-25) in a process that lacked transparency (22, 23, 26, 27). When the CDC admitted that its Pain Guideline ha...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 3, 2021 Category: Palliative Care Tags: CDC health policy kollas opioids pain prop Source Type: blogs

Choosing Palliative Care as a Medical Specialty
by Sylvia Lane (@sylv_lane)There are few things more introspective than deciding on a specialty in medicine. The decision forces you to analyze what interests and values you hold but also who you are as a person. How do you solve problems? How do you work with others? What brings you joy? As a third-year medical student, I was able to try on many specialties. Rotating through various fields allowed me to soak up knowledge from almost every type of healthcare professional. But this experience comes with a heavy burden of choosing a future career path.From the beginning, I knew that I was not like most of my fellow medical s...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 9, 2021 Category: Palliative Care Tags: lane learner medical school medical student residency The profession Source Type: blogs

What Is Grief, If Not Love Persevering?: A Palliative Perspective On WandaVision
by SarahScott B. Dietz (@SDietzMD)WARNING: THIS POST CONTAINS SIGNIFICANT SPOILERS FORWANDAVISION.In January,WandaVision released on Disney+, promising a weekly serial centered around two romatincally involved and familiar Marvel characters, Wanda Maximoff (aka Scarlet Witch) and Vision. The advertisements showed a black and white, vintage look to the show, and gave few clues as to exactly how it would tie in with the rest of theMarvel Cinematic Universe. Fans were intrigued for many reasons, chief among them being that the last time we saw Vision,he was dead. (CW-Superhero violence/death)I dove intoWandaVision like many f...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 7, 2021 Category: Palliative Care Tags: comics dietz grief media television Source Type: blogs

Advance Care Planning? Meh. - Part 2
by Drew Rosielle (@drosielle)This is Part 2/2 of a couple posts about advance care planning (ACP).The last post outlined why there are really good reasons to believe that ACP (completion of health care directives and the healthcare conversations that occur around healthcare directive (HCD) completion, implemented on a broad scale) does not lead to any better, patient-centered outcomes, particularly when evaluated as a health intervention to be applied across a population (which is how ACP is typically conceptualized and researched).In the prior post, I perhaps obnoxiously promised that I thought one of the most important A...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 31, 2021 Category: Palliative Care Source Type: blogs

Advance Care Planning? Meh. - Part 1
by Drew Rosielle (@drosielle) (no degrees)Several years ago I was giving a talk in front of a mostly palliative care audience and asked, "How often do you find yourself, in the care of your patients, saying to yourself something like ' Thank the stars this patient has a healthcare directive (HCD) ' ? " The overwhelming answer was a bunch of shrugs and people agreeing occasionally (but not routinely) HCDs are helpful.For something that seems so central to our work, why is it that so many of my colleagues that day were lukewarm about their utility?It ' s fair to say that the last few months have been a controversial one in t...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 29, 2021 Category: Palliative Care Tags: advance care planning rosielle Source Type: blogs

On the Value of Social Work in Palliative Care
by Vickie Leff (@VickieLeff)Another year, another study proving the value of the palliative care social worker. Edmonds et al (2021) found that when a social worker was involved in a palliative care consultation, whole-person care components were more likely to be addressed, including addressing psychological (82% vs 18%) and spiritual needs (92% vs 8%) and documenting advance directives (90% vs 10%). This adds to what we already knew: involvement of social work impacts quality of care and patient satisfaction (Auerbach, 2007; O ’Donnell et al., 2018).It surprises me that despite much research and team role development, ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 22, 2021 Category: Palliative Care Tags: hospice leff palliative care social work social worker Source Type: blogs

Palliative Care Social Worker Infographic
(Source: Pallimed: A Hospice and Palliative Medicine Blog)
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 22, 2021 Category: Palliative Care Tags: leff social work social worker Source Type: blogs

What Remains of Edith Finch? - A Video Game Review
by Matthew Tyler (@PalliDad)Fortunately for me, the pandemic has not interfered with my life-long hobby: video games. I finally got around to playingWhat Remains of Edith Finch, a game that received high praise for its short but engrossing Lovecraftian-esque narrative. What I experienced was a surprisingly insightful exploration of humanity ’s relationship with death.Coincidentally, I had just readBJ Miller ’s opinion piece “What is Death?” in The New York Times and was struck by the parallels between it and What Remains. This game illustrates how one may “fold death into our lives,” and what can happen when we...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 15, 2021 Category: Palliative Care Tags: game Tyler video games Source Type: blogs

Pallimed GeriPal Virtual Gathering 2021
by Christian Sinclair (@ctsinclair)Short notice, but yes, there will be a Pallimed/GeriPal virtual party this year.Never missed a year! Have we planned a lot around this? No. Do we want to see friends and colleagues and meet new people? Yes. Can we do it with minimal expectations? We hope so!We are not sure what to expect, but when we did this in person there was never that much of a plan anyway, except where to go next, and even that was up for improvisation.So what might we do. Probably hang out in different Zoom rooms talking about different subjects, playing games, talking about palliative care things, or maybe not pal...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 17, 2021 Category: Palliative Care Tags: geripal sinclair Source Type: blogs

Confronting Stigma From Opioid Use Disorder in Cancer Care
by Fitzgerald Jones, Ho, Sager, Rosielle and MerlinHave you ever been so distressed by a perspective piece that it kept you up at night? The type of rumination that fills you with so much angst that you have no choice but to act. This is exactly how we felt when we read theAAHPM Quarterly Winter 2020 Let ’s Think About It Again.1 (member paywall)The column, which is structured as a sort of written debate in which two authors argue a clinical question, describes a case of a 45-year-old man with severe substance use disorder (SUD) recently diagnosed with extensive-stage small-cell lung cancer. He was offered aggr...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 30, 2021 Category: Palliative Care Tags: ftigerald jones ho merlin rosielle sager Source Type: blogs

Confronting Stigma From Opioid Use Diorder in Cancer Care
by Fitzgerald Jones, Ho, Sager, Rosielle and MerlinHave you ever been so distressed by a perspective piece that it kept you up at night? The type of rumination that fills you with so much angst that you have no choice but to act. This is exactly how we felt when we read theAAHPM Quarterly Winter 2020 Let ’s Think About It Again.1 (member paywall)The column, which is structured as a sort of written debate in which two authors argue a clinical question, describes a case of a 45-year-old man with severe substance use disorder (SUD) recently diagnosed with extensive-stage small-cell lung cancer. He was offered aggr...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 30, 2021 Category: Palliative Care Tags: ftigerald jones ho merlin rosielle sager Source Type: blogs

Fostering Student Interest in Palliative Care
by Christian Sinclair (@ctsinclair)Most palliative care teams love to have medical students on service, but the access may be variable. Some schools make palliative care rotations mandatory, some optional, while others make it hard to find or " build your own. " I do outpatient palliative care, so I see medical students less often than my inpatient colleagues, but we do get a number of nursing students, pharmacy residents, psychology learners rotating with our clinic at the University of Kansas Medical Center. Having learners rotate is an excellent way to teach primary palliative care skills, to help learners early in thei...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 29, 2021 Category: Palliative Care Tags: learner sinclair student Source Type: blogs

Social Media Stats for Palliative Care Journals 2020
by Christian Sinclair (@ctsinclair)Over the past two years I have been working to increase the profile of theJournal of Pain and Symptom Management as the associate editor of social media. In that time, I have come to make a few observations on the current state of social media use by palliative care journals and researchers that I would like to share with you dear readers along with some statistics. Could I make all of this into a paper, published in one of said journals? Possibly. But curiously enough I am looking to effect positive change quickly, so for now we will go with a blog, some Tweet threads and data visualizat...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 18, 2021 Category: Palliative Care Tags: research research issues sinclair social media twitter Source Type: blogs

Olanzapine FTW for Nausea Outside of CINV
by Drew Rosielle (@drosielle)A few months agoan interesting olanzapine study was published which I have been meaning to write a post about. It ' s important because while olanzapine has really established itself in the last decade as a highly effective antiemetic for chemotherapy induced nausea and vomiting, and is now in multiple CINV guidelines (eg Antiemetics: ASCO Guideline), etc, we don ' t have a lot of data for its efficacy for nausea outside of CINV, and so a well-done RCT is welcome.The study is amulti-center, US, adult, randomized, placebo-controlled, double-blind trial of olanzapine for nausea in advanced cancer...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 1, 2021 Category: Palliative Care Tags: anorexia cachexia nausea olanzapine rosielle Source Type: blogs