Development and Pilot Test of a Culturally Relevant Toolkit to Enhance Advance Care Planning with Chinese American Patients
First-generation Chinese American patients have low engagement in advance care planning (ACP). Among the causes may be clinician uncertainty about traditional cultural values. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 26, 2021 Category: Palliative Care Authors: Lara Dhingra, Kin Lam, William Cheung, Gavin Hynes, Colleen Fleming-Damon, Stephanie Hicks, Philip Huang, Jack Chen, Victor Chang, Russell Portenoy Tags: Brief Report Source Type: research

Feasibility of Safe Opioid Prescribing in Outpatient Palliative Care: A Quality Improvement Project
No guidelines for safe opioid prescribing in palliative care exist, which contributes to limited monitoring of opioid misuse in palliative care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 26, 2021 Category: Palliative Care Authors: Margaret R. Bauer, Tracy Shamas, Sarah Gillespie-Heyman, Andrea Ruskin Source Type: research

What are the emotional experiences of being a volunteer in palliative and end-of-life care settings? A systematic review and thematic synthesis
: Previous research has focused on the risks of stress, burnout and the impact on general emotional well-being in paid palliative care staff, however volunteers in patient-facing roles are exposed to similar stressors. Volunteers increasingly provide emotional support to patients and families but receive little formal support for themselves. It is important to understand volunteers ’ emotional experiences of their role to identify strategies that could be implemented to support them effectively. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 26, 2021 Category: Palliative Care Authors: Helena Coleman, Catherine Walshe Source Type: research

Extending Advance Care Planning to Black Americans in the Community: A Pilot Study of the PREPARE Program
Advance care planning (ACP) is underutilized, especially among Black Americans. Yet, no ACP interventions have been tested at the community level. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 26, 2021 Category: Palliative Care Authors: Lesli E. Skolarus, Devin L. Brown, Casey L. Corches, Evan Reynolds, Sarah Bailey, Maria Mansour, Maria Cielito Robles, Tia Rice, Mellanie V. Springer, James F. Burke, Rebecca L. Sudore Tags: Letter Source Type: research

Editorial Board
(Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Source Type: research

Table of Contents
(Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Source Type: research

Code Status Blues: Do Physicians Order Do-Not-Resuscitate (DNR) Less Often Since Texas Enacted DNR Law? (W205A)
Respecting patients ’ autonomous wishes is crucial to providing quality end-of-life care. Do-Not-Resuscitate (DNR) orders for patients who request them is a critical part of such care. On April 1, 2018, Texas implemented Senate Bill 11. This law mandates extra steps physicians must take to document consent from hospi talized patients prior to ordering DNR. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Carolyn W. April, Jason Morrow, Michael D. April Tags: Scientific and Quality Improvement Paper Session Abstracts Source Type: research

A Meta-Analysis of the Relationship Between Advance Care Planning and the Care Received at the End of Life Among Patients with Cancer (W205B)
Advance care planning (ACP) is a potentially important intervention in promoting high-quality end-of-life cancer care, but the empirical evidence of this relationship is mixed. This meta-analysis estimated the overall effect of ACP on end-of-life care outcomes among patients with cancer and explored moderators of this relationship. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Kristin Levoy, Suzanne S. Sullivan Source Type: research

A Missed Opportunity: Advance Care Planning Documentation in Patients with COVID-19 (W205C)
Advanced care planning (ACP) supports individuals in understanding and expressing their personal values for medical care in times of serious illness. (1) The COVID-19 pandemic has increased the urgency of ACP discussions, as those infected have high rates of ICU admission, mechanical ventilation, and increased mortality. (2) No prior research has studied the frequency, quality, and factors associated with ACP documentation among patients suspected of having COVID-19. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Raphaela Lipinsky DeGette, Fangdi Sun, Elizabeth Cummings, Lisa X. Deng, Karen Hauser, Zoe Kopp, John Penner, Brandon Scott, Katie Raffel, Molly A. Kantor Source Type: research

Neighborhood Socioeconomic Status Is Associated with Advance Care Planning Among Older Adults (W205D)
Advance care planning (ACP) is low among vulnerable, older adults. There is a need for community-based approaches to increase ACP, but community patterns of ACP are poorly understood. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Sarah S. Nouri, Courtney R. Lyles, Anna D. Rubinsky, Kanan Patel, Riya Desai, Jessica Fields, Mindy C. DeRouen, Aiesha M. Volow, Rebecca L. Sudore Source Type: research

English- and Spanish-Speaking Vulnerable Older Adults Report Many Unique Barriers to Advance Care Planning (W215A)
Advance care planning (ACP) rates are low in diverse, vulnerable older adults, yet little is known about the unique barriers they face and how these barriers impact ACP documentation rates. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Linda H. Phung, Deborah E. Barnes, Aiesha M. Volow, Nikita R. Shirsat, Rebecca L. Sudore Source Type: research

Barriers and Facilitators to Advance Care Planning Among Seriously Ill Chinese Americans and Their Caregivers (W215B)
North American Chinese adults experience disparate end-of-life outcomes. Advance care planning (ACP) is widely used to promote goal-concordant care across the serious illness care continuum. Yet, seriously ill Chinese Americans ’ preferences for ACP engagement remain unknown. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Zhimeng Jia, Irene M. Yeh, Albert S. Yeung, James A. Tulsky, Richard E. Leiter Source Type: research

Empowering the People: Introducing an Advance Care Planning Conversation to Improve Cultural Sensitivity Among African American Heart Failure Patients (W215C)
Advance care planning (ACP) improves goal-concordant care and communication. African Americans (AA) are disproportionately affected by heart failure (HF) with higher morbidity and mortality supporting the need for ACP engagement in this clinical population. Yet, few AAs engage in ACP due to a lack of knowledge and culturally sensitive interventions. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Konda Keebler, Richard A. Taylor, Chao-Hui Sylvia Huang Source Type: research

The Epidemiology of Social Isolation and Loneliness Among Older Adults During the Last Years of Life (W215D)
Social isolation and loneliness are distinct social risk factors critical to the health of older adults, but they have not been well-described at the end of life. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Ashwin A. Kotwal, Irena Cenzer, Linda J. Waite, Louise Hawkley, Alexander K. Smith Source Type: research

A Palliative Care Consult Trigger Tool for Trauma Patients (W225A)
Trauma patients are at increased risk of unmet palliative care needs for many reasons. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Angelo P. Canedo, R. Jonathan Robitsek, Alan R. Roth Source Type: research

The Palliative Care State Policy GPS: A New Tool to Track State Policies on Palliative Care (W225C)
In the United States, there are significant opportunities to advance palliative care (PC) access and quality at the state level. Recently, there has been a rise in PC policies, many of which have stemmed from increased state-level advocacy by palliative care champions. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Carolyn T. Lye, Eugene Rusyn, Shelli Feder, Dena J. Schulman-Green, Stacie Sinclair, Abbe R. Gluck Source Type: research

Novel Communication Liaison Program in the COVID-19 Intensive Care Unit: Impact on Liaison Participants (W225D)
During the COVID pandemic, families were barred from their hospitalized loved ones, while surge critical care teams were overwhelmed with hundreds of patients, leaving little capacity for remote communication. We implemented a novel Communication Liaison (CL) program, following the palliative care consultative model, to facilitate communication between critical care teams and families, and to provide emotional and decisional support to families. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Nicole H. Moraco, Adam D. Lipworth, Megan E. Harper, Sheri A. Keitz, Anne C. Mosenthal Source Type: research

Relationship Between Household Material Hardship and Distress in Parents of Children with Advanced Cancer: A Report from the PediQUEST Response Trial (T315A)
Socioeconomic status (SES) is associated with inferior health outcomes in pediatric cancer, but little is known about SES and distress in parents of children with advanced cancer. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Ijeoma J. Eche, Liliana Orellana, Veronica Dussel, Kira Bona, Joanne Wolfe Source Type: research

Strengthening the Therapeutic Alliance Between Parents of Children with Severe Neurologic Impairment and Healthcare Providers During Critical Decision-Making (T315B)
Parents of children with severe neurologic impairment (SNI) face many important decisions for their child during hospitalizations. These decisions are often made with the support of multidisciplinary providers who must establish a therapeutic alliance, but this can be difficult when stress is high and providers lack continuity. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Jori F. Bogetz, Hannah Lewis, Kelly J. Shipman, Danielle Jonas, Amy C. Trowbridge, Abby R. Rosenberg Source Type: research

Mapping Parents ’ Journey Following Prenatal Diagnosis of Congenital Heart Disease (T315C)
Parents who receive a prenatal diagnosis of congenital heart disease (CHD) experience more stress than those who receive one postnatally, potentially due to the pervasive prenatal uncertainty experienced. In order to identify and support parents ’ processing and coping, their longitudinal emotional experience must first be understood. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Kelly W. Harris, Catherine M. Hammack-Aviran, Kathleen M. Brelsford, Ann Kavanaugh-McHugh, Ellen W. Clayton Source Type: research

Palliative Care to the People: Partnering with a Patient Experience Department to Raise Awareness of Palliative Care in the Community (T315D)
Over 70% of U.S. adults have never heard of palliative care (PC). Of those who have heard of PC, less than 40% know what it is and can explain it to someone else. Lack of awareness and inadequate knowledge of PC are barriers to accessing PC services. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Grant M. Smith, Ashley Bragg, Claire R. Bleymaier, Rachelle A. Mirkin, Stephanie M. Harman Source Type: research

Care for a Dying Patient: EMS Perspectives on Caring for Hospice Patients (F405A)
Emergency Medical Services (EMS) providers frequently encounter patients in end-of-life situations. These situations can become ethically challenging depending on the nature of the event, availability of advanced directives, and overall understanding of the situation by the patient and caregivers. This is particularly true for patients who are enrolled in Hospice, a specific form of end-of-life care available to patients with a terminal illness and expected lifespan of less than six months. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Andrew Wenger, Megan Potilechio, John Aguilar, Joshua Mastenbrook Source Type: research

Innovative Hospice Education for Trainees (F405B)
Residents cite a lack of knowledge and skills as a barrier in facilitating transitions to home hospice from the hospital and clinic. In a fast-paced and compact training environment, curricula must be flexible and targeted. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Briana Ketterer, Julie W. Childers, Robert M. Arnold Source Type: research

The Association Between Varying Levels of Palliative Care Involvement on Costs During Terminal Hospitalizations in Canada from 2012 –2015 (F405C)
Inpatient palliative care is associated with lower inpatient costs; however, this has yet to be studied using a more nuanced, multi-tiered measure of inpatient palliative care and a national population-representative dataset. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Sarina R. Isenberg, Chris Meaney, Peter May, Peter Tanuseputro, Kieran L. Quinn, Danial Qureshi, Stephanie Saunders, Colleen Webber, Hsien Seow, James Downar, Thomas J. Smith, Peter G. Lawlor, Julie Lachance, Kim McGrail, Amy T. Hsu Source Type: research

Playing Nice in the Sandbox: Lessons on Roles, Interdisciplinary Collaboration, and Leadership from a VA National Improvement Intervention (F405D)
The Department of Veterans Affairs (VA) implemented the Life-Sustaining Treatment Decisions Initiative (LSTDI) nationally in 2017. This policy encourages universal goals of care conversations (GoCCs) regarding life-sustaining treatments among veterans with serious illnesses. A key component is expanding clinician roles, including nurses and social workers, in GoCCs. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Jessica Ma, Marie C. Haverfield, Cati Brown-Johnson, Karl A. Lorenz, Karleen F. Giannitrapani Source Type: research

Methylnaltrexone for Refractory Opioid-Induced Constipation in Hospitalized Cancer Patients —A Highly Effective Treatment (F415A)
Methylnaltrexone is a peripherally acting mu-opioid receptor antagonist that has been studied in cancer and non-cancer patients with opioid-induced constipation (OIC), but only in the outpatient setting. For hospitalized patients with cancer pain and laxative-refractory OIC, its effectiveness is unknown. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: David Harris, David Z. Kalir, Cory A. Chevalier, Krista R. Dobbie, Flannery Fielding, Ruth L. Lee, Ahed Makhoul, Susan McInnes, Kyle Neale, Lisa Rybicki, Melanie Robbins-Ong, Kathleen Neuendorf, Sina Najafi Source Type: research

Patient-Reported and End-of-Life Outcomes Among Adults with Oncogene-Driven Lung Cancer in a Clinical Trial of Early Integrated Palliative Care: A Secondary Analysis (F415C)
Targeted therapy has revolutionized treatment for patients with oncogene-driven non-small cell lung cancer (NSCLC), though data are lacking on patient-reported and end-of-life (EOL) care outcomes in this population. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Laura A. Petrillo, Areej El-Jawahri, Emily R. Gallagher, Vicki Jackson, Jennifer Temel, Joseph Greer Source Type: research

What Is Empathy: Cancer Patients ’ Perceptions of an Ill-Defined Construct (F415D)
Patients, clinicians, and healthcare systems associate empathy with high quality medical care. High patient ratings on survey instruments used to assess empathy are associated with greater patient satisfaction, increased self-efficacy, and reduced emotional distress following consultation. These instruments lacked patient input in their development. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Justin J. Sanders, Manisha Dubey, Rachel Schwartz, Judith Hall Source Type: research

Feasibility of Implementing a Standard Operating Protocol for Safe Opioid Prescribing in Outpatient Palliative Care: A Quality Improvement Project (F425A)
The misuse of opioids is a public health emergency. Opioid guidelines exist for chronic pain, but not palliative care. Lack of guidelines contribute to the absence of policies for opioid use in palliative care programs. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Margaret R. Bauer, Tracy L. Shamas, Sarah Gillespie-Heyman, Samuel Adelman, Andrea Ruskin Source Type: research

Using the Palliative Performance Scale as a Trigger to Increase Goals-of-Care Conversations in Elderly Trauma Patients (F425B)
The Trauma Quality Improvement Program (TQIP) guidelines recommend all trauma patients receive palliative care assessment within 24 hours of admission. Those identified with a life-threatening or disabling injury, severe co-morbidities or frailty should have goals of care conversation (GOCC) within 72 hours. We previously showed that pre-injury Palliative Performance Scale (PPS) (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Michele Fiorentino, Patricia A. Walling, Janell C. Rosania, Kathryn Grana, Debbie M. Brucato-Duncan, Jessica Barbosa, Nicole H. Moraco, Nina E. Glass, David H. Livingston, Anne C. Mosenthal Source Type: research

“TIMEOUT” Before PEG Placement: A Policy Approach to Align Shared Decision-Making and Goals of Care Through Palliative Intervention (F425C)
Multiple professional societies promote shared decision-making (SDM) and recommend not offering percutaneous feeding tubes (PEGs) in advanced dementia. Many patients, families, caregivers, nursing homes and clinicians may not be aware of these recommendations. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Brigit C. Palathra, Hoda Abdelaziz, Elizabeth Lee, Cynthia X. Pan, Calvin Hwang, Robert Crupi Source Type: research

Increasing Access to Interventional Pain Management Therapies for Palliative Care Patients with Cancer Through Referral System Improvement (F425D)
Anesthesia providers can be active members of palliative care (PC) teams providing specialized interventional pain management therapies. Providers ’ lack of awareness of anesthesia services limits patient referral, and anesthesia providers are underutilized in PC. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Ewelina K. Gibek, Dena J. Schulman-Green Source Type: research

Support Intervention for Families and Caregivers of Palliative Care Patients (QI701)
Complicated grief is intense, debilitating grief for more than six months after loss and is predicted by pre-loss depressive symptoms and unmet psychosocial needs. Per the Clinical Practice Guidelines for Quality Palliative Care, families are at risk and their psychosocial-spiritual needs should be met to improve outcomes. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Jessica Bland, Rhea Faye Felicilda-Reynaldo Tags: Scientific and Quality Improvement Poster Abstracts Source Type: research

They're Dying: Now What? Improving Nursing Knowledge and Self-Efficacy in End-Of-Life Care (QI702)
29.4% of deaths occur inpatient. Dying patients have higher physical and emotional discomfort, lower quality of life, and prolonged grieving amongst caregivers. In an acute care hospital, lack of knowledge and confidence was revealed in providing care to patients at end of life. Research is sparse in providing effective intervention to improve end-of-life care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Rachel Sabolish, Jennifer Wilson, Hollie Caldwell Source Type: research

Characteristics and Predictors of Hospitalized Neurosurgical Patients Referred for Palliative Care Consultation at a Tertiary Academic Medical Center (QI703)
Neurosurgical (NSG) patients can benefit from specialty palliative care (PC) however there is a paucity of evidence. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Yuya Hagiwara, Mark Rostad, John Arce, Alaa Albashayreh, Stephanie Gilbertson-White Source Type: research

Improving Outpatient Life-Sustaining Treatment Documentation at the West Haven Veteran ’s Affairs Hospital (QI704)
The Veteran ’s Affairs (VA) healthcare system recently implemented the Life Sustaining Treatment (LST) Plan to promote a patient-centered approach to end-of-life decisions. Unfortunately, a majority of these conversations occur in the inpatient setting when patients are acutely ill. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Lindsay Vendetta, Kaoru Harada Source Type: research

Palliative Care in a Pandemic: A Retrospective Chart Review of the Impact of Early Palliative Care Consultation During the COVID-19 Pandemic in the Acute Care Setting (QI705)
COVID-19 is a pandemic with approximately 20% of patients infected requiring hospitalization, and 50% of patients experiencing disease progression to ARDS do not survive. Dying in the hospital is associated with more suffering, and during a pandemic carries additional distress due to rapid decline requiring urgent conversations about escalation of care during social isolation. Our community hospital has 197-beds, including 36-bed ICU, with a dedicated Palliative Care Advance Practice Nurse (APN) service. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Rachel Sabolish, Jennifer Wilson, Hollie Caldwell Source Type: research

Rapid Response to Inpatient Medical Power of Attorney Completion: A Dedicated Social Work Intervention During COVID-19 (QI706)
The high risk of mechanical ventilation with COVID-19 requires health care systems to innovate advance care planning (ACP) delivery for hospitalized patients to promote receipt of goal-concordant care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Sarguni Singh, Katie Herrmann, Wendy Cyriacks-Walker, Jeanie Youngwerth, Kathleen Bickel, Hillary Lum Source Type: research

Identifying the Gaps: Assessment of Hospice and Palliative Care Educational Needs for Internal Medicine and Family Medicine Residents (QI708)
The United States currently lacks enough palliative care (PC) physicians to meet the palliative care needs for all seriously ill patients. One way to address this need is to provide primary PC education to all resident physicians. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Paul Zimmerman, Sean Gaffney, Katherine Aragon, Catherine Quintana Source Type: research

Caring for The Dying Patient: A Quality Improvement Project on Nursing Education and Confidence Regarding Comfort Measures Only (CMO) Patients in the Hospital Setting (QI709)
Most nursing schools provide little to no education on end-of-life care. Due to staffing changes and the closure of a local hospice unit there was an increase in CMO patients dying at the hospital on specialty floors. Hospital leadership requested palliative care education to be provided to nursing staff. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Michael McKenery, Denise Verosky, Andrew Thurston, Katherine Sebesta Source Type: research

Working Together in Seattle, Washington: Impact of a Collaboration of Providence Hospice Team and Long-Term Care Facility with COVID-19 Outbreak on Patient Care (QI710)
During the 2020 COVID-19 pandemic, by the end of May,>35,000 deaths related to Covid-19 were recorded in care facilities, accounting for 42% of US deaths attributed to COVID-19. Transferring sick resident to local hospitals was often the first response to COVID-19 outbreak in long term care facilities (LTC) to reduce spread and manage symptoms. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Catherine Jin Source Type: research

Development of a New Centralized System for the Management of Opioid Therapy for the VA Palliative Care Clinic (QI711)
There is a paucity of data evaluating systems for management of opioid medications in the palliative care clinic population, which is unique due to changing symptoms and prognoses. At the Durham Veterans Administration (VA) palliative care clinic, there is no standardized system for opioid tracking or refill requests. This leads to redundant refill requests and missed or late opioid refills that can have adverse patient outcomes. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Camila Diaz, Jessica Ma, William Bryan, Shajuana McMillan, Toni Cutson Source Type: research

Proactive Palliative Care for Hospitalized Primary Care Patients (QI712)
Early integration of palliative care (PC) improves outcomes for patients with cancer, including quality of life, symptom burden, and health care utilization. Strategies are needed to identify primary care patients who would benefit from early PC. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Cindy Lien, Samantha Shapiro, Mary Buss Source Type: research

The Surprise Question Is Not Correlated with Increases in Advance Care Planning Documentation (QI713)
A positive surprise question (SQ) indicates the provider would not be surprised if the patient died in the next year. The SQ has been proposed as a prompt for advance care planning (ACP). (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Teresa Letellier, Christina Holt, Amy Haskins, Rebecca Hutchinson Source Type: research

Medication Deprescribing at End of Life in the Long-Term Care Population (QI714)
Polypharmacy, generally defined as taking five or more medications, is the leading cause of adverse drug events (ADEs) for older adults and affects as many as 95% of patients residing in long-term care (LTC). Nearly half of all patients nearing the end of life take ten or more medications per day. Deprescribing is the systematic reduction of inappropriate, unnecessary, or harmful medications by healthcare providers. Goals for deprescribing include improved patient outcomes, increased patient satisfaction, and enhanced patient safety. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Theresa Isaacs Source Type: research

The Integration of Palliative Care in General Internal Medicine Practice (QI716)
Over time outpatient palliative care has changed, extending to management of patients with chronic disease. Well-studied outpatient clinic models (particularly in heart failure and oncology) improve access and outcomes, especially if patients are referred early. However, there is a lack of data assessing the impact of embedding palliative care within general internal medicine. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Victoria Sweetnam, Sherell Thomas Nelson, Amanda Overstreet Source Type: research

Symptom Burden in Breast Cancer Patients Seeking Hospice Care in Rural Kenya (QI718)
In Africa the number of new cancer cases is predicted to increase by 70% over the next two decades. Breast cancer in Kenya is associated with a high mortality due to late stage disease at presentation. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Allison Tarus, Kenneth Cornetta, Hussein Elias, Juli Boit Source Type: research

Identifying Areas of Improvement for Care of Hospice-Enrolled Patients Presenting to the Emergency Department (QI720)
While there are some emergencies that require hospice-enrolled patients to present to the Emergency Department (ED) (such as lacerations or equipment malfunction), some hospice-related and predictable emergencies may be equally or superiorly treated at home or inpatient hospice (such as shortness of breath or pain). Although Emergency Medicine and Hospice and Palliative Medicine physicians have opinions on why hospice-enrolled physicians present to the Emergency Department, there is little research on the most common reasons leading hospice-enrolled patients presentation to the ED. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Leah McDonald Source Type: research

Designing a Peer-to-Peer Facilitated Support Network for Active and Bereaved Care Partners of People with Serious Illness: A Multi-Stakeholder Co-Design Project (QI721)
Peer-to-peer facilitated support networks can provide a forum for partnerships with people with shared serious illness experiences. Partnerships may include exchange of information, resources, and psychosocial support. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Matthew Wilson, Beth O'Donnell, Aricca Van Citters, Amelia Cullinan, Megan Holthoff, Eugene Korsunskiy, Stephanie Tomlin, Andrea Buccelleto, J.M. Haines, Anne Holmes, Kristin Johnson, Andrew Williams, Inas Khayal, Amanda Hoggard, Eugene Nelson, Kathy Kirk Source Type: research

Responding to Community Needs During COVID-19: A Virtual, Interdisciplinary Palliative Care Education Series for the Public (QI722)
COVID-19 raised public concerns about planning for and coping with serious illness and death. Social distancing and shelter-in-place orders made leveraging virtual platforms essential in providing the public with access to palliative care experts who could help address these concerns. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 23, 2021 Category: Palliative Care Authors: Claire Bleymaier, Ashley Bragg, Grant Smith, Keri Brenner, Amy Yotopoulos, Charisse Lee Source Type: research