Cancer patients see palliative clinical trials as positive experience | Group living may hold answer to hospice challenges | Physician says it is important to talk with children about death
June 26, 2015
Hospice and Palliative Medicine SmartBrief
News for physicians caring for the seriously ill

Top Story
Cancer patients see palliative clinical trials as positive experience
A study in the Journal of Pain and Symptom Management found advanced cancer patients who previously had taken part in a symptom-controlling clinical trial generally viewed it as a positive experience regardless of whether it led to improvements in pain. Patients in the study said clinical trial participation's benefits included helping future patients and researchers. HCPLive (6/23)
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Palliative & Hospice Care Update
Group living may hold answer to hospice challenges
The "social model" hospice home, in which a number of patients share a private residence, may provide an answer to challenges in caring for the terminally ill, according to end-of-life expert Karen Wyatt. She blogs about several challenges to individual home care, such as the shortage of caregivers and the need for family respite. Additionally, Medicare will reduce payments for hospice care by 11.8% over the next decade. The Huffington Post (6/23)
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Physician says it is important to talk with children about death
Hospice physician Amy Clarkson says it can be difficult to talk with children about death and dying, but avoiding the topic can be harmful. Many children are familiar with the concepts because of TV or their experience with animals. The discussions should be honest but not complex or confrontational, reflecting the child's developmental stage and understanding. Pallimed blog (6/24)
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Patient & Family Perspective
States are requiring hospitals to train family caregivers
Laws requiring hospitals to train family caregivers have been passed in 13 states, while similar legislation is awaiting signatures from governors in Illinois and New York. Some state hospital associations that had concerns about the legislation have ended up supported the push. Stateline (6/22)
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Medical Research
Many heart attack survivors don't get implantable defibrillators, study finds
A study in the Journal of the American Medical Association found that many older heart attack survivors, even patients with very weak and damaged hearts, do not have implantable defibrillators placed. Not all heart attack survivors need the devices, according to researchers, but many without the device would benefit. Researcher Dr. Sean Pokorney said poor post-discharge communication might partially explain the issue. "The health care system needs to continue to focus on improving communication between care providers in the hospital and in the outpatient clinic," he said. HealthDay News (6/23)
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Low memory test scores linked to Alzheimer’s risk
Data on over 2,000 study participants, with an average age of 73, revealed that those who had low scores on tests of memory and thinking skills were at greater likelihood of developing Alzheimer's disease. Researchers said that participants with lower test scores had 10 times the risk of developing Alzheimer's compared with those who scored highest. Findings appeared in the journal Neurology. HealthDay News (6/24)
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Study: Amyloid imaging improves outcomes for patients with indeterminate FDG-PET
Patients who undergo amyloid imaging after an indeterminate FDG-PET scan are more likely to receive earlier treatments for Alzheimer's disease and preserve their cognitive function than those who do not, according to a study reported at the SNMMI Annual Meeting. Four out of every 10 patients who underwent amyloid imaging after an indeterminate FDG scan were treated earlier, and 17% of those showed significant preservation of cerebral function. The result shows that amyloid imaging can improve patient outcomes among those with inconclusive PET scans, said researcher Erica Parker. Medscape (free registration) (6/24)
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Health Policy & Practice
U.S. Supreme Court upholds ACA exchange subsidies
Supreme Court
The Supreme Court. (Mandel Ngan/Getty Images)
The U.S. Supreme Court on Thursday upheld federal subsidies under the Affordable Care Act for people buying insurance through the federal insurance exchange, The 6-3 opinion in King vs. Burwell was written by Chief Justice John Roberts. The decision confirms that people qualify for subsidies whether they buy health plans through state or federal exchanges. NBC News (6/25), The New York Times (tiered subscription model) (6/25)
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N.H. hospitals forced to delay discharges, driving up costs
A Foundation for Healthy Communities report said New Hampshire hospitals frequently delay discharges for medically cleared patients, often because they cannot find an available nursing home bed. Other problems preventing discharge included insurance or Medicaid issues and guardianship for elderly patients. The discharge delays cost hospitals an additional $27 million over three months. New Hampshire Public Radio (6/23)
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Trends & Technology
Survey examines how EHR charting affects docs' productivity, workflow
A Physicians' Alliance of America survey found that EHR use interrupts workflow and affects the productivity of clinicians. According to the report, the productivity of 46% of doctors surveyed decreased with EHR use, compared to 26% who reported an increase in their productivity since implementing EHRs. The study also found that 34% of the over 250 clinicians surveyed spend less than half an hour on charting daily, while 9% spend over 120 minutes performing the task. (6/24)
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How to avoid burnout and sustain the hospice and palliative care workforce
There is a growing demand for hospice and palliative care services, creating a shortage of clinicians with limited providers in the pipeline to deal with this growing need. Learn about the risk factors for burnout along with strategies for building resiliency, improvement of well-being and self-care. This webinar recording (synchronized PowerPoint or audio) is now available for purchase.
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Review articles from the recent issue of JPSM
The June issue of the Journal of Pain and Symptom Management (JPSM) is now available. Read the highlights at
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Combine the extremes, and you will have the true center."
-- Karl Wilhelm Friedrich Schlegel,
poet and philosopher
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