Bill would require hospice recertification every 3 years | Families raise concerns about hospice medication use | Why feeding tubes may not help patients with dementia
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August 22, 2014
Hospice and Palliative Medicine SmartBrief
News for physicians caring for the seriously ill

Top Story
Bill would require hospice recertification every 3 years
Hospices would need to recertify every three years instead of six to eight years under a bill introduced by U.S. Rep. Tom Reed, R-N.Y. The measure includes CMS reviews of facilities based on rates of patients seeking care for longer than 180 days. The lawmaker said the goal of the Hospice Opportunities for Supporting Patients with Integrity and Care Evaluations Act is to increase accountability and transparency. The Ripon Advance (8/19)
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Palliative & Hospice Care Update
Families raise concerns about hospice medication use
Hospices are enrolling more patients who are not close to death, potentially exposing them to more powerful medications and higher drug dosages, according to a Washington Post report. The National Hospice and Palliative Care Organization's J. Donald Schumacher said surveys show hospice is consistently rated among the best care at the end of life. The Washington Post (tiered subscription model) (8/21)
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Why feeding tubes may not help patients with dementia
Providing feeding tubes for dementia patients does not prolong life and raises the risk of complications, palliative and critical care specialist Dr. Jessica Nutik Zitter writes. Providing nutrition is a sensitive issue because food is linked with caregiving. "Does our need to feed our dying loved ones blind us to what's really best for them?" Zitter writes. The New York Times (tiered subscription model)/Well blog (8/21)
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Patient & Family Perspective
Gender gap in elder care wider than for housework, child care
A Princeton University study found daughters do more caregiving for elderly parents when they have a brother than when they have a sister, and researchers said the elder-care gender gap is wider than it is for housework or child care. Study data indicate sons were more likely to be caregivers if they did not have a spouse or sister, and daughters provided more care for moms and sons for dads. HealthDay News (8/19)
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Medical Research
Certain antipsychotic drugs pose strong risks to elderly
An analysis of data on nearly 200,000 adults ages 65 and older found that those taking antipsychotic drugs quetiapine, risperidone and olanzapine had a higher risk of dying and developing acute kidney injury compared with nonusers. Use of these drugs was also associated with a greater risk of low blood pressure, acute urinary retention, pneumonia and heart attack. The findings appeared in Annals of Internal Medicine. Medscape (free registration) (8/20), HealthDay News (8/19)
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Remote monitoring outperforms usual care in HF patients
Data on heart failure patients showed that those who used Biotronik's Home Monitoring system for implantable cardioverter-defibrillators were less likely to suffer worse symptoms and had lower mortality risk during a year of monitoring compared with those who received standard care. The findings appear in the journal Lancet. (Boston) (8/19)
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Brain cell loss may lead to less sleep for elderly
The loss of ventrolateral preoptic neurons among the elderly and Alzheimer's patients may contribute to sleep problems, according to a study in the journal Brain. Beth Israel Deaconess Medical Center researchers analyzed data involving 1,000 elderly participants in the Rush Memory and Aging Project who are being followed until death. HealthDay News (8/20)
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Health Policy & Practice
U.S. tightens control of hydrocodone combo drugs
The Drug Enforcement Administration on Thursday said it would tighten control of hydrocodone combination drugs by rescheduling them from Schedule III to Schedule II. The change means prescriptions for such drugs can cover only a 90-day period instead of the previous 180 days. "Today's action recognizes that these products are some of the most addictive and potentially dangerous prescription medications available," DEA Administrator Michele Leonhart said. USA Today/The Associated Press (8/21), Reuters (8/21), The Wall Street Journal (tiered subscription model) (8/22)
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Sentinel alert on tubing connectors issued by Joint Commission
The Joint Commission issued a Sentinel Event Alert warning of a high risk of tubing misconnections, which can cause adverse events, when implementation of new standards for connectors begins in October. Most patients in hospitals and other health care settings will have some type of intravenous infusion, and Joint Commission CEO Mark Chassin, M.D., said organizational leadership is needed for safe adoption and to empower health care clinicians to report any problems as new connectors are used. Medscape (free registration) (8/21)
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Trends & Technology
Communication tool boosts coordination among doctors, other providers
A centralized clinical communication tool was designed by Listrunner to enhance communication among providers in hospitals by enabling physicians to easily access encrypted clinical information in real time and securely share it with other doctors and nurses. The company plans to use the $500,000 seed funding it raised to continue developing and testing the platform. VentureBeat (8/18)
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AAHPM Developing Countries Scholarship
Applications are now being accepted for the AAHPM Developing Countries Scholarship -- open to physicians who reside in developing countries (as defined by the World Bank). This scholarship will award up to $5,000 to cover travel and related expenses to attend the AAHPM & HPNA Annual Assembly in Philadelphia, Feb. 25 to 28.
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UNIPACs available for your mobile device
AAHPM's popular nine-book UNIPAC series, featuring case-based content and practical tools, is available as e-books. The UNIPAC e-books are fully searchable, with linked references and tables of contents and click-and-zoom tables and figures, making them ideal for point-of-care reference or as a study guide at your fingertips.
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Try to learn something about everything and everything about something."
-- Thomas Huxley,
British biologist
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