Survey examines hematologic oncologists' views on end-of-life care | End-of-life costs lower for older Medicare patients | Few end-stage COPD patients get palliative care referrals, study finds
July 15, 2016
Hospice and Palliative Medicine SmartBrief
News for physicians caring for the seriously ill
Top Story
Survey examines hematologic oncologists' views on end-of-life care
A survey of 349 hematologic oncologists in the Journal of Clinical Oncology found that unrealistic expectations can be a hurdle preventing patients with blood cancer from receiving appropriate end-of-life care. Seventy-five percent of those surveyed agreed that hospice admission more than one week before death and avoidance of intubation in the month before death were acceptable measures of good end-of-life care.
Reuters (7/12) 
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Palliative & Hospice Care Update
End-of-life costs lower for older Medicare patients
A Kaiser Family Foundation report found traditional Medicare claims for beneficiaries who died in 2014 showed per-person spending that year peaked at $43,353 for patients age 73, while per-patient spending was $33,381 at age 85 and $27,779 at age 90. The data may indicate a move toward hospice care at more advanced ages, researchers said.
Kaiser Health News (7/14) 
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Few end-stage COPD patients get palliative care referrals, study finds
Just 1.7% of US patients with end-stage chronic obstructive pulmonary disease got palliative care referrals from 2006 to 2012, even though use of palliative services increased 4.5-fold during that time, Canadian researchers reported in the journal Chest. The study, which included patients on home oxygen hospitalized for COPD exacerbations, showed palliative care referral rates were even lower for minorities, poor patients and those living in rural areas.
MedPage Today (free registration) (7/13) 
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Other News
Patient & Family Perspective
Many seniors with disability choose home care over nursing home
A study published in the Journal of the American Medical Association found that 50% of seniors with one or more disabilities in 2012 received some form of home care rather than moving to a long-term-care facility, compared with 42% of seniors in 1998. Researchers note that while many of the seniors chose home care, 45% of women and close to two-thirds of men who had trouble with basic tasks did not have any caregiving help.
HealthDay News (7/12) 
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Medical Research
Study links exercise to improved well-being, memory in breast cancer survivors
Moderate to vigorous exercise may help reduce stress and fatigue in breast cancer survivors, which may have psychological benefits and improve memory, according to a study in the journal Psycho-Oncology. Chemotherapy or radiation has been linked to memory problems, but the study suggests exercise may boost self-confidence and reduce distress, benefits that are associated with memory improvement.
HealthDay News (7/8) 
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Leukemia drug shows promise against Parkinson's in small study
The leukemia drug nilotinib appears safe for people with Parkinson's disease and might improve patients' physical and cognitive function, researchers reported in the Journal of Parkinson's Disease. The drug appeared to boost the brain's production of dopamine and reduce brain accumulations of certain proteins associated with the disease, but researchers caution that more study is needed.
HealthDay News (7/12) 
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Health Policy & Practice
Report: US health care costs to reach $10,345 per person this year
An HHS report released Wednesday predicts a 5.7% annual increase in national health spending from 2017 to 2019 and 6% annual growth from 2020 to 2025, while per-person health spending is projected to be $10,345 this year, totaling $3.35 trillion for the nation. Medicare is expected to spend an average of almost $18,000 per beneficiary by 2025 when the program will cover 20% of Americans, and Medicaid is projected to spend about $12,500 per beneficiary by 2025, up from $8,000 last year.
The New York Times (free-article access for SmartBrief readers) (7/13),  The Miami Herald (tiered subscription model)/The Associated Press (7/13) 
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Trends & Technology
Study: Drug nonadherence with pill organizers may lead to adverse events
People over age 75 may experience adverse events if they use medication organization devices and are unintentionally nonadherent, researchers reported in the journal Health Technology Assessment. Researchers said the MOD studies they found were mostly poor quality and how medication adherence affects outcomes is not clear. News (7/11) 
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Society & Ethics
Public views have changed on end-of-life care discussions
Public discussion has moved away from derogatory terms for end-of-life counseling and discussions, thanks mainly to efforts by people seeking better experiences for loved ones with serious conditions, write Mark Dann and Sean Crowley of Compassion & Choices. Congress is considering bipartisan bills to improve end-of-life care by providing clinician training and funding, they said.
The Hill (7/13) 
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