Scholars@Duke
Arif H Kamal

Arif H Kamal

Associate Consulting Professor in the Department of Medicine
Medicine, Medical Oncology
arif.kamal@duke.edu
Box 2715, Duke University, Durham, NC 27710
Box 2715, Duke University, Durham, NC 27710

Selected Publications

Health-related quality of life among prostate cancer survivors with metastatic disease and non-metastatic disease and men without a cancer history in the USA.

Journal Article J Cancer Surviv · June 2025 BACKGROUND: Few studies have comprehensively compared health-related quality of life (HRQoL) between metastatic prostate cancer survivors, survivors with non-metastatic disease, and men without a cancer history. METHODS: We used the Surveillance, Epidemiol ... Full text Link to item Cite

US Medicare Hospice and Palliative Medicine Physician Workforce and Service Delivery in 2008-2020.

Journal Article J Pain Symptom Manage · June 2024 CONTEXT: Despite clinical benefits of early palliative care, little is known about Medicare physician workforce specialized in Hospice and Palliative Medicine (HPM) and their service delivery settings. OBJECTIVES: To examine changes in Medicare HPM physici ... Full text Link to item Cite

American Cancer Society's report on the status of cancer disparities in the United States, 2023.

Journal Article CA Cancer J Clin · 2024 In 2021, the American Cancer Society published its first biennial report on the status of cancer disparities in the United States. In this second report, the authors provide updated data on racial, ethnic, socioeconomic (educational attainment as a marker) ... Full text Link to item Cite

Social Deprivation and End-of-Life Care Use Among Adults With Cancer.

Journal Article JCO Oncol Pract · January 2024 PURPOSE: Socioeconomic differences are partially responsible for racial inequities in cancer outcomes, yet the association of area-level socioeconomic disadvantage and race with end-of-life (EOL) cancer care quality is poorly understood. METHODS: This retr ... Full text Link to item Cite

A tripartite approach toward ending cancer as we know it, for everyone: An American Cancer Society perspective.

Journal Article J Surg Oncol · November 2023 Gaps in the cancer care continuum are vast, both in the United States and globally. The American Cancer Society orchestrates an integrated, tripartite approach toward improving the lives of cancer patients and their families through research, advocacy, and ... Full text Link to item Cite

Medicaid Expansion Associated With Increase In Palliative Care For People With Advanced-Stage Cancers.

Journal Article Health Aff (Millwood) · July 2023 Clinical guidelines have endorsed early palliative care for patients with advanced malignancies, but receipt remains low in the US. This study examined the association between Medicaid expansion under the Affordable Care Act and receipt of palliative care ... Full text Link to item Cite

Using digital phenotyping to understand health-related outcomes: A scoping review.

Journal Article Int J Med Inform · June 2023 BACKGROUND: Digital phenotyping may detect changes in health outcomes and potentially lead to proactive measures to mitigate health declines and avoid major medical events. While health-related outcomes have traditionally been acquired through self-report ... Full text Link to item Cite

Index Symptoms and Prognosis Awareness of Patients With Pancreatic Cancer: A Multi-Site Palliative Care Collaborative.

Journal Article J Palliat Care · April 2023 BACKGROUND: Pancreatic cancer has a poor 5-year survival and carries significant morbidity. Pain is a commonly studied symptom in pancreatic cancer; however, few studies examine the frequency of multiple patient-reported symptoms. Our aim is to ascertain p ... Full text Link to item Cite

Associations of Early Completion of Advance Directives With Key End-of-Life Quality Measures: Analysis of an ASCO Quality Oncology Practice Initiative Patient Cohort.

Journal Article JCO Oncol Pract · April 2023 PURPOSE: Despite the growing calls for early and ubiquitous completion of advance directives (ADs), studies exploring links between AD completion and their impact on outcomes of patients with cancer have mixed conclusions. We used the ASCO Quality Oncology ... Full text Link to item Cite

Clinical Impact of ASCO Choosing Wisely Guidelines on Staging Imaging for Early-Stage Breast Cancers: A Time Series Analysis Using SEER-Medicare Data.

Journal Article JCO Oncol Pract · February 2023 PURPOSE: American Society for Clinical Oncology released the Choosing Wisely list in 2012, highlighting low-value procedures that lack evidence, advising against the use of positron emission tomography, computerized tomography, and radionuclide bone scans ... Full text Link to item Cite

Patient-Reported Quality Measures for Palliative Care: The Time is now.

Journal Article J Pain Symptom Manage · February 2023 CONTEXT: While progress has been made in the ability to measure the quality of hospice and specialty palliative care, there are notable gaps. A recent analysis conducted by Center for Medicare and Medicaid Services (CMS) revealed a paucity of patient-repor ... Full text Link to item Cite

"Between Wings of Hope and Fear": Muslim Parents' Experiences with the American Health Care System.

Journal Article J Palliat Med · January 2023 Background and Objectives: Historically marginalized religious and cultural groups are at risk for lower quality of care than majority groups. No study to date specifically queries Muslim experiences with the American health care system (AHCS). We performe ... Full text Link to item Cite

What Is Neuropathic Pain and How Is It Best Managed?

Chapter · January 1, 2023 Neuropathic pain is a common source of distress in patients cared for by palliative care clinicians. This chapter describes the prevalence, pathophysiology, and assessment and treatment approaches to patients with neuropathic pain. ... Full text Cite

How Are Adjuvant Medications Such as Corticosteroids and NSAIDs Used for Pain Management?

Chapter · January 1, 2023 Adjuvant medications to complement surgical and opioid-based techniques for pain management are an important and often-used modality. NSAIDs and corticosteroids have a useful role in pain management for patients in palliative care. In patients for whom the ... Full text Cite

Top Ten Tips Palliative Care Clinicians Should Know About Managing Immune-Mediated Endocrine Toxicities in Cancer.

Journal Article J Palliat Med · November 2022 Immune checkpoint inhibitors (ICI), such as PD-1/PDL-1 and CTLA-4, have become widely used in the treatment of solid and hematological malignancies; their use and side effects are increasingly seen in the palliative care (PC) population. These drugs can re ... Full text Link to item Cite

Oral Chemotherapy Metric Performance in Quality Oncology Practice Initiative Practices: Updated Trends and Analysis.

Journal Article J Natl Compr Canc Netw · October 2022 BACKGROUND: Oral chemotherapy performance measures were first introduced into ASCO's Quality Oncology Practice Initiative (QOPI) in 2013. This study examined performance on these measures among QOPI-participating practices and evaluated whether it differed ... Full text Link to item Cite

Pre-Treatment Staging Imaging in Rectal Cancer: Results From the Quality Oncology Practice Initiative.

Journal Article JCO Oncol Pract · August 2022 PURPOSE: For patients with nonmetastatic rectal cancer, the National Comprehensive Cancer Network guidelines recommend initial staging using pelvic magnetic resonance imaging or endorectal ultrasound to determine the stage of the disease before initial the ... Full text Link to item Cite

Relationship Between Participation in ASCO's Quality Oncology Practice Initiative Program and American Board of Internal Medicine's Maintenance of Certification Program.

Journal Article JCO Oncol Pract · August 2022 PURPOSE: Medical oncologists have a variety of options for demonstrating proficiency in providing high-quality patient care. Perhaps, the best-known opportunity for demonstrating individual expertise and lifelong learning is the American Board of Internal ... Full text Link to item Cite

Hematology/Oncology Fellowship Programs' Participation in the Quality Oncology Practice Initiative.

Journal Article JCO Oncol Pract · July 2022 PURPOSE: In the first decade of this millennium, ASCO pioneered a quality measurement tool, the Quality Oncology Practice Initiative (QOPI). Despite an Accreditation Council for Graduate Medical Education (ACGME) requirement since 2012 for oncology fellows ... Full text Link to item Cite

Improving Outcomes Measurement in Palliative Care: The Lasting Impact of Randy Curtis and his Collaborators.

Journal Article J Pain Symptom Manage · June 2022 Palliative care research is deeply challenging for many reasons, not the least of which is the conceptual and operational difficulty of measuring outcomes within a seriously ill population such as critically ill patients and their family members. This manu ... Full text Link to item Cite

Leading from the Heart.

Journal Article J Pain Symptom Manage · June 2022 Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Muslims.

Journal Article J Palliat Med · May 2022 Islam is the fastest-growing religion across the world and in the United States. Adherents of Islam are known as Muslims. Globally, Muslims comprise the second largest religious group with 1.8 billion people, or 24% of the world's population, and range in ... Full text Link to item Cite

Clinician End-of-Life Experiences With Pediatric Muslim Patients at a US Quaternary Care Center.

Journal Article J Pain Symptom Manage · May 2022 CONTEXT: A small, growing body of data exist discussing the experiences of Muslim patients with the palliative care system, both in the United States and abroad, as well as providers' experiences with Muslim patients. However, no studies evaluate clinician ... Full text Link to item Cite

Opioid Prescribing and Use Among Cancer Survivors: A Mapping Review of Observational and Intervention Studies.

Journal Article J Pain Symptom Manage · April 2022 CONTEXT: Recent years show a sharp increase in research on opioid use among cancer survivors, but evidence syntheses are lacking, leaving knowledge gaps. Corresponding research needs are unclear. OBJECTIVES: To provide an evidence synthesis. METHODS: We se ... Full text Link to item Cite

Patient-reported distress as an early warning sign of unmet palliative care needs and increased healthcare utilization in patients with advanced cancer.

Journal Article Support Care Cancer · April 2022 INTRODUCTION: Cancer patients' sources of distress are often unaddressed, and patient-reported distress data could be utilized to identify those with unmet and impending care needs. We explored the association between moderate/severe distress and healthcar ... Full text Link to item Cite

Study protocol for a randomised trial evaluating the non-inferiority of stepped palliative care versus early integrated palliative care for patients with advanced lung cancer.

Journal Article BMJ Open · February 10, 2022 INTRODUCTION: Integrating palliative care (PC) early in the illness course for patients with serious cancers improves their outcomes and is recommended by national organisations such as the American Society of Clinical Oncology. However, monthly visits wit ... Full text Link to item Cite

Clinician Perspectives Guiding Approach to Comprehensiveness of Palliative Care Assessment.

Journal Article J Palliat Med · February 2022 Background: National Consensus Project for quality palliative care guidelines emphasizes the importance of a comprehensive assessment of all care domains, including physical, psychosocial, and spiritual aspects of care, for seriously ill patients. However, ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Spirituality in Serious Illness.

Journal Article J Palliat Med · February 2022 Assessment of spiritual suffering and provision of spiritual care are a central component of palliative care (PC). Unfortunately, many PC clinicians, like most medical providers, have received limited or superficial training in spirituality and spiritual d ... Full text Link to item Cite

Meaning-Centered Pain Coping Skills Training: A Pilot Feasibility Trial of a Psychosocial Pain Management Intervention for Patients with Advanced Cancer.

Journal Article J Palliat Med · January 2022 Background: Pain from advanced cancer can greatly reduce patients' physical, emotional, and spiritual well-being. Objective: To examine the feasibility and acceptability of a behavioral pain management intervention, Meaning-Centered Pain Coping Skills Trai ... Full text Link to item Cite

Comparing Palliative Care Knowledge in Metropolitan and Nonmetropolitan Areas of the United States: Results from a National Survey.

Journal Article J Palliat Med · December 2021 Background: Despite recent growth in access to specialty palliative care (PC) services, awareness of PC by patients and caregivers is limited and misconceptions about PC persist. Identifying gaps in PC knowledge may help inform initiatives that seek to red ... Full text Link to item Cite

Palliative Care Use for Critically Ill Patients With Brain Metastases.

Journal Article J Pain Symptom Manage · November 2021 CONTEXT: Critically ill patients with brain metastases (BM) face significant uncertainty regarding prognosis and survival and can benefit from Palliative care (PC). However, research regarding the role of PC in this population is lacking. OBJECTIVES: We so ... Full text Link to item Cite

Specialty Palliative Care in COVID-19: Early Experiences from the Palliative Care Quality Collaborative.

Journal Article J Palliat Med · November 2021 Background: The COVID-19 pandemic has spurred unprecedented need for specialty palliative care. The Palliative Care Quality Collaborative (PCQC) provides unique infrastructure for rapid data collection and analysis. Objectives: To capture and describe real ... Full text Link to item Cite

Identification of Patient-Reported Outcome Phenotypes Among Oncology Patients With Palliative Care Needs.

Journal Article JCO Oncol Pract · October 2021 PURPOSE: Despite evidence-based guidelines recommending early palliative care, it remains unclear how to identify and refer oncology patients, particularly in settings with constrained access to palliative care. We hypothesize that patient-reported outcome ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Prognostication in Critical Illness and Heart, Kidney, and Liver Diseases.

Journal Article J Palliat Med · September 2021 Specialty palliative care (PC) clinicians are frequently asked to discuss prognosis with patients and their families. When conveying information about prognosis, PC clinicians need also to discuss the likelihood of prolonged hospitalization, cognitive and ... Full text Link to item Cite

Spotlight on International Quality: COVID-19 and Its Impact on Quality Improvement in Cancer Care.

Journal Article JCO Glob Oncol · September 2021 This report from ASCO's International Quality Steering Group summarizes early learnings on how the COVID-19 pandemic and its stresses have disproportionately affected cancer care delivery and its delivery systems across the world. This article shares persp ... Full text Link to item Cite

Development of a Mobile Health App (TOGETHERCare) to Reduce Cancer Care Partner Burden: Product Design Study.

Journal Article JMIR Form Res · August 13, 2021 BACKGROUND: Approximately 6.1 million adults in the United States serve as care partners for cancer survivors. Studies have demonstrated that engaging cancer survivors and their care partners through technology-enabled structured symptom collection has sev ... Full text Link to item Cite

Inpatient palliative care utilization for patients with brain metastases.

Journal Article Neuro-oncology practice · August 2021 IntroductionGiven the high symptom burden and complex clinical decision making associated with a diagnosis of brain metastases (BM), specialty palliative care (PC) can meaningfully improve patient quality of life. However, no prior study has forma ... Full text Cite

Palliative Care Specialist Access is Associated With Rankings of Hospital Quality.

Journal Article J Pain Symptom Manage · July 2021 CONTEXT: Increasing evidence has shown that access to specialty palliative care, particularly outpatient palliative care clinics, can yield improved health outcomes and be a marker of hospital quality. OBJECTIVE: To determine whether an association exists ... Full text Link to item Cite

Occupational and Personal Consequences of the COVID-19 Pandemic on US Oncologist Burnout and Well-Being: A Study From the ASCO Clinician Well-Being Task Force.

Journal Article JCO Oncol Pract · July 2021 INTRODUCTION: The COVID-19 pandemic is an unprecedented global crisis profoundly affecting oncology care delivery. PURPOSE: This study will describe the occupational and personal consequences of the COVID-19 pandemic on oncologist well-being and patient ca ... Full text Link to item Cite

Creating a Blueprint of Well-Being in Oncology: An Approach for Addressing Burnout From ASCO's Clinician Well-Being Taskforce.

Journal Article Am Soc Clin Oncol Educ Book · June 2021 Optimizing the well-being of the oncology clinician has never been more important. Well-being is a critical priority for the cancer organization because burnout adversely impacts the quality of care, patient satisfaction, the workforce, and overall practic ... Full text Link to item Cite

Differences between patients with cardiovascular disease and cancer referred for palliative care.

Journal Article Am Heart J · March 2021 Our analysis from a national registry shows that compared to cancer, cardiovascular disease patients referred to palliative care are a decade older, have worse functional status and clinician-estimated prognosis. Both groups have very high symptom burden, ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Teaching Trainees How to Conduct a Family Meeting.

Journal Article J Palliat Med · February 2021 The family meeting is an essential component of effective palliative care (PC); however, medical students and junior doctors-in-training often consider leading a family meeting to be a daunting task. The old "see one, do one, teach one" axiom should not ap ... Full text Link to item Cite

Characteristics of Advance Care Planning in Patients With Cancer Referred to Palliative Care.

Journal Article JCO Oncol Pract · February 2021 PURPOSE: Advance care planning (ACP) is a process in which patients share their values, goals, and preferences regarding future medical care. ACP can improve care quality, yet may be challenging to address for patients with cancer. We sought to characteriz ... Full text Link to item Cite

Associations of Patient Characteristics and Care Setting with Complexity of Specialty Palliative Care Visits.

Journal Article J Palliat Med · January 2021 Background: Information routinely collected during a palliative care consultation request may help predict the level of complexity of that patient encounter. Objectives: We examined whether patient and consultation characteristics, as captured in consultat ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know about Implementing a Team Wellness Program.

Journal Article J Palliat Med · January 2021 Palliative care (PC) providers often face challenging and emotional cases while operating in the structures that are not ideally resourced. This combination can lead to burnout and further jeopardize resources from turnover, morale, and decreased productiv ... Full text Link to item Cite

Perceptions of Facilitators and Barriers to Measuring and Improving Quality in Palliative Care Programs.

Journal Article Am J Hosp Palliat Care · December 2020 OBJECTIVE: To examine perceptions of facilitators and barriers to quality measurement and improvement in palliative care programs and differences by professional and leadership roles. METHODS: We surveyed team members in diverse US and Canadian palliative ... Full text Link to item Cite

Hospice Use Among Patients With Cancer: Trends, Barriers, and Future Directions.

Journal Article JCO Oncol Pract · December 2020 Patients with advanced cancer and their families frequently encounter clinical and logistical challenges related to end-of-life care. Hospice provides interdisciplinary and holistic care to meet patients' biomedical, psychosocial, and spiritual needs in th ... Full text Link to item Cite

Evaluation of a Virtual Learning Collaborative to Integrate Palliative Care Into Routine Oncology Practice.

Journal Article JCO Oncol Pract · November 2020 PURPOSE: The integration of palliative care into usual oncology care is a best practice, but implementation can be challenging. METHODS: We convened a virtual learning collaborative (VLC) of oncology practices with a focus on integrating palliative care. T ... Full text Link to item Cite

Hospice Employees' Perceptions of Their Work Environment: A Focus Group Perspective.

Journal Article Int J Environ Res Public Health · August 24, 2020 Burnout in healthcare professionals can lead to adverse effects on physical and mental health, lower quality of care, and workforce shortages as employees leave the profession. Hospice professionals are thought to be at particularly high risk for burnout. ... Full text Link to item Cite

Abstract 2033: Reducing cancer caregiver burden: A user-centered design approach for an mHealth app

Conference Cancer Research · August 15, 2020 AbstractBackground: Informal cancer caregivers are being asked to provide more extensive home care for cancer patients. It is well documented that caregivers frequently experience psychological and behaviora ... Full text Cite

Importance of quality-of-life priorities and preferences surrounding treatment decision making in patients with cancer and oncology clinicians.

Journal Article Cancer · August 1, 2020 BACKGROUND: Shared decision-making (SDM) occurs when a patient partners with their oncologist to integrate personal preferences and values into treatment decisions. A key component of SDM is the elicitation of patient preferences and values, yet little is ... Full text Link to item Cite

Top Ten Things Palliative Care Clinicians Should Know About Caring for Hindus.

Journal Article J Palliat Med · July 2020 Hinduism is one of the five major world religions with >1 billion followers worldwide and encompasses a diversity of belief systems. As of 2010, an estimated 1.8 million Hindus lived in the United States, and this number is expected to increase to 4.8 mill ... Full text Link to item Cite

Incidence of Opioid-Associated Deaths in Cancer Survivors in the United States, 2006-2016: A Population Study of the Opioid Epidemic.

Journal Article JAMA Oncol · July 1, 2020 This study analyzes the incidence of opioid-associated deaths in cancer survivors vs the general population in the US from 2006 through 2016 using National Center for Health Statistics death certificate data. ... Full text Link to item Cite

Multisite, Randomized Trial of Early Integrated Palliative and Oncology Care in Patients with Advanced Lung and Gastrointestinal Cancer: Alliance A221303.

Journal Article J Palliat Med · July 2020 Background: We conducted a multicenter, randomized trial of early integrated palliative and oncology care in patients with advanced cancer to confirm the benefits of early palliative care (PC) seen in prior single-center studies. Methods: We randomly assig ... Full text Link to item Cite

Enhancing meaning in the face of advanced cancer and pain: Qualitative evaluation of a meaning-centered psychosocial pain management intervention.

Journal Article Palliat Support Care · June 2020 OBJECTIVES: The objectives of this study were to obtain patient evaluations of the content, structure, and delivery modality of Meaning-Centered Pain Coping Skills Training (MCPC), a novel psychosocial intervention for patients with advanced cancer and pai ... Full text Link to item Cite

Prevalence and Predictors of Burnout Among Hospice and Palliative Care Clinicians in the U.S.

Journal Article J Pain Symptom Manage · May 2020 CONTEXT: Many clinical disciplines report high rates of burnout, which leads to low quality of care. Palliative care clinicians routinely manage patients with significant suffering, aiming to improve quality of life. As a major role of palliative care clin ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Integrating Population Health Principles into Practice.

Journal Article J Palliat Med · April 2020 The field of palliative care (PC) has spent the past decade demonstrating that it improves outcomes for patients, clinicians, and health systems. Forward-thinking organizations preparing for a reimbursement system rooted in value have built robust inpatien ... Full text Link to item Cite

A Call to Action: Ethics Committee Roundtable Recommendations for Addressing Burnout and Moral Distress in Oncology.

Journal Article JCO Oncol Pract · April 2020 Oncologist well-being is critical to initiating and maintaining the physician-patient relationship, yet many oncologists suffer from symptoms of burnout. Burnout has been linked to poor physical and mental health, as well as increased medical errors, patie ... Full text Link to item Cite

The need for a Serious Illness Digital Ecosystem (SIDE) to improve outcomes for patients receiving palliative and hospice care.

Journal Article Am J Manag Care · April 2020 Palliative and hospice care services produce immense benefits for patients living with serious illness and for their families. Due to the national shift toward value-based payment models, health systems and payers share a heightened awareness of the need t ... Full text Open Access Link to item Cite

Standards, Guidelines, and Quality Measures for Successful Specialty Palliative Care Integration Into Oncology: Current Approaches and Future Directions.

Journal Article J Clin Oncol · March 20, 2020 Although robust evidence demonstrates that specialty palliative care integrated into oncology care improves patient and health system outcomes, few clinicians are familiar with the standards, guidelines, and quality measures related to integration. These t ... Full text Link to item Cite

Trends and Factors Associated with Place of Death for Individuals with Dementia in the United States.

Journal Article J Am Geriatr Soc · February 2020 OBJECTIVES: To assess trends and factors associated with place of death among individuals with Alzheimer's disease-related dementias (ADRD). DESIGN: Cross-sectional analysis. SETTING: Centers for Disease Control and Prevention Wide-ranging OnLine Data for ... Full text Link to item Cite

A feasible and acceptable multicultural psychosocial intervention targeting symptom management in the context of advanced breast cancer.

Journal Article Psychooncology · February 2020 OBJECTIVE: Advanced breast cancer patients around the world experience high symptom burden (ie, distress, pain, and fatigue) and are in need of psychosocial interventions that target symptom management. This study examined the feasibility, acceptability, a ... Full text Link to item Cite

Digital Health for the Seriously Ill: Making Your Own Electronic Tools, Apps, and Websites

Conference JOURNAL OF PAIN AND SYMPTOM MANAGEMENT · February 1, 2020 Link to item Cite

Sojourn's Scholars Present: In the Expert's Studio (FR457)

Conference Journal of Pain and Symptom Management · February 2020 Full text Cite

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Patients with Hematologic Malignancies.

Journal Article J Palliat Med · November 2019 Hematologic malignancies differ in several important ways from solid organ cancers, and warrant a unique approach to palliative care (PC) integration. As PC has moved upstream from end-of-life care, PC clinicians are increasingly asked to see patients with ... Full text Link to item Cite

Proposed Criteria for Systematic Evaluation of Qualitative Oncology Research.

Journal Article J Oncol Pract · October 2019 Oncology has made significant advances in standardizing how clinical research is conducted and reported. The advancement of such research that improves oncology practice requires an expansion of not only our research questions but also the research methods ... Full text Link to item Cite

Usability of PCforMe in Patients With Advanced Cancer Referred to Outpatient Palliative Care: Results of a Randomized, Active-Controlled Pilot Trial.

Journal Article J Pain Symptom Manage · September 2019 CONTEXT: Low utilization of palliative care services warrant testing of new solutions to educate and engage patients around the benefits of palliative care. OBJECTIVES: We sought out to develop and test a novel, mobile health solution to prepare patients f ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Children in Neonatal and Pediatric Intensive Care Units.

Journal Article J Palliat Med · September 2019 Over the past several years, pediatric critical care units increasingly count on the expert advisement of palliative care specialists. Given the limited availability of pediatric palliative care specialists, all palliative care clinicians may be required t ... Full text Link to item Cite

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · August 1, 2019 In recent years, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Adult Cancer Pain have undergone substantial revisions focusing on the appropriate and safe prescription of opioid analgesics, optimization of nonopioid analgesics and ... Full text Link to item Cite

National Trends in End-of-Life Care for Veterans With Advanced Cancer in the Veterans Health Administration: 2009 to 2016.

Journal Article J Oncol Pract · June 2019 PURPOSE: It is imperative to provide quality end-of-life (EOL) care for patients with cancer. Although rates of hospice use within the Veterans Health Administration have improved, antineoplastic administration and intensive care unit (ICU) admission at th ... Full text Link to item Cite

Policy Changes Key To Promoting Sustainability And Growth Of The Specialty Palliative Care Workforce.

Journal Article Health Aff (Millwood) · June 2019 Specialized palliative care teams improve outcomes for the steadily growing population of people living with serious illness. However, few studies have examined whether the specialty palliative care workforce can meet the growing demand for its services. W ... Full text Link to item Cite

Characteristics and Trends Among Patients With Cardiovascular Disease Referred to Palliative Care.

Journal Article JAMA Netw Open · May 3, 2019 IMPORTANCE: Use of palliative care (PC) for patients with cardiovascular disease (CVD) has increased recently. However, it is unknown if patients are receiving earlier referrals to PC. OBJECTIVE: To assess characteristics and trends of patients with CVD re ... Full text Link to item Cite

Identifying Palliative Care Champions to Promote High-Quality Care to Those with Serious Illness.

Journal Article J Am Geriatr Soc · May 2019 Leading medical authorities advocate for routine integration of palliative care for all major causes of death in the United States. With rapid growth and acceptance, the field of palliative care is tasked with addressing a compelling question of its time: ... Full text Link to item Cite

Hospice Use Among Patients with Heart Failure.

Journal Article Card Fail Rev · May 2019 Despite its many benefits, hospice care is underused for patients with heart failure. This paper discusses the factors contributing to this underuse and offers recommendations to optimise use for patients with heart failure and proposes metrics to optimise ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Medical Cannabis.

Journal Article J Palliat Med · March 2019 The use of medical cannabis is increasing significantly throughout the United States in spite of limited and sometimes contradictory data about its effectiveness. Palliative care providers are being asked to consider cannabis as part of symptom-directed tr ... Full text Link to item Cite

Disparities in place of death for patients with hematological malignancies, 1999 to 2015.

Journal Article Blood Adv · February 12, 2019 Patients with hematologic malignancies (HMs) often receive aggressive end-of-life care and less frequently use hospice. Comprehensive longitudinal reporting on place of death, a key quality indicator, is lacking. Deidentified death certificate data were ob ... Full text Link to item Cite

Integrated outpatient palliative care for patients with advanced cancer: A systematic review and meta-analysis.

Journal Article Palliat Med · February 2019 BACKGROUND:: Despite increasing emphasis on integration of palliative care with disease-directed care for advanced cancer, the nature of this integration and its effects on patient and caregiver outcomes are not well-understood. AIM:: We evaluated the effe ... Full text Link to item Cite

Engaging Multidisciplinary Stakeholders to Drive Shared Decision-Making in Oncology.

Journal Article J Palliat Care · January 2019 Although recognized as best practice, regular integration of shared decision-making (SDM) approaches between patients and oncologists remains an elusive goal. It is clear that usable, feasible, and practical tools are needed to drive increased SDM in oncol ... Full text Link to item Cite

Characterization of the Recommendations in the Choosing Wisely Initiative.

Journal Article Am J Med Qual · 2019 Choosing Wisely is a comprehensive set of recommendations that guides clinicians and patients away from low-value services. The recommendations were reviewed to investigate their breadth and limitations. The authors performed an abstraction of all Choosing ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Children.

Journal Article J Palliat Med · December 2018 Given the limited number of pediatric-specific palliative care programs, palliative care providers of all disciplines may be called on to care for infants, children, and adolescents with serious illness. This article provides a review of the unique compone ... Full text Open Access Link to item Cite

Evaluation of the Measuring and Improving Quality in Palliative Care Survey.

Journal Article J Oncol Pract · December 2018 PURPOSE: To evaluate the reliability, content validity, and variation among sites of a survey to assess facilitators and barriers to quality measurement and improvement in palliative care programs. METHODS: We surveyed a sample of diverse US and Canadian p ... Full text Link to item Cite

Management of cancer pain

Chapter · November 16, 2018 Cite

Specialized care of the terminally ill

Chapter · November 16, 2018 Cite

Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities.

Journal Article Cancer · November 15, 2018 BACKGROUND: Place of death is an essential component of high quality cancer care and comprehensive national trends and disparities in place of death are unknown. METHODS: Deidentified death certificate data were obtained via the National Center for Health ... Full text Link to item Cite

Practical Strategies for Optimizing and Integrating Palliative Care in Cancer.

Journal Article Curr Oncol Rep · November 13, 2018 PURPOSE OF REVIEW: Recent reforms in medical payment coupled with a rapidly evolving pharmacotherapeutic armamentarium is creating a transition in the field of oncology. This transition represents a key period for conceptual reevaluation, providing an oppo ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Interventional Symptom Management Options When Caring for Patients with Gastrointestinal Malignancies.

Journal Article J Palliat Med · September 2018 Patients diagnosed with advanced stages of gastrointestinal (GI) malignancies are often quite symptomatic, with symptoms primarily related to anatomic sites of obstruction. Endoscopic approaches to the palliation of GI malignancies have begun to overtake s ... Full text Link to item Cite

Expanding Palliative Medicine across Care Settings: One Health System Experience.

Journal Article J Palliat Med · September 2018 BACKGROUND: The success of our hospital-based Palliative Care program stimulated requests to duplicate the program across the health system continuum of care. OBJECTIVE: To develop a model of care focused on a high-need, high-cost population that could be ... Full text Link to item Cite

Going for Broke: A Longitudinal Study of Patient-Reported Financial Sacrifice in Cancer Care.

Journal Article J Oncol Pract · September 2018 PURPOSE: Patients with cancer are at risk for substantial treatment-related costs; however, little is known about patients' willingness to sacrifice to receive cancer care and how their attitudes and burden may change with time. PATIENTS AND METHODS: We co ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Mental Health and Serious Illness.

Journal Article J Palliat Med · August 2018 Palliative care has long recognized the importance of treating the whole person to address a patient's physical, mental, and spiritual suffering. To address psychological suffering, palliative care often draws upon the pharmacotherapy and psychotherapy off ... Full text Link to item Cite

The Surprise Question and Identification of Palliative Care Needs among Hospitalized Patients with Advanced Hematologic or Solid Malignancies.

Journal Article J Palliat Med · June 2018 BACKGROUND: Little is known about quality of life (QOL), depression, and end-of-life (EOL) outcomes among hospitalized patients with advanced cancer. OBJECTIVE: To assess whether the surprise question identifies inpatients with advanced cancer likely to ha ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know When Caring for Patients with Endometrial Cancer.

Journal Article J Palliat Med · June 2018 Endometrial cancer incidence has been increasing over the last two decades, likely due to the obesity epidemic. The majority of these cancers are confined to the uterus at diagnosis and can be cured with surgery. Overall, five-year disease-specific surviva ... Full text Link to item Cite

Supportive Care in Lung Cancer: Improving Value in the Era of Modern Therapies.

Journal Article Am Soc Clin Oncol Educ Book · May 23, 2018 Driven by a discipline-wide imperative to maximize patient centeredness and value, supportive care services have experienced remarkable growth and acceptance in oncology care. Two such services with a growing evidence base and examples of routine integrati ... Full text Link to item Cite

Top Ten Tips for Palliative Care Clinicians Caring for Cancer Patients Receiving Immunotherapies.

Journal Article J Palliat Med · May 2018 Patients with cancer face an ever-changing landscape of tumor-directed therapies available to improve quality of life and potentially increase survival. The most recent advances, immunotherapeutics, offer a novel way to target cancer cells by engaging the ... Full text Link to item Cite

Palliative Care.

Journal Article Ann Intern Med · March 6, 2018 Palliative care prioritizes symptom management and quality of life throughout the course of serious illness. Regardless of whether care is inpatient or outpatient, primary or subspecialty, a solid understanding of the basics of effective communication, sym ... Full text Link to item Cite

A Person-Centered, Registry-Based Learning Health System for Palliative Care: A Path to Coproducing Better Outcomes, Experience, Value, and Science.

Journal Article J Palliat Med · March 2018 BACKGROUND: Palliative care offers an approach to the care of people with serious illness that focuses on quality of life and aligning care with individual and family goals, and values in the context of what is medically achievable. OBJECTIVE: Measurement ... Full text Link to item Cite

Top 10 Tips Palliative Care Clinicians Should Know About Radiation Oncology.

Journal Article J Palliat Med · March 2018 As palliative care (PC) moves upstream in the course of advanced illness, it is critical that PC providers have a broad understanding of curative and palliative treatments for serious diseases. Possessing a working knowledge of radiation therapy (RT), one ... Full text Link to item Cite

Top 10 Tips Palliative Care Clinicians Should Know When Caring for Patients with Ovarian Cancer.

Journal Article J Palliat Med · February 2018 The vast majority of women diagnosed with ovarian cancer present with advanced-stage disease with a five-year survival rate less than 50%. Studies have shown that in the past, gynecologic oncologists were not routinely collaborating with palliative care ph ... Full text Link to item Cite

Predicting 6- and 12-Month Risk of Mortality in Patients With Platinum-Resistant Advanced-Stage Ovarian Cancer: Prognostic Model to Guide Palliative Care Referrals.

Journal Article Int J Gynecol Cancer · February 2018 OBJECTIVE: Predictive models are increasingly being used in clinical practice. The aim of the study was to develop a predictive model to identify patients with platinum-resistant ovarian cancer with a prognosis of less than 6 to 12 months who may benefit f ... Full text Link to item Cite

Circling the Dragon-Taming Health IT Systems to Measure What Matters (TH367)

Conference Journal of Pain and Symptom Management · February 2018 Full text Cite

Comparing the Palliative Care Needs of Patients With Hematologic and Solid Malignancies.

Journal Article J Pain Symptom Manage · January 2018 CONTEXT: Hematologic cancer patients use palliative care services less frequently than their solid tumor counterparts. Prior work suggests that these patients have a sizable symptom burden, but comparisons between hematologic and solid tumor patients near ... Full text Link to item Cite

A Survey to Evaluate Facilitators and Barriers to Quality Measurement and Improvement: Adapting Tools for Implementation Research in Palliative Care Programs.

Journal Article J Pain Symptom Manage · December 2017 CONTEXT: Although critical for improving patient outcomes, palliative care quality indicators are not yet widely used. Better understanding of facilitators and barriers to palliative care quality measurement and improvement might improve their use and prog ... Full text Link to item Cite

Tracking Patients in Community-Based Palliative Care through the Centers for Medicare & Medicaid Services Healthcare Innovation Project.

Journal Article J Palliat Med · November 2017 BACKGROUND: Although limited, the evidence base for Community-Based Palliative Care (CBPC) has shown that it improves patient health outcomes, increases satisfaction, and decreases cost. Minimal data exist comparing points of entry into palliative care and ... Full text Link to item Cite

The Quality Improvement Environment: Results of the 2016 AAHPM/HPNA Membership Needs Assessment Survey.

Journal Article J Pain Symptom Manage · November 2017 CONTEXT: The American Academy of Hospice and Palliative Medicine (AAHPM) and Hospice and Palliative Nurses Association (HPNA) convened the Measuring What Matters (MWM) initiative in 2013, which recommended 10 quality performance measures; yet, little is kn ... Full text Link to item Cite

Out-of-Pocket Costs, Financial Distress, and Underinsurance in Cancer Care.

Journal Article JAMA Oncol · November 1, 2017 This cross-sectional survey study examines financial distress and cost expectations among patients with cancer presenting for anticancer therapy. ... Full text Link to item Cite

Standardization and Scaling of a Community-Based Palliative Care Model.

Journal Article J Palliat Med · November 2017 BACKGROUND: Although limited, the descriptions of Community-Based Palliative Care (CBPC) demonstrates variability in team structures, eligibility, and standardization across care settings. OBJECTIVE: In 2014, Four Seasons Compassion for Life, a nonprofit h ... Full text Link to item Cite

Quality Improvement Pearls for the Palliative Care and Hospice Professional.

Journal Article J Pain Symptom Manage · November 2017 Rapid changes in how palliative care clinicians are evaluated and paid present an imperative for clinicians to adeptly and routinely perform quality improvement in usual practice. Like empathic communication and facilitating goals of care discussions, qual ... Full text Link to item Cite

The Implementation of Measuring What Matters in Research and Practice: Series Commentary.

Journal Article J Pain Symptom Manage · November 2017 The Measuring What Matters (MWM) initiative identified 10 indicators of high-quality palliative and hospice care. Members of the AAHPM Research Committee, through a special series of articles, examined applications of the MWM quality indicators in research ... Full text Link to item Cite

One Size Does Not Fit All: Disease Profiles of Serious Illness Patients Receiving Specialty Palliative Care.

Journal Article J Pain Symptom Manage · October 2017 INTRODUCTION: Understanding the symptom profiles of seriously ill patients who receive palliative care, especially noncancer diagnoses where the data are sparse and are critical to better targeting our resources to the needs of patients. METHODS: We perfor ... Full text Link to item Cite

Pediatric-Specific End-of-Life Care Quality Measures: An Unmet Need of a Vulnerable Population.

Journal Article J Oncol Pract · October 2017 We must ensure that the 20,000 US children (age 0 to 19 years) who die as a result of serious illness annually receive high-quality end-of-life care. Ensuring high-quality end-of-life care requires recognition that pediatric end-of-life care is conceptuall ... Full text Link to item Cite

Delivering palliative care in a community hospital: Experiences and lessons learned from the front lines

Journal Article Journal of Clinical Outcomes Management · October 1, 2017 Objective: To describe an approach to develop a community-centric palliative care program in a rural community health system and to review data collected over the program's first year. Methods: We describe the underlying foundations of our program developm ... Cite

Oncology and Palliative Care Integration: Cocreating Quality and Value in the Era of Health Care Reform.

Journal Article J Oncol Pract · September 2017 Recent payment reforms in health care have spurred thinking regarding how strengthened partnerships can cocreate quality and value. Oncology is an important area in which to consider further collaborations in patient care, as a result of increasing treatme ... Full text Link to item Cite

Improvements in Patient and Health System Outcomes Using an Integrated Oncology and Palliative Medicine Approach on a Solid Tumor Inpatient Service.

Journal Article J Oncol Pract · September 2017 PURPOSE: Early palliative care (PC) improves outcomes for outpatients with advanced cancer. Its effect on hospitalized patients with cancer is unknown. Herein, we report on the influence of a novel, fully integrated inpatient medical oncology and PC partne ... Full text Link to item Cite

Unmet Needs of African Americans and Whites at the Time of Palliative Care Consultation.

Journal Article Am J Hosp Palliat Care · June 2017 CONTEXT: Differences among patient populations that present to consultative palliative care are not known. Such an appreciation would inform health-care delivery tailored to unique populations. OBJECTIVES: We aimed to compare characteristics and palliative ... Full text Link to item Cite

Addressing Palliative Care Clinician Burnout in Organizations: A Workforce Necessity, an Ethical Imperative.

Journal Article J Pain Symptom Manage · June 2017 Clinician burnout reduces the capacity for providers and health systems to deliver timely, high quality, patient-centered care and increases the risk that clinicians will leave practice. This is especially problematic in hospice and palliative care: patien ... Full text Link to item Cite

Comparing the Palliative Care Needs of Those With Cancer to Those With Common Non-Cancer Serious Illness.

Journal Article J Pain Symptom Manage · June 2017 BACKGROUND: Historically, palliative care has been focused on those with cancer. Although these ties persist, palliative care is rapidly integrating into the care of patients with common, non-cancer serious illnesses. Despite this, the bulk of literature i ... Full text Link to item Cite

Why Burnout Is So Hard to Fix.

Journal Article J Oncol Pract · June 2017 Full text Link to item Cite

"It Is Like Heart Failure. It Is Chronic … and It Will Kill You": A Qualitative Analysis of Burnout Among Hospice and Palliative Care Clinicians.

Journal Article J Pain Symptom Manage · May 2017 CONTEXT: Although prior surveys have identified rates of self-reported burnout among palliative care clinicians as high as 62%, limited data exist to elucidate the causes, ameliorators, and effects of this phenomenon. OBJECTIVES: We explored burnout among ... Full text Link to item Cite

Assessing Psychological Toxicity and Patient-Reported Distress as the Sixth Vital Sign in Cancer Care and Clinical Trials.

Journal Article AMA J Ethics · May 1, 2017 As the number of available cancer therapies continues to grow, there is increasing interest in their impact on cancer patients' lived experiences. Screening for distress is one way to measure psychological dimensions of cancer patients' experiences, and do ... Full text Link to item Cite

Operationalizing the Measuring What Matters Spirituality Quality Metric in a Population of Hospitalized, Critically Ill Patients and Their Family Members.

Journal Article J Pain Symptom Manage · March 2017 CONTEXT: Measuring What Matters (MWM) quality indicators support measurement of the percentage of patients who have spiritual discussions, if desired. OBJECTIVES: The objective of this study was to 1) determine the ease of, and barriers to, prospectively c ... Full text Link to item Cite

Abstract P4-19-01: Non-metastatic and metastatic breast cancer patients' priorities when considering a treatment decision

Conference Cancer Research · February 15, 2017 AbstractThis abstract was not presented at the symposium. ... Full text Cite

Concordance Between Veterans' Self-Report and Documentation of Surrogate Decision Makers: Implications for Quality Measurement.

Journal Article J Pain Symptom Manage · January 2017 CONTEXT: The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in th ... Full text Link to item Cite

Top 10 Tips for Using Advance Care Planning Codes in Palliative Medicine and Beyond.

Journal Article J Palliat Med · December 2016 Although recommended for all persons with serious illness, advance care planning (ACP) has historically been a charitable clinical service. Inadequate or unreliable provisions for reimbursement, among other barriers, have spurred a gap between the evidence ... Full text Link to item Cite

Performance of Consultative Palliative Care Model in Achieving Quality Metrics in the ICU.

Journal Article J Pain Symptom Manage · December 2016 CONTEXT: Quality metrics for intensive care unit (ICU)-based palliative care have been proposed, but it is unknown how consultative palliative care can contribute to performance on these measures. OBJECTIVES: Assess adherence to proposed quality metrics of ... Full text Link to item Cite

Adherence to Measuring What Matters Items When Caring for Patients With Hematologic Malignancies Versus Solid Tumors.

Journal Article J Pain Symptom Manage · December 2016 CONTEXT: Measuring What Matters (MWM) prioritizes quality measures in palliative care practice. Hematologic malignancy patients are less likely to access palliative care, yet little is known about their unique needs. Differences in MWM adherence may highli ... Full text Link to item Cite

Development of the Quality Data Collection Tool for Prospective Quality Assessment and Reporting in Palliative Care.

Journal Article J Palliat Med · November 2016 BACKGROUND: Assessing and reporting the quality of care provided are increasingly important in palliative care, but we currently lack practical, efficient approaches for collection and reporting. OBJECTIVE: In response, the Global Palliative Care Quality A ... Full text Link to item Cite

Anticholinergic Drug Burden in Noncancer Versus Cancer Patients Near the End of Life.

Journal Article J Pain Symptom Manage · November 2016 CONTEXT: Anticholinergic drugs can cause several side effects, impairing cognition and quality of life (QOL). Cancer patients are often exposed to increasing cumulative anticholinergic load (ACL) as they approach death, but this burden has not been examine ... Full text Link to item Cite

Cancer Cachexia: Beyond Weight Loss.

Journal Article J Oncol Pract · November 2016 Cancer cachexia is a multifactorial syndrome characterized by skeletal muscle loss leading to progressive functional impairment. Despite the ubiquity of cachexia in clinical practice, prevention, early identification, and intervention remain challenging. T ... Full text Link to item Cite

Association of Practice-Level Hospital Use With End-of-Life Outcomes, Readmission, and Weekend Hospitalization Among Medicare Beneficiaries With Cancer.

Journal Article J Oncol Pract · October 2016 PURPOSE: To determine the relationships between hospital use of treating oncology practices and patient outcomes. PATIENTS AND METHODS: Retrospective analysis of 397,646 Medicare beneficiaries who received anticancer therapy in 2012. Each beneficiary was a ... Full text Link to item Cite

Accessibility and Barriers to Oncology Appointments at 40 National Cancer Institute-Designated Comprehensive Cancer Centers: Results of a Mystery Shopper Project.

Journal Article J Oncol Pract · October 2016 PURPOSE: Patients turn to National Cancer Institute (NCI) -designated comprehensive cancer centers because of perceived better quality and more timely access to care. However, recent studies have found that patients at various institutions may struggle to ... Full text Link to item Cite

Defining High-Quality Palliative Care in Oncology Practice: An American Society of Clinical Oncology/American Academy of Hospice and Palliative Medicine Guidance Statement.

Journal Article J Oncol Pract · September 2016 PURPOSE: Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored ... Full text Link to item Cite

Building Resilience for Palliative Care Clinicians: An Approach to Burnout Prevention Based on Individual Skills and Workplace Factors.

Journal Article J Pain Symptom Manage · August 2016 For palliative care (PC) clinicians, the work of caring for patients with serious illness can put their own well-being at risk. What they often do not learn in training, because of the relative paucity of evidence-based programs, are practical ways to miti ... Full text Link to item Cite

Top 10 Tips About the Physician Quality Reporting System for Palliative Care Professionals.

Journal Article J Palliat Med · August 2016 The U.S. healthcare system is shifting from a fee-for-service (FFS) system to a valued-based reimbursement system focused on improving the quality of healthcare. The Centers for Medicare and Medicaid Services (CMS) implemented the Physician Quality Reporti ... Full text Link to item Cite

Measuring Burnout in Palliative Care: Authors' Reply.

Journal Article J Pain Symptom Manage · August 2016 Full text Link to item Cite

Is Advanced Imaging in Early-Stage Breast Cancer Ever Warranted? Reconciling Clinical Judgment With Common Quality Measures.

Journal Article J Natl Compr Canc Netw · August 2016 BACKGROUND: The American Board of Internal Medicine Foundation's Choosing Wisely initiative aims to reduce unnecessary advanced imaging for early-stage breast cancer (ESBC). Additionally, NCCN Clinical Practice Guidelines in Oncology for Breast Cancer perm ... Full text Link to item Cite

Usability Testing of an Electronic Patient-Reported Outcome System for Survivors of Critical Illness.

Journal Article Am J Crit Care · July 2016 BACKGROUND: Web-based electronic patient-reported outcomes (ePRO) measures are increasingly used to facilitate patient-centered health assessments. However, it is unknown if ePRO completion is feasible for recently ill intensive care unit (ICU) survivors a ... Full text Link to item Cite

Assessing Emotional Suffering in Palliative Care: Use of a Structured Note Template to Improve Documentation.

Journal Article J Pain Symptom Manage · July 2016 CONTEXT: Documentation of the emotional or psychological needs of seriously ill patients receiving specialty palliative care is endorsed by the "Measuring What Matters" project as a quality performance metric and recommended for use by hospice and palliati ... Full text Link to item Cite

Comparing Unmet Needs to Optimize Quality: Characterizing Inpatient and Outpatient Palliative Care Populations.

Journal Article J Pain Symptom Manage · June 2016 CONTEXT: Palliative care (PC) consultation services are available in most hospitals; outpatient services are rapidly growing to meet the needs of patients at earlier stages of the disease trajectory. OBJECTIVES: We aimed to compare the unmet needs of PC pa ... Full text Link to item Cite

The Cambia Sojourns Scholars Leadership Program: Project Summaries from the Inaugural Scholar Cohort.

Journal Article J Palliat Med · June 2016 BACKGROUND: As palliative care grows and evolves, robust programs to train and develop the next generation of leaders are needed. Continued integration of palliative care into the fabric of usual health care requires leaders who are prepared to develop nov ... Full text Link to item Cite

Prevalence and Predictors of Burnout Among Hospice and Palliative Care Clinicians in the U.S.

Journal Article J Pain Symptom Manage · April 2016 CONTEXT: Many clinical disciplines report high rates of burnout, which lead to low quality of care. Palliative care clinicians routinely manage patients with significant suffering, aiming to improve quality of life. As a major role of palliative care clini ... Full text Link to item Cite

Concordance of Advance Care Plans With Inpatient Directives in the Electronic Medical Record for Older Patients Admitted From the Emergency Department.

Journal Article J Pain Symptom Manage · April 2016 CONTEXT: Measuring What Matters identified quality indicators to examine the percentage of patients with documentation of a surrogate decision maker and preferences for life-sustaining treatments. OBJECTIVES: To determine the rate of advance care planning ... Full text Link to item Cite

Characterizing the Hospice and Palliative Care Workforce in the U.S.: Clinician Demographics and Professional Responsibilities.

Journal Article J Pain Symptom Manage · March 2016 CONTEXT: Palliative care services are growing at an unprecedented pace. Yet, the characteristics of the clinician population who deliver these services are not known. Information on the roles, motivations, and future plans of the clinician workforce would ... Full text Link to item Cite

Adherence to Measuring What Matters Measures Using Point-of-Care Data Collection Across Diverse Clinical Settings.

Journal Article J Pain Symptom Manage · March 2016 CONTEXT: Measuring What Matters (MWM) for palliative care has prioritized data collection efforts for evaluating quality in clinical practice. How these measures can be implemented across diverse clinical settings using point-of-care data collection on qua ... Full text Link to item Cite

ReCAP: Feasibility and Effectiveness of a Pilot Program to Facilitate Quality Improvement Learning in Oncology: Experience of the American Society of Clinical Oncology Quality Training Program.

Journal Article J Oncol Pract · February 2016 PURPOSE: Studies have demonstrated that structured training programs can improve health professionals' skills in performing clinical care or research. We sought to develop and test a novel quality training program (QTP) tailored to oncology clinicians. MET ... Full text Link to item Cite

The Burden of Polypharmacy in Patients Near the End of Life.

Journal Article J Pain Symptom Manage · February 2016 CONTEXT: Patients with advanced illness are prescribed multiple medications in the last year of life, intensifying the risk of negative consequences related to polypharmacy. OBJECTIVES: To describe the medication burden of patients near the end of life and ... Full text Link to item Cite

Methodological Research Priorities in Palliative Care and Hospice Quality Measurement.

Journal Article J Pain Symptom Manage · February 2016 Quality measurement is a critical tool for improving palliative care and hospice, but significant research is needed to improve the application of quality indicators. We defined methodological priorities for advancing the science of quality measurement in ... Full text Link to item Cite

Feeling Heard and Understood: A Patient-Reported Quality Measure for the Inpatient Palliative Care Setting.

Journal Article J Pain Symptom Manage · February 2016 CONTEXT: As endorsed by the palliative care "Measuring What Matters" initiative, capturing patients' direct assessment of their care is essential for ongoing quality reporting and improvement. Fostering an environment where seriously ill patients feel hear ... Full text Link to item Cite

Feasibility and effectiveness of a pilot program to facilitate quality improvement learning in oncology: Experience of the American Society of Clinical Oncology Quality Training Program

Journal Article Journal of Oncology Practice · February 1, 2016 Purpose Studies have demonstrated that structured training programs can improve health professionals' skills in performing clinical care or research.Wesought to develop and test a novel quality training program (QTP) tailored to oncology clinicians. Method ... Full text Cite

Comparison of Quality Oncology Practice Initiative (QOPI) Measure Adherence Between Oncology Fellows, Advanced Practice Providers, and Attending Physicians.

Journal Article J Cancer Educ · December 2015 Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. ... Full text Link to item Cite

Usability and Acceptability of the QDACT-PC, an Electronic Point-of-Care System for Standardized Quality Monitoring in Palliative Care.

Journal Article J Pain Symptom Manage · November 2015 CONTEXT: Few resources exist to support collaborative quality monitoring in palliative care. These tools, if proven efficient through technology-enabled methods, may begin to routinize data collection on quality during usual palliative care delivery. Usabi ... Full text Link to item Cite

Improving the Quality of Palliative Care Through National and Regional Collaboration Efforts.

Journal Article Cancer Control · October 2015 BACKGROUND: The measurement and reporting of the quality of care in the field of palliation has become a required task for many health care leaders and specialists in palliative care. Such efforts are aided when organizations collaborate together to share ... Full text Link to item Cite

Symptom Burden of Chronic Lung Disease Compared with Lung Cancer at Time of Referral for Palliative Care Consultation.

Journal Article Ann Am Thorac Soc · September 2015 RATIONALE: A growing evidence base supports provision of palliative care services alongside life-prolonging care. Whereas palliative care processes have been implemented widely in the care of patients with lung cancer, the same is not true for patients wit ... Full text Link to item Cite

Priorities for Evaluating Palliative Care Outcomes in Intensive Care Units.

Journal Article Crit Care Nurs Clin North Am · September 2015 Defining the quality of intensive care unit (ICU) care when patients are dying is challenging. Palliative care has been recommended to improve outcomes of dying ICU patients; however, traditional ICU quality indicators do not always align with palliative c ... Full text Link to item Cite

Polypharmacy in patients with advanced cancer and the role of medication discontinuation.

Journal Article Lancet Oncol · July 2015 Polypharmacy is a well known problem in elderly patients in general, but its prevalence and effects in patients with cancer are less clear, particularly in end-of-life settings. This Review examines the existing literature on polypharmacy in advanced cance ... Full text Link to item Cite

Symptom Burden and Performance Status among Community-Dwelling Patients with Serious Illness.

Journal Article J Palliat Med · June 2015 BACKGROUND: Predicting when burdensome symptoms will arise or worsen is important to preserving quality of life in patients with serious illness. OBJECTIVES: We explored the relationship between prevalence and severity of symptoms and underlying performanc ... Full text Link to item Cite

The Population Burden of Chronic Symptoms that Substantially Predate the Diagnosis of a Life-Limiting Illness.

Journal Article J Palliat Med · June 2015 Many people in our communities live with symptoms for years or decades, something of relevance to hospice/palliative care clinicians and researchers. The proportion of people in the community at large who have a chronic symptom is likely to approximate the ... Full text Link to item Cite

Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: a randomized clinical trial.

Journal Article JAMA Intern Med · May 2015 IMPORTANCE: For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy fo ... Full text Link to item Cite

Correlation between the international consensus definition of the Cancer Anorexia-Cachexia Syndrome (CACS) and patient-centered outcomes in advanced non-small cell lung cancer.

Journal Article J Pain Symptom Manage · April 2015 CONTEXT: The cancer anorexia-cachexia syndrome (CACS) is common in patients with advanced solid tumors and is associated with adverse outcomes including poor quality of life (QOL), impaired functioning, and shortened survival. OBJECTIVES: To apply the rece ... Full text Link to item Cite

Top ten inpatient palliative medicine billing and coding mistakes (and how to fix them this week).

Journal Article J Palliat Med · March 2015 Palliative care (PC) has undergone incredible growth in the last 10 years, having gained subspecialty status and penetration into 85% of hospitals over 300 beds. The comprehensive services provided by multiple members of the PC team combined with low reimb ... Full text Link to item Cite

The quality imperative for palliative care.

Journal Article J Pain Symptom Manage · February 2015 Palliative medicine must prioritize the routine assessment of the quality of clinical care we provide. This includes regular assessment, analysis, and reporting of data on quality. Assessment of quality informs opportunities for improvement and demonstrate ... Full text Link to item Cite

Quality of palliative care for patients with advanced cancer in a community consortium.

Journal Article J Pain Symptom Manage · February 2015 BACKGROUND: Measuring quality of care delivery is essential to palliative care program growth and sustainability. We formed the Carolinas Consortium for Palliative Care and collected a quality data registry to monitor our practice and inform quality improv ... Full text Link to item Cite

Quality measures for palliative care in patients with cancer: a systematic review.

Journal Article J Oncol Pract · July 2014 PURPOSE: Quality assessment is a critical component of determining the value of medical services, including palliative care. Characterization of the current portfolio of measures that assess the quality of palliative care delivered in oncology is necessary ... Full text Link to item Cite

Preparedness planning before mechanical circulatory support: a "how-to" guide for palliative medicine clinicians.

Journal Article J Pain Symptom Manage · May 2014 The role of palliative medicine in the care of patients with advanced heart failure, including those who receive mechanical circulatory support, has grown dramatically in the last decade. Previous literature has suggested that palliative medicine providers ... Full text Link to item Cite

Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer.

Journal Article J Palliat Med · April 2014 BACKGROUND: As the role of palliative care (PC) has yet to be clearly defined in patients with heart failure (HF), such patients may face barriers regarding PC referral. In order to maximally meet the needs of HF patients, it is necessary to understand how ... Full text Link to item Cite

Optimizing the quality of breast cancer biomarker use at Duke Cancer Institute.

Journal Article J Natl Compr Canc Netw · February 2014 Advances in identifying biomarker profiles in patients with early-stage breast cancer have improved 5-year curative rates. Identification of the HER2 receptor provides valuable information that has been shown to extend survival in adjuvant and metastatic s ... Full text Link to item Cite

Community-based palliative care: the natural evolution for palliative care delivery in the U.S.

Journal Article J Pain Symptom Manage · August 2013 Palliative care in the U.S. has evolved from a system primarily reliant on community-based hospices to a combined model that includes inpatient services at most large hospitals. However, these two dominant approaches leave most patients needing palliative ... Full text Link to item Cite

Timing of end-of-life care discussion with performance on end-of-life quality indicators in ovarian cancer.

Journal Article Gynecol Oncol · July 2013 OBJECTIVES: (1) To describe the prevalence, timing and setting of documented end-of-life (EOL) discussions in patients with advanced ovarian cancer; and (2) to assess the impact of timing and setting of documented end-of-life discussions on EOL quality car ... Full text Link to item Cite

Prevalence and impact of correlative science in breast cancer phase II trials.

Journal Article Breast Cancer Res Treat · June 2013 Correlative science (CS) can potentially augment clinical trial results by identifying biomarkers of response and resistance to a novel intervention. We evaluated recently published breast cancer phase II trials (BP2T) to determine prevalence, characterist ... Full text Link to item Cite

Conformance with supportive care quality measures is associated with better quality of life in patients with cancer receiving palliative care.

Journal Article J Oncol Pract · May 2013 PURPOSE: As palliative care further integrates into cancer care, descriptions of how supportive care quality measures improve patient outcomes are necessary to establish best practices. METHODS: We assessed the relationship between conformance to 18 pallia ... Full text Link to item Cite

Evolution of the Quality Oncology Practice Initiative supportive care quality measures portfolio and conformance at a Veterans Affairs medical center.

Journal Article J Oncol Pract · May 2013 PURPOSE: A growing set of quality measures is being implemented to evaluate all components of cancer care, from diagnosis through the end of life. We investigated the Quality Oncology Practice Initiative (QOPI) quality measures portfolio. Additionally, we ... Full text Link to item Cite

The generalizability paradox within palliative care clinical trials.

Journal Article Ann Palliat Med · April 2013 We are increasingly recognizing that personalized advanced and chronic illness care requires meticulous assessment and management of supportive care needs across the entire disease trajectory. This requires drawing clinical decisions from a research eviden ... Full text Link to item Cite

Demonstration of a sustainable community-based model of care across the palliative care continuum.

Journal Article J Pain Symptom Manage · December 2012 CONTEXT: In the U.S., the number of hospital-based palliative care programs has increased rapidly, but availability of outpatient palliative care remains limited. Multiple barriers impede the financial viability of these programs. Four Seasons, a nonprofit ... Full text Link to item Cite

Integrating technology into palliative care research.

Journal Article Curr Opin Support Palliat Care · December 2012 Featured Publication PURPOSE OF REVIEW: As palliative care research evolves and grows within resource-strained environments, further integration of novel methods to assist in completing protocols is needed. Technology-assisted techniques, including the use of software and hard ... Full text Link to item Cite

Further data supporting that paclitaxel-associated acute pain syndrome is associated with development of peripheral neuropathy: North Central Cancer Treatment Group trial N08C1.

Journal Article Cancer · October 15, 2012 BACKGROUND: Paclitaxel causes an acute pain syndrome (P-APS), occurring within days after each dose and usually abating within days. Paclitaxel also causes a more classic peripheral neuropathy, which steadily increases in severity with increasing paclitaxe ... Full text Link to item Cite

Left Brain, Right Brain

Journal Article Journal of Palliative Medicine · August 1, 2012 Full text Cite

Similar survival with single-agent capecitabine or taxane in first-line therapy for metastatic breast cancer.

Journal Article Breast Cancer Res Treat · July 2012 Featured Publication Capecitabine is often offered as a first-line chemotherapy option for metastatic breast cancer (MBC). In this study, we compare characteristics of and survival among women prescribed first-line capecitabine or taxane monotherapy for MBC. Women receiving fi ... Full text Link to item Cite

In the clinic. Palliative care.

Journal Article Ann Intern Med · February 7, 2012 Featured Publication Full text Link to item Cite

Improving the management of dyspnea in the community using rapid learning approaches.

Journal Article Chron Respir Dis · February 2012 Featured Publication Patients with chronic pulmonary disease often suffer from breathlessness or dyspnea. Traditional evidence generation techniques to expand upon current treatment paradigms are limited by the significant delay between study initiation and clinical implementa ... Full text Link to item Cite

Dyspnea review for the palliative care professional: treatment goals and therapeutic options.

Journal Article J Palliat Med · January 2012 Featured Publication Although dyspnea is frequently encountered in the palliative care setting, its optimal management remains uncertain. Clinical approaches begin with accurate assessment, as delineated in part one of this two-part series. Comprehensive dyspnea assessment, wh ... Full text Link to item Cite

Palliative care needs of patients with cancer living in the community.

Journal Article J Oncol Pract · November 2011 Featured Publication PURPOSE: With improved effectiveness of early detection and treatment, many patients with cancer are now living with advanced disease and associated symptoms. As cancer becomes a chronic illness, adequate attention to patients' symptoms and psychosocial ne ... Full text Link to item Cite

Collecting data on quality is feasible in community-based palliative care.

Journal Article J Pain Symptom Manage · November 2011 Featured Publication BACKGROUND: Quality measurement in palliative care requires robust data from standardized data collection processes. We developed and tested the feasibility of the Quality Data Collection Tool version 1.0 (QDACTv1.0) for use in community-based palliative c ... Full text Link to item Cite

Dyspnea review for the palliative care professional: assessment, burdens, and etiologies.

Journal Article J Palliat Med · October 2011 Featured Publication BACKGROUND: Dyspnea is a common symptom experienced by many patients with chronic, life-threatening, and/or life-limiting illnesses. Although it can be defined and measured in several ways, dyspnea is best described directly by patients through regular ass ... Full text Link to item Cite

The value of data collection within a palliative care program.

Journal Article Curr Oncol Rep · August 2011 Featured Publication Collecting reliable and valid data is an increasing expectation within palliative care. Data remain the crux for demonstrating value and quality of care, which are the critical steps to program sustainability. Parallel goals of conducting research and perf ... Full text Link to item Cite

Management of dyspnea within a rapid learning healthcare model.

Journal Article Curr Opin Support Palliat Care · June 2011 Featured Publication PURPOSE OF REVIEW: This review addresses a distressing symptom experienced by many palliative care patients, for which available interventions have been only partially effective. A new model of healthcare delivery and research - rapid learning healthcare - ... Full text Link to item Cite

Natural history of paclitaxel-associated acute pain syndrome: prospective cohort study NCCTG N08C1.

Journal Article J Clin Oncol · April 10, 2011 PURPOSE: The characteristics and natural history of the paclitaxel-acute pain syndrome (P-APS) and paclitaxel's more chronic neuropathy have not been well delineated. METHODS: Patients receiving weekly paclitaxel (70 to 90 mg/m(2)) completed daily question ... Full text Link to item Cite

Palliative care consultations in patients with cancer: a mayo clinic 5-year review.

Journal Article J Oncol Pract · January 2011 Featured Publication PURPOSE: We sought to characterize the aggregate features and survival of patients who receive inpatient palliative care consultation, particularly focusing on patients with cancer, to identify opportunities to improve clinical outcomes. METHODS: We review ... Full text Link to item Cite

Large gallstone ileus.

Journal Article J Hosp Med · January 2011 Featured Publication Full text Link to item Cite

Breast medical oncologists' use of standard prognostic factors to predict a 21-gene recurrence score.

Journal Article Oncologist · 2011 Featured Publication BACKGROUND: Half of all breast cancers are early stage, lymph node negative, and hormone receptor positive. A 21-gene (Oncotype DX®; Genomic Health, Inc., Redwood City, CA) recurrence score (RS) is prognostic for recurrence and predictive of chemotherapy b ... Full text Link to item Cite

Idiopathic systemic capillary leak syndrome (Clarkson's disease): the Mayo clinic experience.

Journal Article Mayo Clin Proc · October 2010 Featured Publication OBJECTIVE: To determine clinical features, natural history, and outcome of a well-defined cohort of 25 consecutive patients with idiopathic systemic capillary leak syndrome (SCLS) evaluated at a tertiary care center. PATIENTS AND METHODS: Records of patien ... Full text Link to item Cite

Glutathione-s-transferase-pi expression in early breast cancer: association with outcome and response to chemotherapy.

Journal Article Cancer Invest · June 2010 Glutathione-S-transferase-pi (GST-pi) is a detoxification enzyme expressed in breast cancer; however its involvement in chemotherapy sensitivity and prognosis is not well understood. We evaluated the expression of GSTpi and its predictive role of chemother ... Full text Link to item Cite

Disseminated sporotrichosis.

Journal Article J Hosp Med · March 2010 Full text Link to item Cite

Tamoxifen pharmacogenomics: the role of CYP2D6 as a predictor of drug response.

Journal Article Clin Pharmacol Ther · January 2008 Tamoxifen continues to be a standard endocrine therapy for the prevention and treatment of estrogen receptor (ER)-positive breast cancer. Tamoxifen can be considered a classic "pro-drug," requiring metabolic activation to elicit pharmacological activity. C ... Full text Link to item Cite

Hereditary hemorrhagic telangiectasia.

Journal Article Mayo Clin Proc · November 2007 Featured Publication Full text Link to item Cite

Tamoxifen: Using pharmacogenetics to rediscover an old drug

Journal Article Breast Cancer Online · October 1, 2007 Tamoxifen can be considered a classic 'pro-drug', requiring metabolic activation to elicit pharmacological activity. Our findings suggest that both genetic and drug-induced factors that alter CYP2D6 enzyme activity influence the clinical response to tamoxi ... Full text Cite

How to interpret and pursue an abnormal prothrombin time, activated partial thromboplastin time, and bleeding time in adults.

Journal Article Mayo Clin Proc · July 2007 Featured Publication The prothrombin time (PT) and activated partial thromboplastin time (APTT) are among the most commonly ordered coagulation tests. In 2005, more than 140,000 PT and more than 95,000 APTT tests were performed at Mayo Clinic. The most common indications for o ... Full text Link to item Cite

Reflections: when the disease hits home.

Journal Article J Cancer Educ · 2007 Featured Publication Full text Link to item Cite

Effect of the antioxidant α-tocopherol in an experimental model of pulmonary hypertension and fibrosis: Administration of monocrotaline

Journal Article Nutrition Research · September 1, 2004 Monocrotaline, a pyrrolizidine alkaloid, causes in mammals a respiratory condition closely resembling adult respiratory distress syndrome and chronic obstructive pulmonary disease, which is preceded in the lung parenchyma by high levels of angiotensin conv ... Full text Cite