Scholars@Duke
Anthony Nicholas Galanos

Anthony Nicholas Galanos

Professor of Medicine
Medicine, Geriatrics
galan001@mc.duke.edu
Box 3003 Med Ctr, Durham 27710
3507 Busse Bldg, Durham 27710

Selected Publications

Caring for Each Other: A Resident-Led Peer Debriefing Skills Workshop.

Journal Article J Grad Med Educ · April 2023 BACKGROUND: Inadequate time and space to process critical incidents contribute to burnout. Residents do not regularly participate in emotional debriefs. An institutional needs assessment revealed only 11% of surveyed pediatrics and combined medicine-pediat ... Full text Open Access Link to item Cite

How we manage grief.

Journal Article Clin Adv Hematol Oncol · September 2022 Link to item Cite

Palliative Care Consultations in Patients with Severe Traumatic Brain Injury: Who Receives Palliative Care Consultations and What Does that Mean for Utilization?

Journal Article Neurocrit Care · June 2022 BACKGROUND: Palliative care has the potential to improve goal-concordant care in severe traumatic brain injury (sTBI). Our primary objective was to illuminate the demographic profiles of patients with sTBI who receive palliative care encounters (PCEs), wit ... Full text Open Access Link to item Cite

Grief in Medical Students: The Short and Long-Term Impacts on Health and Well-Being.

Journal Article Am J Hosp Palliat Care · February 2022 CONTEXT: Healthcare workers often experience grief stemming from the loss of patients under their care. The impact of personal grief on healthcare workers' wellbeing is less well described, particularly for trainees. To better characterize the prevalence a ... Full text Link to item Cite

Grief: The Epidemic Within an Epidemic.

Journal Article Am J Hosp Palliat Care · April 2021 COVID-19 has not only dramatically changed the way we live, it has also impacted how we die and how we grieve. With more and more Americans dying in ICU settings, away from family, and more funerals being held virtually, the pandemic has seriously curtaile ... Full text Link to item Cite

Impact of a Palliative Care Education Module in Patients With Heart Failure.

Journal Article Am J Hosp Palliat Care · December 2020 BACKGROUND: Heart failure (HF) impacts 6.2 million American adults. With no cure, therapies aim to prevent progression and manage symptoms. Inclusion of palliative care (PC) helps improve symptoms and quality of life. Heart failure guidelines recommend the ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Bereavement and Grief.

Journal Article J Palliat Med · August 2020 Palliative care (PC) focuses on caring for the whole person, from birth to death, while managing symptoms and helping to navigate medical complexities. Care does not stop at the time of death, however, as assisting patients, families, and fellow clinicians ... Full text Link to item Cite

Palliative Care Consultation Is Underutilized in Critically Ill General Surgery Patients.

Journal Article Am J Hosp Palliat Care · February 2020 BACKGROUND: American College of Surgeons recommends palliative care and surgeons collaborate on the care of patients with poor prognoses. These collaborations are done to discuss symptom management and goals of care. However, contemporary practice patterns ... Full text Link to item Cite

Age, knowledge, preferences, and risk tolerance for invasive cardiac care.

Journal Article Am Heart J · January 2020 BACKGROUND/OBJECTIVES: The extent to which individual knowledge, preferences, and priorities explain lower use of invasive cardiac care among older vs. younger adults presenting with acute coronary syndrome (ACS) is unknown. We directly surveyed a group of ... Full text Link to item Cite

Assessing the Impact of a Novel Integrated Palliative Care and Medical Oncology Inpatient Service on Health Care Utilization before Hospice Enrollment.

Journal Article J Palliat Med · April 2019 BACKGROUND: Evidence increasingly supports the integration of specialist palliative care (PC) into routine cancer care. A novel, fully integrated PC and medical oncology inpatient service was developed at Duke University Hospital in 2011. OBJECTIVE: To ass ... Full text Link to item Cite

Hip Fracture in the Elderly Patients: A Sentinel Event.

Journal Article Am J Hosp Palliat Care · April 2018 IMPORTANCE: Hip fracture in the elderly patients is associated with increased morbidity and mortality. There is great need for advance care planning should a patient fail to rehabilitate or experience an adverse event during or after recovery. This study w ... 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

A Successful Debrief Program for House Staff.

Journal Article J Soc Work End Life Palliat Care · 2017 Challenging end-of-life encounters can be stressful and may lead to burnout. Monthly debriefing sessions are led by a physician and clinical social worker (LCSW). Sessions focus on experiences and emotional reactions rather than case details. Themes identi ... Full text Link to item Cite

Age-Related Differences in Care Preferences, Treatment Decisions, and Clinical Outcomes of Seriously Ill Hospitalized Adults: Lessons from SUPPORT

Chapter · January 1, 2017 Although older patients preferred less aggressive care than younger patients, many older patients wanted cardiopulmonary resuscitation and care focused on life extension. Patients� families and healthcare providers underestimated older patients’ desire for ... Cite

Methylphenidate use in the elderly population: What do we know now?

Journal Article Consultant · November 1, 2016 Stimulants have been used for centuries medicinally, recreationally, and to alleviate fatigue. Because of its favorable pharmacokinetics and low abuse potential, methylphenidate became a highly prescribed drug for the treatment of attention-deficit/hyperac ... Cite

Usefulness of Palliative Care to Complement the Management of Patients on Left Ventricular Assist Devices.

Journal Article Am J Cardiol · September 1, 2016 Within the last decade, advancements in left ventricular assist device therapy have allowed patients with end-stage heart failure (HF) to live longer and with better quality of life. Like other life-saving interventions, however, there remains the risk of ... Full text Link to item Cite

Promoting Palliative Care.

Journal Article Acad Med · December 2015 Full text Link to item Cite

End-of-life Heart Failure Care in the United States.

Journal Article Heart Fail Clin · October 2015 Heart failure (HF) is increasingly common in the United States and is associated with a high degree of morbidity and mortality. As patients approach the end of life there is a significant increase in health care resource use. Patients with end-stage HF hav ... Full text Link to item Cite

Caring for Each Other: A Resident-Led Peer Debriefing Skills Workshop.

Journal Article J Grad Med Educ · April 2023 BACKGROUND: Inadequate time and space to process critical incidents contribute to burnout. Residents do not regularly participate in emotional debriefs. An institutional needs assessment revealed only 11% of surveyed pediatrics and combined medicine-pediat ... Full text Open Access Link to item Cite

How we manage grief.

Journal Article Clin Adv Hematol Oncol · September 2022 Link to item Cite

Palliative Care Consultations in Patients with Severe Traumatic Brain Injury: Who Receives Palliative Care Consultations and What Does that Mean for Utilization?

Journal Article Neurocrit Care · June 2022 BACKGROUND: Palliative care has the potential to improve goal-concordant care in severe traumatic brain injury (sTBI). Our primary objective was to illuminate the demographic profiles of patients with sTBI who receive palliative care encounters (PCEs), wit ... Full text Open Access Link to item Cite

Grief in Medical Students: The Short and Long-Term Impacts on Health and Well-Being.

Journal Article Am J Hosp Palliat Care · February 2022 CONTEXT: Healthcare workers often experience grief stemming from the loss of patients under their care. The impact of personal grief on healthcare workers' wellbeing is less well described, particularly for trainees. To better characterize the prevalence a ... Full text Link to item Cite

Grief: The Epidemic Within an Epidemic.

Journal Article Am J Hosp Palliat Care · April 2021 COVID-19 has not only dramatically changed the way we live, it has also impacted how we die and how we grieve. With more and more Americans dying in ICU settings, away from family, and more funerals being held virtually, the pandemic has seriously curtaile ... Full text Link to item Cite

Impact of a Palliative Care Education Module in Patients With Heart Failure.

Journal Article Am J Hosp Palliat Care · December 2020 BACKGROUND: Heart failure (HF) impacts 6.2 million American adults. With no cure, therapies aim to prevent progression and manage symptoms. Inclusion of palliative care (PC) helps improve symptoms and quality of life. Heart failure guidelines recommend the ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Bereavement and Grief.

Journal Article J Palliat Med · August 2020 Palliative care (PC) focuses on caring for the whole person, from birth to death, while managing symptoms and helping to navigate medical complexities. Care does not stop at the time of death, however, as assisting patients, families, and fellow clinicians ... Full text Link to item Cite

Palliative Care Consultation Is Underutilized in Critically Ill General Surgery Patients.

Journal Article Am J Hosp Palliat Care · February 2020 BACKGROUND: American College of Surgeons recommends palliative care and surgeons collaborate on the care of patients with poor prognoses. These collaborations are done to discuss symptom management and goals of care. However, contemporary practice patterns ... Full text Link to item Cite

Age, knowledge, preferences, and risk tolerance for invasive cardiac care.

Journal Article Am Heart J · January 2020 BACKGROUND/OBJECTIVES: The extent to which individual knowledge, preferences, and priorities explain lower use of invasive cardiac care among older vs. younger adults presenting with acute coronary syndrome (ACS) is unknown. We directly surveyed a group of ... Full text Link to item Cite

Assessing the Impact of a Novel Integrated Palliative Care and Medical Oncology Inpatient Service on Health Care Utilization before Hospice Enrollment.

Journal Article J Palliat Med · April 2019 BACKGROUND: Evidence increasingly supports the integration of specialist palliative care (PC) into routine cancer care. A novel, fully integrated PC and medical oncology inpatient service was developed at Duke University Hospital in 2011. OBJECTIVE: To ass ... Full text Link to item Cite

Hip Fracture in the Elderly Patients: A Sentinel Event.

Journal Article Am J Hosp Palliat Care · April 2018 IMPORTANCE: Hip fracture in the elderly patients is associated with increased morbidity and mortality. There is great need for advance care planning should a patient fail to rehabilitate or experience an adverse event during or after recovery. This study w ... 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

A Successful Debrief Program for House Staff.

Journal Article J Soc Work End Life Palliat Care · 2017 Challenging end-of-life encounters can be stressful and may lead to burnout. Monthly debriefing sessions are led by a physician and clinical social worker (LCSW). Sessions focus on experiences and emotional reactions rather than case details. Themes identi ... Full text Link to item Cite

Age-Related Differences in Care Preferences, Treatment Decisions, and Clinical Outcomes of Seriously Ill Hospitalized Adults: Lessons from SUPPORT

Chapter · January 1, 2017 Although older patients preferred less aggressive care than younger patients, many older patients wanted cardiopulmonary resuscitation and care focused on life extension. Patients� families and healthcare providers underestimated older patients’ desire for ... Cite

Methylphenidate use in the elderly population: What do we know now?

Journal Article Consultant · November 1, 2016 Stimulants have been used for centuries medicinally, recreationally, and to alleviate fatigue. Because of its favorable pharmacokinetics and low abuse potential, methylphenidate became a highly prescribed drug for the treatment of attention-deficit/hyperac ... Cite

Usefulness of Palliative Care to Complement the Management of Patients on Left Ventricular Assist Devices.

Journal Article Am J Cardiol · September 1, 2016 Within the last decade, advancements in left ventricular assist device therapy have allowed patients with end-stage heart failure (HF) to live longer and with better quality of life. Like other life-saving interventions, however, there remains the risk of ... Full text Link to item Cite

Promoting Palliative Care.

Journal Article Acad Med · December 2015 Full text Link to item Cite

End-of-life Heart Failure Care in the United States.

Journal Article Heart Fail Clin · October 2015 Heart failure (HF) is increasingly common in the United States and is associated with a high degree of morbidity and mortality. As patients approach the end of life there is a significant increase in health care resource use. Patients with end-stage HF hav ... Full text Link to item Cite

Medical Purgatory.

Journal Article J Palliat Med · July 2015 Full text Open Access Link to item Cite

Re: The Sidney Project™.

Journal Article J Pain Symptom Manage · March 2015 Full text Link to item Cite

Adaptive leadership: a novel approach for family decision making.

Journal Article J Palliat Med · March 2013 Family members of intensive care unit (ICU) patients want to be involved in decision making, but they may not be best served by being placed in the position of having to solve problems for which they lack knowledge and skills. This case report presents an ... Full text Link to item Cite

Expectations and outcomes in geriatric patients with do-not-resuscitate orders undergoing emergency surgical management of bowel obstruction.

Journal Article JAMA Surg · January 2013 OBJECTIVE: To describe the outcomes and the expected postoperative course for patients with do-not-resuscitate (DNR) orders (DNR patients) who undergo emergency surgical management of bowel obstruction. DESIGN: We retrospectively identified all patients wh ... Full text Link to item Cite

End-of-life care at an academic medical center: are attending physicians, house staff, nurses, and bereaved family members equally satisfied? Implications for palliative care.

Journal Article Am J Hosp Palliat Care · February 2012 BACKGROUND: End-of-life care is deemed to be poor in the United States - particularly in large teaching hospitals. Via a brief survey, we examined satisfaction with end-of-life care for those patients who died in our academic medical center from provider a ... Full text Link to item Cite

Complexities of defibrillator deactivation.

Journal Article Ann Intern Med · July 20, 2010 Full text Link to item Cite

Management of pain in older adults with cancer

Chapter · January 1, 2010 Although the world is full of suffering, it is also full of the overcoming of it. – Helen Keller, Optimism (1903) Why focus on the elderly? Geriatric patients are complex, do not fit in the traditional biomedical model, and are underrepresented in cancer r ... Full text Cite

Antidepressant medication use in palliative care.

Journal Article Am J Hosp Palliat Care · 2006 Full text Link to item Cite

Antidepressant medication use in palliative care.

Journal Article The American journal of hospice & palliative care · 2006 Cite

Home automated external defibrillators in a geriatric population: a brief discussion of the evidence.

Journal Article J Am Geriatr Soc · January 2006 The literature has identified significant successes in cardiac resuscitation with the use of automated external defibrillators (AEDs) in public areas. As of September 2004, the Food and Drug Administration has authorized the purchase of these devices by th ... Full text Link to item Cite

Ethnic differences in the place of death of elderly hospice enrollees.

Journal Article J Am Geriatr Soc · December 2005 Elderly minorities are more likely to die in inpatient settings than their Caucasian counterparts. It is not known whether this difference is due to cultural preferences for place of death or decreased access to hospice. This analysis examines ethnic diffe ... Full text Link to item Cite

Place of death and caregiver satisfaction [2] (multiple letters)

Journal Article American Journal of Hospice and Palliative Medicine · November 1, 2004 Cite

Palliative care in long-term care: Communicating with families

Journal Article Annals of Long-Term Care · July 1, 2004 The percentage of Medicare recipients who die in nursing homes continues to grow. This necessitates skills and competencies in end-of-life care, despite the current scarcity of training in medical and nursing schools. The principles and tenets of Palliativ ... Cite

Estimates of future physical functioning by seriously ill hospitalized patients, their families, and their physicians.

Journal Article J Am Geriatr Soc · February 2002 OBJECTIVES: To compare prognostic estimates made by seriously ill hospitalized patients, their surrogates, and their physicians about the patients' activities of daily living (ADLs) 2 months after admission; compare the accuracy of their estimates; and ide ... Full text Link to item Cite

Post-myocardial infarction risk stratification in elderly patients.

Journal Article Am Heart J · July 2001 BACKGROUND: The purpose of this study was to examine the use of post-myocardial infarction (MI) risk stratification in the elderly. Although expert panels have recommended risk stratification after MI, limited data are available on whether patients actuall ... Full text Link to item Cite

Preference for place of death in a continuing care retirement community.

Journal Article Gerontologist · February 2001 PURPOSE: To describe death-related planning and preferences for place of death among well elders in a community characterized by a low rate of hospital deaths. DESIGN AND METHODS: Cross-sectional prevalence survey of independent-living residents (n = 219) ... Full text Link to item Cite

Palliative care

Journal Article Clinics in Family Practice · January 1, 2001 It is hoped that the reader has an appreciation for what care near the end of life could be, and that it should be viewed as a shift in focus to optimize quality of life and minimize symptoms rather than attempting to cure a disease. Symptom management and ... Full text Cite

Impact of depressive symptoms on hospitalization risk in community-dwelling older persons.

Journal Article J Am Geriatr Soc · October 2000 OBJECTIVE: To determine whether depressive symptoms in older adults are associated with an increased risk for hospitalization. DESIGN: A 6 month cohort study. SETTING: Five counties in the northern Piedmont of North Carolina from the Duke University site o ... Full text Link to item Cite

Prediction of survival for older hospitalized patients: the HELP survival model. Hospitalized Elderly Longitudinal Project.

Journal Article J Am Geriatr Soc · May 2000 OBJECTIVE: To develop and validate a model estimating the survival time of hospitalized persons aged 80 years and older. DESIGN: A prospective cohort study with mortality follow-up using the National Death Index. SETTING: Four teaching hospitals in the US. ... Full text Link to item Cite

Age-related differences in care preferences, treatment decisions, and clinical outcomes of seriously ill hospitalized adults: lessons from SUPPORT.

Journal Article J Am Geriatr Soc · May 2000 OBJECTIVES: To review previously published findings about how patient age influenced patterns of care for seriously ill patients enrolled in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). DESIGN: An observ ... Full text Link to item Cite

Patients who want their family and physician to make resuscitation decisions for them: observations from SUPPORT and HELP. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project.

Journal Article J Am Geriatr Soc · May 2000 OBJECTIVE: To determine the extent to which older or seriously ill inpatients would prefer to have their family and physician make resuscitation decisions for them rather than having their own stated preferences followed if they were unable to decide thems ... Full text Link to item Cite

Predicting functional status outcomes in hospitalized patients aged 80 years and older.

Journal Article J Am Geriatr Soc · May 2000 OBJECTIVE: To develop a model estimating the probability of a patient aged 80 years or older having functional limitations 2 months and 12 months after being hospitalized. DESIGN: A prospective cohort study. SETTING: Four teaching hospitals in the US. PART ... Full text Link to item Cite

Age-related differences in care preferences, treatment decisions, and clinical outcomes of seriously ill hospitalized adults: Lessons from SUPPORT

Journal Article Journal of the American Geriatrics Society · 2000 OBJECTIVES: To review previously published findings about how patient age influenced patterns of care for seriously ill patients enrolled in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). DESIGN: An observ ... Cite

Prediction of survival for older hospitalized patients: The HELP survival model

Journal Article Journal of the American Geriatrics Society · 2000 OBJECTIVE: To develop and validate a model estimating the survival time of hospitalized persons aged 80 years and older. DESIGN: A prospective cohort study with mortality follow-up using the National Death Index. SETTING: Four teaching hospitals in the US. ... Cite

Older age, aggressiveness of care, and survival for seriously ill, hospitalized adults. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.

Journal Article Ann Intern Med · November 16, 1999 BACKGROUND: Older age is associated with less aggressive treatment and higher short-term mortality due to serious illness. It is not known whether less aggressive care contributes to this survival disadvantage in elderly persons. OBJECTIVE: To determine th ... Full text Link to item Cite

Patient age and decisions to withhold life-sustaining treatments from seriously ill, hospitalized adults. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment.

Journal Article Ann Intern Med · January 19, 1999 BACKGROUND: Patient age may influence decisions to withhold life-sustaining treatments, independent of patients' preferences for or ability to benefit from such treatments. Controversy exists about the appropriateness of using age as a criterion for making ... Full text Link to item Cite

Relationship of body mass index to subsequent mortality among seriously ill hospitalized patients. SUPPORT Investigators. The Study to Understand Prognoses and Preferences for Outcome and Risks of Treatments.

Journal Article Crit Care Med · December 1997 OBJECTIVE: To determine if body mass Index (BMI = weight [kg]/height [m]2), predictive of mortality in longitudinal epidemiologic studies, was also predictive of mortality in a sample of seriously ill hospitalized subjects. DESIGN: Prospective, multicenter ... Full text Link to item Cite

Seriously ill hospitalized adults: do we spend less on older patients? Support Investigators. Study to Understand Prognoses and Preference for Outcomes and Risks of Treatments.

Journal Article J Am Geriatr Soc · September 1996 OBJECTIVE: To determine the effect of age on hospital resource use for seriously ill adults, and to explore whether age-related differences in resource use are explained by patients' severity of illness and preferences for life-extending care. STUDY DESIGN ... Full text Link to item Cite

Community dwelling elderly are appropriate subjects for intensive dietary choice restriction studies.

Journal Article J Nutr Elder · 1995 There is a traditional belief that the elderly have difficulty coping with dietary change, and therefore have a diminished likelihood of successfully responding to nutritional interventions or restrictions. Using a controlled mild zinc-deficiency feeding s ... Full text Link to item Cite

The comprehensive assessment of community dwelling elderly: why functional status is not enough.

Journal Article Aging (Milano) · October 1994 The present study attempts to determine empirically the relationship of measures of functional status to other domains common to geriatric assessment, and to ascertain whether functional status can substitute for other domains of clinical assessment. A com ... Full text Link to item Cite

Marginal zinc deficiency in older adults: responsiveness of zinc status indicators.

Journal Article J Am Coll Nutr · October 1994 OBJECTIVE: Suspicions that mild zinc deficiency is common among the elderly cannot be confirmed or refuted because definitive indicators of zinc status are lacking. The goal of this study was to document the clinical responsiveness of parameters of zinc st ... Full text Link to item Cite

Nutrition and function: is there a relationship between body mass index and the functional capabilities of community-dwelling elderly?

Journal Article J Am Geriatr Soc · April 1994 OBJECTIVE: To determine if there is a relationship between body mass index and the ability to perform the usual activities of living in a sample of community-dwelling elderly. DESIGN: Secondary data analysis of The National Health and Nutrition Examination ... Full text Link to item Cite

Sociodemographic correlates of health beliefs among black and white community dwelling elderly individuals.

Journal Article Int J Aging Hum Dev · 1994 This study examined the hypothesis that sociodemographic characteristics such as age, education, race, and gender would be predictive of Multidimensional Health Locus of Control Subscale scores in a population-based sample of 342 community dwelling elderly ... Full text Link to item Cite

Medical education in geriatrics: The lasting impact of the aging game

Journal Article Educational Gerontology · January 1, 1993 In an effort to sensitize medical students to the problems of the frail elderly, a simulation experience known as the Aging Game is a required portion of the In troduction to Clinical Medicine course for medical students at Duke University. The immediate p ... Full text Cite

Suicide in the elderly.

Journal Article South Med J · March 1992 Full text Link to item Cite

Underestimating disability.

Journal Article Ann Intern Med · July 1, 1991 Full text Link to item Cite

Geriatrics as a career.

Journal Article J Med Educ · October 1987 Full text Link to item Cite

Geriatrics as a career

Journal Article Journal of Medical Education · January 1, 1987 Cite