The National Palliative Care Registry: A Decade of Supporting Growth and Sustainability of Palliative Care Programs

Rogers, Maggie; Meier, Diane E.; Heitner, Rachael; Aldridge, Melissa D.; Spragens, Lynn; Kelley, Amy S.; Nemec, Stefanie R.

doi:10.1089/jpm.2019.0262

Cited by 36 publications

(29 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Specialist palliative care services remain a scarce resource in many hospitals across the country. 36 Even at hospitals with robust palliative care teams, palliative care utilization in the time of the COVID-19 pandemic may be low, 37 and possibly even more so for patients of racial and ethnic minorities. 38 In order to improve access to palliative care services, studies have examined the use of web-based applications, 39 tele-palliative care consultation, 40 , 41 and work-force expansion through training and redeployment of psychiatry trainees.…”

Section: Discussionmentioning

confidence: 99%

Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection

Rao

Zaaqoq

Kang

et al. 2021

Am J Hosp Palliat Care

View full text Add to dashboard Cite

Background: Critically ill patients with COVID-19 infection on extracorporeal membrane oxygenation (ECMO) face high morbidity and mortality. Palliative care consultation may benefit these patients and their families. Prior to the pandemic, our institution implemented a policy of automatic palliative care consultation for all patients on ECMO due to the high mortality, medical complexity, and psychosocial distress associated with these cases. Objectives: The main objective was to describe the role of the palliative care team for patients on ECMO for COVID-19 infection. The secondary objective was to describe the clinical outcomes for this cohort. Design: Case series. Settings/Subjects: All patients age 18 or older infected by the novel coronavirus who required cannulation on ECMO from March through July of 2020, at an urban, academic medical center in the United States. Inter-disciplinary palliative care consultation occurred for all patients. Results: Twenty-three patients (median age 43 years [range 28-64], mean body mass index 34.9 kg/m2 [SD 9.2], 65% Hispanic ethnicity) were cannulated on ECMO. Eleven patients died during the hospitalization (48%). Patients older than 50 years of age demonstrated a trend toward increased odds of death compared to those younger than 50 years of age (OR 9.1, P = 0.07). Patients received an average of 6.8 (SD 3.7) palliative clinical encounters across all disciplines. The actions provided by the palliative care team included psychosocial support and counseling, determination of surrogate decision maker (for 100% of patients), pain management (83%), and non-pain symptom management (83%). Conclusions: Here, we present one of the first studies describing the patient characteristics, outcomes, and palliative care actions for critically ill patients with COVID-19 on ECMO. Almost half of the patients in this cohort died during their hospitalization. Given the high morbidity and mortality of this condition, we recommend involvement of palliative care for patients/families with COVID-19 infection who are on ECMO. The impact of palliative care on patient and family outcomes, such as symptom control, satisfaction with communication, rates of anxiety, and grief experience merits further investigation.

show abstract

Section: Discussionmentioning

confidence: 99%

Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection

Rao

Zaaqoq

Kang

et al. 2021

Am J Hosp Palliat Care

View full text Add to dashboard Cite

show abstract

“…The workload for palliative care teams increased during the pandemic. Because most teams are small in number and the different providers have complementary roles, it is vital to keep the existing palliative care providers free from COVID-19 ( 27 ). By coaching primary health care teams with guidelines and order sets for the management of COVID-19 symptoms, the optimal use of palliative care consultation for non-COVID-19 patients could be ensured.…”

Section: Palliative Care During Covid-19mentioning

confidence: 99%

Palliative Care for Cancer Patients During the COVID-19 Pandemic, With Special Focus on Lung Cancer

2020

View full text Add to dashboard Cite

“…Effective management of symptoms is an important goal at the end of life, especially among persons who value quality of life over duration 1 . The focus on symptom management helped to spawn the field of palliative care, which has grown considerably over the past two decades 2 . Nonetheless, symptom burden at the end of life remains stubbornly high 3…”

mentioning

confidence: 99%

Trends in Restricting Symptoms at the End of Life from 1998 to 2019: A Cohort Study of Older Persons

Gill

Gahbauer

Murphy

2020

J American Geriatrics Society

View full text Add to dashboard Cite

OBJECTIVES To describe changes in the occurrence of restricting symptoms at the end of life from 1998 to 2019 and compare these changes according to the condition leading to death. DESIGN Prospective longitudinal study. SETTING Greater New Haven, CT. PARTICIPANTS A total of 665 decedents from a cohort of 754 community‐living persons, 70 years or older. MEASUREMENTS The occurrence of 16 restricting symptoms was ascertained during monthly interviews. Information on the conditions leading to death was obtained from death certificates and comprehensive assessments that were completed every 18‐months. For each restricting symptom, adjusted rates (per 100 person‐months) were calculated separately for six multiyear time intervals. RESULTS From 1998 to 2019, rates decreased for five (31.3%) restricting symptoms (difficulty sleeping; chest pain or tightness; shortness of breath; cold or flu symptoms; and nausea, vomiting, or diarrhea), increased for three (18.8%: arm or leg weakness; urinary incontinence; and memory or thinking problem), and changed little for the other eight (50.0%: poor eyesight; anxiety; depression; musculoskeletal pain; fatigue; dizziness or unsteadiness; frequent or painful urination; and swelling in feet or ankles). The decrease in rates was most pronounced for shortness of breath, with a reduction from 15.0 (95% credible interval = 11.7–18.6) in 1998 to 2001 to 8.2 (95% credible interval = 5.9–10.5) in 2014 to 2019, yielding a rate ratio (95% credible interval) of 0.92 (0.86–0.98). When evaluated according to the condition leading to death, the results were similar, with 10 of the 13 statistically significant rate ratios representing decreases in rates over time and only 3 representing increases. CONCLUSION The occurrence of most restricting symptoms at the end of life has been decreasing or stable over the past two decades. These results suggest that end‐of‐life care has been improving, although additional efforts will be needed to further reduce symptom burden at the end of life.

show abstract

The National Palliative Care Registry: A Decade of Supporting Growth and Sustainability of Palliative Care Programs

Cited by 36 publications

References 2 publications

Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection

Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection

Palliative Care for Cancer Patients During the COVID-19 Pandemic, With Special Focus on Lung Cancer

Trends in Restricting Symptoms at the End of Life from 1998 to 2019: A Cohort Study of Older Persons

Contact Info

Product

Resources

About