Literature Review

Transforming care: Spencer Health Solutions and Pharmerica partner to simplify medication management and improve lives The MarCom Journal, Morrisville, NC; by Leigh White, PharMerica and Daphne Earley, Spencer Health Solutions; 1/21/25In a move set to redefine how medication is managed, Spencer Health Solutions (SHS), a leader in innovative healthcare technology, and PharMerica, one of the nation’s largest and most trusted long-term care pharmacy services provider, are joining forces. This transformative partnership aims to make managing medications easier and more reliable for individuals with complex medication needs, senior living communities, and payers nationwide. ... Spencer Health Solutions (SHS) is dedicated to transforming medication management through innovative healthcare technology. ... PharMerica ... serves the long-term care, senior living, hospital, home infusion, hospice, behavioral, specialty and oncology pharmacy markets. 

Remember that other people may be totally wrong. But they don’t think so. Don’t condemn them. Any fool can do that. Try to understand them. Only wise, tolerant, exceptional people even try to do that. ~Dale Carnegie

Stories of bereavement: Examining medical students’ reflections on loss and griefOmega-Journal of Death and Dying; Johanna Shapiro, Nicholas Freeman, Alexis Nguyen, Nancy Dang, Yasaman Lorkalantari; 12/24Medical students in this study reported similar reactions to personal and professional loss, with some expected differences, such as students who experienced professional loss more often noting compassion for others and more frequently discussing managing the feelings of others, the importance of skill acquisition, processing personal emotions and team support. Students experiencing personal loss understandably appeared more focused on their own grief and more often commented about feelings of helplessness and numbness. Students in both groups reported little about how they coped with their grief or about receiving either informal or institutional support. The similarity of the essays, while due to many factors, may suggest internalizing pressures to conform to socially desirable narratives. Medical educators and clinical supervisors should help students develop effective coping skills in response to loss, provide better institutional support, and encourage students to tell authentic stories about their experiences of loss and grief. 

The 2024 election and potential battle for the social safety netJAMA Health Forum; Sara N. Bleich, PhD; Benjamin D. Sommers, MD, PhD; Rita Hamad, MD, PhD; 1/25Federal safety net programs play a major role in providing nutrition assistance, health insurance, income support, and much more to tens of millions of people with low incomes, including children, parents, and adults with disabilities or chronic conditions. Trump’s return to office for a second term with a Republican-controlled Senate and House leaves the future of the US social safety net unclear. Clinicians and public health professionals should elevate and advance strong evidence about the positive effects of the social safety net and the likely harms that would ensue if access or benefits are reduced.

Medical professionals’ perceptions of and experiences with terminally ill Orthodox Jewish patientsAmerican Journal of Hospice and Palliative Medicine; Moshe C. Ornstein, MD, MA; David Harris, MD; 1/25Orthodox Jewish patients with terminal illnesses have unique goals and desires, often driven by halakha (Jewish law and ethics) and cultural norms. Compared to the general population, Orthodox Jewish patients with terminal illnesses are more likely to request aggressive measures at end-of-life and are less likely to have completed advanced directives and health care power of attorney documentation. They also do not always have a rabbinic authority involved in decision-making. Health care professionals highlighted strong religious and community support as positive elements of caring for this population and recommend that medical teams establish early and direct communication with rabbinic authorities for those patients for whom a rabbi’s involvement is desired.

Dying at home: A family guide for caregivingJohn Hopkins University Press; by Andrea Sankar with CM Cassady; 2/24A comprehensive guide for those caring for a loved one nearing the end of life. Many people seek the comfort and dignity of dying at home. Advances in pharmacology and hospice care allow the dying to remain at home relatively free of pain and symptoms, but navigating professional services, insurance coverage, and family dynamics often compounds the complexity of this process. Extensively updated and revised, this third edition of Andrea Sankar's Dying at Home: A Family Guide for Caregiving provides essential information that caregivers and dying persons need to navigate this journey.

Requests for medical assistance in dying by young Dutch people with psychiatric disordersJAMA Psychiatry; Lizanne J.S. Schweren, PhD; Sanne P.A. Rasing, PhD; Monique Kammeraat, BSc; Leah A. Middelkoop, MSc; Ruthie Werner, MSc; Saskia Y.M. Mérelle, PhD; Julian M. Garcia, MD; Daan H.M. Creemers, PhD; Sisco M.P. van Veen, MD, PhD; 1/25This cohort study found that the number of young psychiatric patients in the Netherlands who requested MAID-PS [medical assistance in dying based on psychiatric suffering] increased between 2012 and 2021 and that applications were retracted or rejected for most. Those who died by MAID or suicide were mostly female and had long treatment histories and prominent suicidality. These findings suggest that there is an urgent need for more knowledge about persistent death wishes and effective suicide prevention strategies for this high-risk group.

[Sweden] The process of pain assessment in people with dementia living in nursing homes: A scoping reviewPalliative Care and Social Practice; Caroline Kreppen Overen, Maria Larsson, Adelheid Hummelvoll Hillestad, Ingela Karlsson, Siren Eriksen; 1/25Studies have documented a pain prevalence in people with dementia living in nursing homes of 35%–43%, but a possible prevalence of 60%–80%. This scoping review provides a comprehensive description of pain assessment in people with dementia living in nursing homes as a process in three steps. Self-reported information is the most appropriate when assessing pain, as symptom experience is subjective and highly personal. However, for people with dementia living in nursing homes, self-reporting represents a challenge due to cognitive impairment, including difficulties with language and communication. People with dementia might express pain with different behavioural expressions or signs, such as agitation, apathy, restlessness or wandering. Numerous observational assessment tools targeting pain in people with dementia have been developed and evaluated and systematic use of standardized observational tools has been recommended.

FTC releases second interim staff report on prescription drug middlemen: Report finds PBMs charge significant markups for cancer, HIV, and other critical specialty generic drugsFTC press release; by FTC staff; 1/14/25Staff’s latest report found that the ‘Big 3 PBMs’—Caremark Rx, LLC (CVS), Express Scripts, Inc. (ESI), and OptumRx, Inc. (OptumRx)—marked up numerous specialty generic drugs dispensed at their affiliated pharmacies by thousands of percent, and many others by hundreds of percent. Such significant markups allowed the Big 3 PBMs and their affiliated specialty pharmacies to generate more than $7.3 billion in revenue from dispensing drugs in excess of the drugs’ estimated acquisition costs from 2017-2022. The Big 3 PBMs netted such significant revenues all while patient, employer, and other health care plan sponsor payments for drugs steadily increased annually, according to the staff report. Key Findings include:

The HOPE Assessment Tool Series: Understanding the Required Timed VisitsCHAP blog; by Jennifer Kennedy; 1/25It’s January 2025, and we are counting down to the implementation of the HOPE Assessment Tool on October 1, 2025. That date may seem far away, but there is much preparation you need to do in the coming months for a seamless launch on the “go-date”. Your staff will need consistent education about the assessment tool content and their responsibility for the administration and completion of the timed visits. [Click the link above to read the entire story.]

Policy priorities for the first 100 daysC-TAC press release; 1/20/25The first 100 days of the Trump Administration and 119th Congress offer a pivotal opportunity to enact bold policies that improve the quality of care for individuals with serious illness while reducing overall healthcare costs. By addressing key policy priorities, we can create a healthcare system that delivers better outcomes for patients and families. C-TAC calls on policymakers to act now to advance solutions in the following areas:

Virtual nursing could upend traditional staff ratiosBecker's Clinical Leadership; by Paige Twenter; 1/13/25In conversations about virtual, team-based nursing services, the term "nurse-to-patient ratios" is an anachronism, according to nursing leaders at Providence and Trinity Health. Within the traditional primary nursing model, a virtual mountain of research demonstrates low nurse-to-patient ratios bolster safety and quality of care. However, as new virtual programs emerge and pick up steam, new research indicates that virtual nursing models improve communication, safety and quality — all without assigning a ratio.

Engaging the hospice community in end-of-life care in prisons (Part 2)ehospice; by Barry R. Ashpole; 1/21/25Part 1 offered a broad overview of the potential role community hospices can play to improve end-of-life care (EoLC) for a particularly vulnerable and underserved population. As has been widely acknowledged, prisons and correctional facilities are caught between the proverbial “rock and a hard place,” between issues of security and public safety and the civil rights of the prison inmates to healthcare comparable to what is available to the populace-at-large. Part 2 takes a closer look at specific initiatives by some community hospices to support prison inmates towards the end of life. Prior to conducting research for its 2020 report, ‘Dying Behind Bars: How can we better support people in prison at the end-of-life,’ Hospice UK had only anecdotal evidence of the important work that some hospices were engaged in to support prison inmates at the end of life. The scope of this support had not been established at a national level. After conducting a survey of hospice services across England, researchers found that 25 hospices – representing approximately 15% of hospices in the country – are indeed providing this care and support, working with 34 different prisons.Publisher's note: Also see: Engaging the hospice community in end-of-life care in prisons (Part 1) that was also discussed in Hospice News' Global challenges persist in bringing hospice care to incarcerated populations.