Literature Review

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

[UK] Identifying challenges related to the management of comorbidities in people with dementia in residential care: Expert delphi consensus exerciseJournal of Applied Gerontology; Serena Sabatini, Frances Hawes, Kelechi Eluigwe, Eugene Y. H. Tang; 1/25Improving early detection, management, and treatment of comorbid conditions to dementia in residential care could slow down cognitive and functional decline, and increase residents’ quality of life. ... Mental illnesses, delirium, and sensory impairments were identified as the most difficult comorbidities to dementia to deal with. Medication management, symptom management, shortage of staff, lack of training among staff, and limited resources from the broader healthcare system were identified as the most difficult issues when dealing with dementia comorbidities. To address disparities between different residential care homes there is the need of mandatory standards of care across UK residential care homes, and of clear guidelines on topics such as pathways of care for residents’ medical problems, staff to resident ratios, and minimum wages.

Truth-telling, and ethical considerations in terminal care: an Eastern perspectiveNursing Ethics; Qing Ma; Yi Wu; Ronghua Fang; 1/25 Truth-telling for terminally ill patients is a challenging ethical and social issue for Chinese health care professionals. However, despite the existence of ethical and moral standards for nurses, they frequently encounter moral dilemmas when making decisions about truth-telling to patients with end-stage diseases in China. This article focuses on nursing morality, ethics, norms, and philosophy in health care and discusses countermeasures taken by nurses in truth-telling decision-making in combination with Chinese Confucian culture. The analysis identifies key ethical strategies tailored to Chinese nurses’ practices, emphasizing individual autonomy, cultural sensitivity, and family dynamics in truth-telling decisions.

Use of digital health technologies by older US adultsJAMA Network Open; Cornelius A. James, MD; Tanima Basu, MS, MA; Brahmajee K. Nallamothu, MD, MPH; Jeffery T. Kullgren, MD, MPH, MS; 1/25Older adults use various types of DHT [digital health technologies], and they use patient portals most often. Although some older adults have unique physical and cognitive needs that can affect the utility and usability of DHTs, in aggregate they share some predictors of DHT use with younger adults. Additionally, our study showed a statistically significant association between non-Hispanic Black race and ethnicity and DHT use. Various factors may contribute to this finding, including medical mistrust among Black patients leading to decreased engagement with the health system and increased reliance on DHTs. This study highlights the need to carefully consider the unique characteristics of older adults when developing and deploying DHTs to avoid worsening the digital divide. 

Hospice care in the Emergency Department: An evolving landscapeJournal of Palliative Medicine; by Eliot Hill, Ky Stoltzfus, Joanna Brooks; 1/25Despite the increasing focus on goal-concordant care in the emergency department (ED), there is limited data about patients who receive a new hospice referral and the care paths of patients on hospice who present there. [In this study,] six patients received a new hospice referral. Of these, four had a primary diagnosis of cancer, three received a palliative care consult, and three were discharged to an inpatient hospice facility (hospice house). No patients had repeat health care encounters at our hospital. 42% (31/74) of patients enrolled in hospice required admission. Conclusion: New hospice referrals in the ED are possible but rare. Further research should investigate possible missed opportunities to provide goal-concordant care.

Experts are debating whether some cancers shouldn’t be called thatJAMA; Rita Rubin, MA; 1/25Back in 2012, the National Cancer Institute (NCI) convened a conference to discuss the overdiagnosis and overtreatment of indolent tumors—asymptomatic lesions unlikely to progress for years—that are detected by mammography, prostate-specific antigen (PSA) testing, and other screening tools. “I don’t think the name is that important,” acknowledged Hwang, who participated in the 2012 NCI conference about overdiagnosis and overtreatment. “It’s how we react to the diagnosis and how we convey risk to the patients.” In other words, stop calling low-risk tumors cancer, but make sure patients understand that such lesions are risk factors for cancer and, therefore, require diligent monitoring. Or keep calling the tumors cancer, but make sure patients understand that these lesions are unlikely to cause problems, so active surveillance, not immediate treatment, is appropriate.

Overcoming barriers to make patient-reported outcome collection the standard of care in oncologyJAMA Oncology; James A. Colbert, MD, MBA; Louis Potters, MD; 1/25Multiple studies have demonstrated the clear benefits of collecting patient-reported outcomes (PROs) in oncology care. These benefits include measurable effects on patient symptom burden, toxicity, emergency department (ED) use, and even cancer survival. Despite these well-recorded advantages, adoption of PRO collection beyond research studies and clinical trials remains low. Barriers to more widespread adoption in oncology care include clinician skepticism, historical technological limitations, and the challenges related to change management. We owe it to patients to make PRO collection standard practice. Achieving this will require additional education, the embrace of new technologies, and a willingness among clinicians to follow the data and adopt new routines that will necessitate changing established patient care models.

Saturday newsletters focus on headlines and research - enjoy!

The human edge: How AI can assist but never replace JD Supra; by Ralph Losey; 1/29/25 The rise of artificial intelligence has evoked both awe and apprehension. he list of its potential contributions seems endless. Yet, whispers of fear persist in our conversations: What if AI surpasses us? What if it replaces us entirely? These fears, while understandable, stem from a fundamental misunderstanding of what AI is—and what it is not. While AI may outperform humans in specific analytical domains, .. it can never replicate the full spectrum of what it means to be human. Far from being a threat to humanity, AI—when governed responsibly—offers a transformative tool to amplify our potential, not a rival to our existence. [Click on the title's link to continue reading.]

Opioid painkillers less available to people of color HealthDay News / Coastal Breeze News, Marco Island, FL; 1/30/25 People of color now have less access to prescription opioid painkillers than white patients, an unintended consequence of efforts to stem America’s opioid epidemic. Communities of color have a 40% to 45% lower distribution of commonly prescribed opioids, compared to majority white communities, researchers reported in a study published Jan. 23 in the journal Pain. This could prevent opioid painkillers from reaching those in true need of them, like cancer patients, researchers said. 

‘Small but significant’ keys to amplifying hospice grief support Hospice News; by Holly Vossel; 1/29/25 Grief support service lines can be an important pathway for hospices to reach communities outside of their patient populations. Building strong bereavement programs comes with myriad considerations around community outreach, collaboration development and strategic planning. ... Similar to many hospices nationwide, Angela Hospice offers bereavement services to its hospice patient families and across communities throughout its service region. The hospice provider’s bereavement program includes one-on-one counseling sessions, group therapy, as well as education and informative online and in-person workshops. Angela Hospice additionally offers an annual summer grief camp for children, Camp Monarch. Editor's note: The CMS Hospice Conditions of Participation (CoPs) require each hospice to provide bereavement/grief support patients' families, both before the death and after. The CMS Hospice CoPs identify "bereavement" and/or "grief" 155 times. 

Strike-throughs in 1/29 issueGreetings Readers, we regret that the emailed version of our Wednesday, January 29th issue had numerous strike-throughs throughout, while our web version did not. Thank you for letting us know! We have fixed this and provide for you both (1) a link to the page and (2) a downloadable PDF for your files.  Ongoing, freely let us know any challenges or ways we can improve your newsletter experience.  Joy Berger, Editor in Chief

16 states where virus activity remains high: 5 updates Becker's Clinical Leadership; by Alexandra Murphy; 1/27/25 The CDC is reporting high levels of respiratory virus activity across the U.S. While respiratory syncytial virus levels are beginning to peak in many areas of the country, flu-related emergency department visits are at very high levels and are still rising, according to the latest data. Thirteen states are experiencing "high" respiratory virus activity: Texas, Oklahoma, South Dakota, Minnesota, Florida, Georgia, South Carolina, Maryland, Pennsylvania, New York, Connecticut, Hawaii and Washington, D.C. Three states are experiencing "very high" levels: New Hampshire, New Jersey and Wisconsin. [Click here for the CDC's "Respiratory Virus Activity Levels," with more detailed data and maps for all 50 states.]