Literature Review

‘We don’t talk about death’: Winston-Salem journalist seeks to help people understand dying, deathbed visions Fox 8 WGHP - High Point, NC; by Bob Buckley; 5/29/24 There may not be anything that fascinates people more than death. It may be the thing many people avoid confronting the most. “In our culture, we’re pretty separated from death. And I don’t know the figures, but the vast majority … take place in hospitals. We don’t talk about death a lot in our culture,” said Phoebe Zerwick, a journalist based in Winston-Salem who recently wrote about deathbed visions for the New York Times Magazine. ... Zerwick became aware of the work of Dr. Christopher Kerr. ... “The biggest difference between hallucinations and these experiences is how the person is made to feel,” Dr. Kerr said. “Most hallucinations leave the person distressed and agitated and would be further confused. These experiences bring comfort. They bring meaning. They’re drawn from life. They really validate the life.” ... “I think the moral of the story is to be present and to be present with people when they are terminally ill. Be present when they’re dying,” Zerwick said.

Nurse charged with stealing pills while taking care of hospice patient Fox56; by Emily Cherkauskas; 5/22/24Pennsylvania State Police say a registered nurse stole hundreds of prescription pills while taking care of a hospice patient. According to Pennsylvania State Police, on Feb. 12, troopers were contacted by the director of operations at the Amedisys Home Health / Hospice Care. Troopers were told that Registered Nurse Ashley Laura Miller, 36, of Mohrsville, had become a suspect in the theft and diversion of Oxycodone and Ativan prescriptions. ... [Upon] the passing of the patient, an additional nurse noted that 200 Oxycodone and 30 Ativan pills were missing from the narcotics count. ... On Wednesday, May 22, Miller was arraigned with bail set at $5000.

A Philadelphia pharmacy’s closure after 26 years highlights the industry’s growing challenges Times Daily; by Lizzy McClellan Ravitch, The Philadelphia Inquirerer; 5/11/24Last Monday, Friendly Pharmacy filled 318 prescriptions. For about 100 of them, insurance companies paid the pharmacy less than $3. In 22 instances that day, the reimbursement was less than the cost of the medication. ... [Managing pharmacist Brad] Tabaac plans to close his doors on May 31 after 26 years in business. ... Independent pharmacies like Friendly, as well as some chains, have been pinched by pricing and fees set by pharmacy benefit managers — the companies that handle prescription drug plans for health insurance. The three biggest pharmacy benefit managers are CVS Health, Optum Rx and Express Scripts. They control nearly 90% of the market, according to the National Community Pharmacists Association (NCPA), and some of their parent companies also own pharmacies.

Ordered to pay $1.536B in criminal fines and forfeiture for distributing misbranded opioid medication Office of Public Affairs, U.S. Department of Justice; Press Release; 5/3/24Endo Health Solutions Inc. (EHSI) was ordered to pay $1.086 billion in criminal fines and an additional $450 million in criminal forfeiture — the second-largest set of criminal financial penalties ever levied against a pharmaceutical company —for violations of the Federal Food, Drug and Cosmetic Act related to the distribution of the opioid medication Opana ER with INTAC (Opana ER). ...

Substance use disorders in hospice palliative care: A narrative review of challenges and a case for physician interventionCambridge University Press; by Lauren Rudy and Emilie Lacroix; 2/29/24Objectives: Substance use disorders (SUDs) are frequently encountered in hospice palliative care (HPC) and pose substantial quality-of-life issues for patients. However, most HPC physicians do not directly treat their patients’ SUDs due to several institutional and personal barriers. ...Results: ... Recommendations for physicians and training environments to address these challenges include developing familiarity with standardized SUD assessment tools and pain management practice guidelines, creating and disseminating visual campaigns to combat stigma, including SUD assessment and intervention as fellowship competencies, and obtaining additional training in psychosocial interventions.

Walmart Health is closingWalmart; 4/30/24Back in 2019, we launched Walmart Health centers. During our five-year journey, we made meaningful impacts with patients while continuing to learn, pivot and evolve. While our mission to help people save money and live better remains, today we are sharing the difficult decision to close Walmart Health and Walmart Health Virtual Care. Through our experience managing Walmart Health centers and Walmart Health Virtual Care, we determined there is not a sustainable business model for us to continue.

Attitudes and beliefs regarding Pain Medicine: results of a national palliative physician survey Journal of Pain and Symptom Management; by Daniel K Partain, Wil L Santivasi, Mihir M Kamdar, Susan M Moeschler, Jon C Tilburt, Karen M Fischer, Jacob J Strand; 4/25/24 online ahead of print Objectives: To evaluate referral rates, co-management strategies, and beliefs of palliative physicians about the value of Pain Medicine specialists in patients with serious illness. Conclusion: This study shows that Palliative Care physicians have highly positive attitudes toward Pain Medicine specialists, but referrals remain low. Facilitating professional collaboration via joint educational/clinical sessions is one possible solution to drive ongoing interprofessional care in patients with complex pain.

AI could play role in preventing prescribing of unnecessary drugs in older adults McKnights Senior Living, by Kristen Fischer; 4/22/24 A new study finds that artificial intelligence could encourage doctors to stop prescribing drugs that aren’t necessary — especially in older adults, who tend to be on multiple medications. The report was published 4/18 in the Journal of Medical Systems. More than 40% of older adults are taking five or more prescription medications, a rate that raises their risk for potentially harmful drug interactions. ... AI isn’t a perfect tool compared with having an actual doctor. For instance, it tended not to pay much attention to a person’s pain level, suggesting that the patient stop taking pain medications but not others for clinical ailments such as high cholesterol or high blood pressure, the authors reported.

Comparative effectiveness of acupuncture vs massage for relieving pain in patients with advanced cancer The ASCO Post; by Jun J. Mao, MD, MSCE and Andrew S. Epstein, MD; 4/17/24... The IMPACT study was conducted at Memorial Sloan Kettering Cancer Center and regional sites in New York, New Jersey, and Florida to evaluate the long-term comparative effectiveness of acupuncture vs massage for pain in patients with advanced cancer. ... The primary outcome—change in worst pain intensity score from baseline to 26 weeks—was measured using the Brief Pain Inventory (BPI ranging from 0–10; higher numbers indicate worse pain intensity or interference). The secondary outcomes included fatigue, insomnia, and quality of life. ... To use these therapies, it is important to seek credentialed practitioners who have training or experience in working with patients who have cancer. 

‘We’re the telescope looking forward’: Medical ethicists ask tough questions as part of $66 million research project CU Department of Medicine, by Mark Harden; 4/5/24 In the original “Jurassic Park” movie, after the process of bringing dinosaurs back to life is explained to a team of consultants, one of them voices a warning: “Your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should.” University of Colorado Department of Medicine faculty members will be asking the “should” question years before there’s an answer to “could.” They’ve joined in a nationwide study of whether tiny, battery-powered electric devices and genetic material, swallowed in capsule form, could one day replace surgery or injections as treatments for metabolic diseases such as diabetes and obesity.

Cancer patients often want ‘one more round.’ Should doctors say no? The Washington Post, by Mikkael A. Sekeres, MD; 3/31/24 My patient was in his early 30s and his leukemia had returned again following yet another round of treatment. He was a poster child for the recently reported rise in cancer rates in the young, and had just asked me what chemotherapy cocktail I could devise for him next, to try to rid him of his cancer. I hesitated before answering. Oncologists are notorious for always being willing to recommend to our patients one more course of treatment, even when the chances of success are negligible.  

Antibiotics in end-of-life care NEJM Journal Watch, by Abigail Zuger, MD; 3/27/24Antibiotics often are considered to be among the gentler and more comfort-oriented interventions in end-of-life care, certainly far less aggressive than intubation or last-ditch surgery. ... Still, antibiotics do entail their own costs in the form of toxicities and need for intravenous access, and liberal antibiotic use reliably worsens institutional and community drug-resistance profiles. ... A new review was written for infectious disease consultants but contains specific suggestions that should interest both generalists and other subspecialists caring for dying patients. 

Partners In Care sets sights on service diversification, hospice-pharmacy partnership Hospice News, by Jim Parker; 3/22/24 Hospice providers need to evolve with their changing patient populations and the larger health care system, according to Greg Hagfors, CEO of Partners In Care. The Oregon-based hospice, palliative care and home health provider recently celebrated the 45th anniversary of its founding, which preceded the establishment of the Medicare Hospice Benefit. ... Hospice News recently spoke with Hagfors about the ways the industry has changed since Partners In Care came on the scene — and how it is moving towards the future.