Publications by authors named "Diane Meier"
Article Synopsis
- Interventions aimed at improving care for seriously ill patients often do not reach marginalized communities, including racialized, indigenous, and rural populations, despite their demonstrated benefits.
- The study focused on understanding the implementation of the Serious Illness Care Program in healthcare systems that primarily serve these underserved groups by conducting qualitative interviews and focus groups with healthcare team members.
- Three main themes were identified regarding implementation factors: patient-related challenges, specific elements of the intervention, and the health system's context; notable barriers include resource limitations and mistrust in healthcare, while mission-driven efforts and interprofessional collaboration were seen as supportive factors.
Importance: Family caregivers provide the majority of health care to the 18 million patients with cancer in the US. Yet despite providing complex medical and nursing care, a large proportion of caregivers report no formal support or training. In recognition of this gap, many interventions to support cancer caregivers have been developed and tested over the past 2 decades.
View Article and Find Full Text PDFObjective: Characterize key factors and training needs of U.S. cancer centers in implementing family caregiver support services.
View Article and Find Full Text PDFBackground: Clinicians treating cancer-related pain with opioids regularly encounter nonmedical stimulant use (i.e., methamphetamine, cocaine), yet there is little evidence-based management guidance.
View Article and Find Full Text PDFContext: Black patients experience health disparities in access and quality of care.
Objective: To identify and characterize the literature on the experiences of Black patients with serious illness across multiple domains - physical, spiritual, emotional, cultural, and healthcare utilization.
Methods: We conducted a scoping review of US literature from the last ten years using the PRISMA-ScR framework.
Palliative care programs have played a significant role during the COVID-19 pandemic. However, the financial impact of the pandemic and operational challenges for palliative care programs have raised concerns for their future viability. To explore palliative care program leaders' perceptions of the future viability of their programs in the context of the pandemic and inform future educational and program development.
View Article and Find Full Text PDFPatients with serious respiratory illness and their caregivers suffer considerable burdens, and palliative care is a fundamental right for anyone who needs it. However, the overwhelming majority of patients do not receive timely palliative care before the end of life, despite robust evidence for improved outcomes. This policy statement by the American Thoracic Society (ATS) and partnering societies advocates for improved integration of high-quality palliative care early in the care continuum for patients with serious respiratory illness and their caregivers and provides clinicians and policymakers with a framework to accomplish this.
View Article and Find Full Text PDFArticle Synopsis
- * The study aimed to gather expert opinions from palliative care and addiction specialists about treating different clinical scenarios involving opioid misuse in cancer patients through a modified Delphi approach.
- * Key findings included that buprenorphine/naloxone is appropriate for treating patients with untreated OUD, while the appropriateness of methadone varies based on prognosis; overprescribing of opioids by non-OUD patients was also found to require careful consideration, depending on their medical history and prognosis.
Importance: Opioid use disorder (OUD) is an important comorbidity in individuals with advanced cancer, in whom pain is common. Full-agonist opioid medications are the cornerstone of cancer pain management, but the existing literature does not address how to manage cancer pain in patients with OUD.
Objective: To conduct an expert panel to develop consensus on the appropriateness of management of cancer pain in individuals with co-occurring advanced cancer and OUD.
The COVID-19 pandemic has spurred unprecedented need for specialty palliative care. The Palliative Care Quality Collaborative (PCQC) provides unique infrastructure for rapid data collection and analysis. To capture and describe real-time, real-world experiences of specialty palliative care professionals caring for patients with COVID-19 through a rapid reporting tool and registry.
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- The management of opioid misuse and opioid use disorder (OUD) in patients with serious illness is a crucial but under-researched area, highlighting the challenges clinicians face with opioid therapy due to risks of misuse.
- A modified Delphi approach is being used to gather expert opinions from 60 clinicians to develop practical management guidelines, using case studies for discussion and feedback over three rounds.
- The study is ethically approved and aims to create consensus-based recommendations for effectively managing opioid misuse and OUD in the context of serious illnesses.