Publications by authors named "Hannon Breffni"

Context: Hematological malignancies represent a heterogeneous group of diseases with variable and often unpredictable illness trajectories. Comparisons between hematological and solid tumor malignancy referrals to an outpatient palliative care clinic have not been explored.

Objectives: This study compared characteristics, referral trends, and time from first palliative care clinic visit to death between patients with hematological and solid tumor malignancies.

View Article and Find Full Text PDF

Background: Novel systemic anticancer therapies (SACT) in the form of targeted and immunotherapies are increasingly replacing traditional chemotherapy. Little is known about the impact of novel SACT on healthcare resource utilization (HCRU) at the end of life.

Methodology: A retrospective review of patients attending a tertiary cancer center in Toronto, Canada, with advanced solid or hematological malignancies who died in 2019.

View Article and Find Full Text PDF
Article Synopsis
  • Pancreatic cancer is a challenging disease with a poor outlook and significant symptoms, requiring a collaborative approach in healthcare and research for better patient outcomes.
  • The Canadian National Pancreas Conference (NPC) took place in November 2023, bringing together healthcare providers and researchers to focus on enhancing the prognosis and quality of life for pancreatic cancer patients.
  • The conference covered various topics, including diagnosis, palliative care, and current management strategies, with reviews of the sessions offered in relation to existing research.
View Article and Find Full Text PDF

Routine symptom screening may identify unmet needs, but must consider patient engagement and clinician workloads.

View Article and Find Full Text PDF

Patients with hematologic malignancies (HMs) struggle with immense physical and psychological symptom burden, which negatively affect their quality of life (QOL) throughout the continuum of illness. These patients are often faced with substantial prognostic uncertainty as they navigate their illness course, which further complicates their medical decision making, especially at the end of life (EOL). Consequently, patients with HM often endure intensive medical care at the EOL, including frequent hospitalization and intensive care unit admissions, and they often die in the hospital.

View Article and Find Full Text PDF

Importance: Artificial intelligence (AI) chatbots pose the opportunity to draft template responses to patient questions. However, the ability of chatbots to generate responses based on domain-specific knowledge of cancer remains to be tested.

Objective: To evaluate the competency of AI chatbots (GPT-3.

View Article and Find Full Text PDF

Purpose: Randomized controlled trials have demonstrated that palliative care (PC) can improve quality of life and survival for outpatients with advanced cancer, but there are limited population-based data on the value of inpatient PC. We assessed PC as a component of high-value care among a nationally representative sample of inpatients with metastatic cancer and identified hospitalization characteristics significantly associated with high costs.

Methods: Hospitalizations of patients 18 years and older with a primary diagnosis of metastatic cancer from the National Inpatient Sample from 2010 to 2019 were analyzed.

View Article and Find Full Text PDF
Article Synopsis
  • - The COVID-19 pandemic significantly impacted cancer care delivery, particularly concerning where patients died and the availability of specialized palliative care (SPC).
  • - A study analyzed data from Ontario’s Cancer Registry to assess the association between the pandemic and home deaths or SPC delivery, focusing on socioeconomic disparities.
  • - Findings showed that while home deaths increased during the pandemic, this rise was less pronounced among the most deprived socioeconomic group, revealing potential disparities in end-of-life care access.
View Article and Find Full Text PDF

Purpose: For patients with advanced cancer, early consultations with palliative care (PC) specialists reduce costs, improve quality of life, and prolong survival. However, capacity limitations prevent all patients from receiving PC shortly after diagnosis. We evaluated whether a prognostic machine learning system could promote early PC, given existing capacity.

View Article and Find Full Text PDF

Young adults (YAs), defined as individuals between the ages of 18 and 39 years, experience unique challenges when diagnosed with advanced cancer. Using the social constructivist grounded theory approach, we aimed to develop a theoretical understanding of how YAs live day to day with their diagnosis. A sample of 25 YAs (aged 22-39 years) with advanced cancer from across Canada participated in semi-structured interviews.

View Article and Find Full Text PDF

Purpose: Telehealth allows patients to maintain contact with healthcare providers without necessitating travel, and is becoming increasingly utilized. The purpose of this study is to describe the components of telehealth palliative care interventions for patients with advanced cancer before the COVID-19 pandemic; identify any intervention components associated with improvements in outcomes; and evaluate reporting of interventions.

Methods: This scoping review was registered on the Open Science Framework.

View Article and Find Full Text PDF
Article Synopsis
  • The study looked at a new way to give early palliative care to adults with serious cancer, comparing it to regular symptom checks.
  • 69 patients were involved, and those in the palliative care group got more help than those with just regular care.
  • Early results showed that patients liked the new method and found it helpful for discussing their symptoms, which will help in planning future studies.
View Article and Find Full Text PDF

Background: Family caregivers of patients with advanced cancer often have poor quality of life (QOL) and mental health. We examined the effectiveness of interventions offering support for caregivers of patients with advanced cancer on caregiver QOL and mental health outcomes.

Methods: We searched Ovid MEDLINE, EMBASE, Cochrane CENTRAL, and Cumulative Index to Nursing and Allied Health Literature databases from inception through June 2021.

View Article and Find Full Text PDF

Context: Early palliative care (EPC) is widely recommended but its implementation may be challenging.

Objectives: We conducted a qualitative analysis of Canadian palliative care physicians' opinions about conditions necessary to provide EPC.

Methods: A survey assessing attitudes and opinions regarding EPC was distributed to physicians providing primary or specialized palliative care, as identified by the Canadian Society of Palliative Care Physicians.

View Article and Find Full Text PDF
Article Synopsis
  • Early palliative care is really helpful for patients with serious illnesses, but most studies have been done in rich cities, making it hard to apply everywhere else.
  • There aren't enough palliative care experts, so regular doctors will need training to help patients effectively.
  • We need to create new ways to provide palliative care that work for different places and cultures, so everyone can get the help they need when they need it.
View Article and Find Full Text PDF

Objectives: Outpatient in-person early palliative care improves quality of life for patients with advanced cancer. The COVID-19 pandemic forced a rapid shift to telehealth visits; however, little is known about how telehealth in outpatient palliative care settings should be optimised beyond the pandemic. We aimed to explore, from the perspective of patients attending an outpatient palliative care clinic, the most appropriate model of care for in-person versus telehealth visits.

View Article and Find Full Text PDF

Antidepressants require several weeks for the onset of action, a lag time that may exceed life expectancy in palliative care. Ketamine has demonstrated rapid antidepressant effects, but has been minimally studied in cancer and palliative care populations. Herein, the objective was to determine the feasibility, safety, tolerability and preliminary efficacy of intranasal racemic ketamine for major depressive disorder (MDD) in patients with advanced cancer.

View Article and Find Full Text PDF

Outpatient palliative care facilitates timely symptom management, psychosocial care and care planning. A growing number of cancer centers have either stand-alone or embedded outpatient palliative care clinics. In this "Controversies in Palliative Care" article, three groups of thought leaders independently answer this question.

View Article and Find Full Text PDF

Background: Age-related complex medical conditions have been commonly reported among adolescents and young adults with advanced life-limiting illness. There is increasing interest in exploring their palliative care needs and end-of-life experiences.

Aim: This scoping review aimed to explore the available literature about providing palliative and end-of-life care to adolescents and young adults with advanced life-limiting illnesses.

View Article and Find Full Text PDF

Background: Family physicians' (FPs) long-term relationships with their oncology patients position them ideally to provide primary palliative care, yet their involvement is variable. We examined perceptions of FP involvement among outpatients receiving palliative care at a cancer center and identified factors associated with this involvement.

Methods: Patients with advanced cancer attending an oncology palliative care clinic (OPCC) completed a 25-item survey.

View Article and Find Full Text PDF

Objectives: Medical assistance in dying (MAiD) is legal in an increasing number of countries, but there are concerns that its availability may compromise access to palliative care. We assessed public interest in MAiD, palliative care, both, or neither, and examined characteristics associated with this interest.

Methods: We surveyed a representative sample of the adult Canadian public, accessed through a panel from May to June 2019.

View Article and Find Full Text PDF
Article Synopsis
  • Early palliative care (EPC) enhances quality of life for patients with advanced cancer but may not be suitable for everyone, highlighting a need for better patient triage based on symptom severity.
  • A subgroup analysis of a randomized trial indicates that patients with high baseline symptoms benefitted from EPC in terms of quality of life, care satisfaction, and clinician-patient interactions, while those with lower symptoms saw no significant differences.
  • The findings suggest that symptom severity can effectively guide decisions for early referrals to palliative care.
View Article and Find Full Text PDF
Article Synopsis
  • Some patients didn't show up for their appointments at a cancer support clinic, which can mean they have unmet medical needs.
  • Researchers looked at why these no-shows happened by comparing them to patients who did attend.
  • They found that no-shows were often younger, lived farther away, and did not do as well health-wise, showing they needed new ways like virtual visits to help them attend.
View Article and Find Full Text PDF

A PHP Error was encountered

Severity: Warning

Message: fopen(/var/lib/php/sessions/ci_sessioniih24ja4k3baa1ad8jseubqi36sgo2ej): Failed to open stream: No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 177

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: session_start(): Failed to read session data: user (path: /var/lib/php/sessions)

Filename: Session/Session.php

Line Number: 137

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once