Malignant Hematologic Oncology Referrals to an Outpatient Palliative Care Clinic at a Tertiary Cancer Center.

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.

Novel Systemic Anticancer Therapy and Healthcare Utilization at the End of Life: A Retrospective Cohort Study.

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.

Routine Symptom Screening to Address Supportive Care Needs.

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

Integrating Palliative Care and Hematologic Malignancies: Bridging the Gaps for Our Patients and Their Caregivers.

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.

Physician and Artificial Intelligence Chatbot Responses to Cancer Questions From Social Media.

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.

Palliative Care as a Component of High-Value and Cost-Saving Care During Hospitalization for Metastatic Cancer.

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.

Machine Learning to Allocate Palliative Care Consultations During Cancer Treatment.

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.

Advanced Cancer in Young Adults (YAs): Living in a Liminal Space.

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.

Telehealth palliative care interventions for patients with advanced cancer: a scoping review.

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.

Interventions to improve outcomes for caregivers of patients with advanced cancer: a meta-analysis.

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.

Palliative Care Physicians' Perceptions of Conditions Required to Provide Early Palliative Care.

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.

Telehealth outpatient palliative care in the COVID-19 pandemic: patient experience qualitative study.

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.

A Phase II, Open-Label Clinical Trial of Intranasal Ketamine for Depression in Patients with Cancer Receiving Palliative Care (INKeD-PC Study).

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.

Should Outpatient Palliative Care Clinics in Cancer Centers be Stand Alone or Embedded?

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.

Palliative care for adolescents and young adults with advanced illness: A scoping review.

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.

Family physicians' involvement in palliative cancer care.

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.

Public interest in medical assistance in dying and palliative care.

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.