Recommendations for Preventing Medication Diversion and Misuse in Hospice Care: A Modified Delphi Study.

Context: Recommendations are needed to help minimize the risks of medication diversion and misuse in the hospice setting.

Objective: To identify recommendations that could help prevent medication diversion and misuse in hospice care.

Methods: A modified Delphi method was utilized.

Screening for Opioid Misuse in the Nonhospitalized Seriously Ill Patient.

Responding to an epidemic of opioid-related deaths, guidelines and laws have been implemented to promote safe opioid prescribing practices. This study evaluates differences in screening practices and knowledge of laws between oncologists and cardiologists who prescribe opiates. Surveys regarding screening practices and knowledge of opioid prescribing laws were distributed in March 2017 to oncology and congestive heart failure (CHF) clinicians at the University of Virginia.

Do Palliative Care Clinics Screen for Substance Abuse and Diversion? Results of a National Survey.

Background: Opioids are the mainstay of treatment of cancer pain. With increased use there have been concerns about rising rates of prescription drug abuse and diversion. Although there has been an increase in research and practice guidelines about the scope of the problem for chronic, nonmalignant pain, less information is available about both the frequency of the problem and current practices regarding screening for substance abuse and diversion in patients and family members seen in palliative care clinics.

Screening for substance abuse risk in cancer patients using the Opioid Risk Tool and urine drug screen.

Purpose: The use of opioids for management of cancer-related pain has increased significantly and has been associated with a substantial rise in rates of substance abuse and diversion. There is a paucity of data not only on the prevalence of substance abuse in cancer patients, but also for issues of drug use and diversion in family caregivers. This study aimed to evaluate the frequency of risk factors for substance abuse and diversion, and abnormal urine drug screens in cancer patients receiving palliative care.

Association of hospice patients' income and care level with place of death.

Importance: Terminally ill patients with lower incomes are less likely to die at home, even with hospice care.

Objectives: To examine the relationship between income and transfer from home before death and the interaction between income and level of hospice care as a predictor of transfer from home in patients admitted to routine home hospice care.

Design: We matched zip codes to US census tracts to generate median annual household incomes and divided the measure into $10,000 increments (≤$20,000 to >$50,000).

Screening for substance abuse and diversion in Virginia hospices.

Background: Although inadequate treatment of pain is a problem for hospice patients, increases in the medical use of opioids have been accompanied by increasing levels of abuse and diversion in the community. Balancing pain relief with concerns about abuse and diversion is a difficult issue for hospices.

Objectives: The aim of this study was to determine policies and practices in Virginia hospices regarding substance abuse and diversion in patients and their families.

Communication strategies and cultural issues in the delivery of bad news.

Good communication is a fundamental skill for all palliative care clinicians. Patients present with varied desires, beliefs, and cultural practices, and navigating these issues presents clinicians with unique challenges. This article provides an overview of the evidence for communication strategies in delivering bad news and discussing advance care planning.