Publications by authors named "Shane Belin"
Context: Specialty palliative care remains inaccessible for many with serious illness, especially in rural areas. Telehealth may be one solution.
Objectives: To describe how telehealth increases access to specialty palliative care, describe facilitators and barriers to its use, and summarize evidence of patient benefits.
Therapeutic alliance (TA), or the extent to which patients feel a sense of caring and trust with their physician, may have an impact on health care utilization. We sought to determine if TA is associated with: (1) emergency department (ED) visits within 30 days of death and (2) hospice enrollment. This is a secondary analysis of data from a randomized clinical trial.
View Article and Find Full Text PDFImplementing a Serious Illness Risk Prediction Model: Impact on Goals of Care Documentation.
J Pain Symptom Manage
December 2023
Context: Goals of care conversations can promote high value care for patients with serious illness, yet documented discussions infrequently occur in hospital settings.
Objectives: We sought to develop a quality improvement initiative to improve goals of care documentation for hospitalized patients.
Methods: Implementation occurred at an academic medical center in Pittsburgh, Pennsylvania.
Patients with advanced cancer are commonly prescribed opioids, yet patient attitudes about opioid risks (eg, opioid use disorder, or OUD) are understudied. Our objective was to use in-depth qualitative interviews to understand perceptions of opioid prescribing and OUD in patients with advanced, solid-tumor cancers and their support people. We conducted a qualitative study using a rigorous inductive, qualitative descriptive approach to examine attitudes about OUD in patients with advanced cancer (n = 20) and support providers (n = 11).
View Article and Find Full Text PDFPurpose: Stigma surrounding prescription opioids, or is increasingly recognized as a barrier to effective and guideline-concordant cancer pain management. Patients with advanced cancer report high rates of pain and prescription opioid exposure, yet little is known about how opioid stigma may manifest in this population.
Methods: We conducted in-depth qualitative interviews with 20 patients with advanced cancer and 11 support providers between March 2020, and May 2021.
Importance: Guidelines recommend early specialty palliative care for all patients with advanced cancer, but most patients lack access to such services.
Objective: To assess the effect of CONNECT (Care Management by Oncology Nurses to Address Supportive Care Needs), a primary palliative care intervention delivered by oncology nurses, on patient outcomes.
Design, Setting, And Participants: This cluster randomized clinical trial of the CONNECT intervention vs standard care was conducted from July 25, 2016, to October 6, 2020.
Purpose: Responses to the opioid epidemic in the United States, including efforts to monitor and limit prescriptions for noncancer pain, may be affecting patients with cancer. Oncologists' views on how the opioid epidemic may be influencing treatment of cancer-related pain are not well understood.
Methods: We conducted a multisite qualitative interview study with 26 oncologists from a mix of urban and rural practices in Western Pennsylvania.
Background: Failure to deliver care near the end of life that reflects the needs, values and preferences of patients with advanced cancer remains a major shortcoming of our cancer care delivery system.
Methods: A mixed-methods comparative effectiveness trial of in-person advance care planning (ACP) discussions versus web-based ACP is currently underway at oncology practices in Western Pennsylvania. Patients with advanced cancer and their caregivers are invited to enroll.