"Start low, go slow," a strategy to tailor treatment dosing in older or vulnerable adults with advanced solid cancer: A systematic review and meta-analysis.

Introduction: The use of standard-dose cancer treatment can result in a decline in the functional abilities of older adults with cancer. The "start-low, go-slow" (SLGS) strategy involves initiating cancer treatment at lower-than-standard doses in selected patients who are vulnerable to excess toxicity and escalating based on tolerance. We performed a systematic review and meta-analysis to assess the available data and the effectiveness of the SLGS strategy in the treatment of cancer in older adults with incurable solid cancer.

Hospice Administrators' and Providers' Perspectives on Providing Upstream Palliative Care: Facilitators, Barriers, and Policy Prescriptions.

Among patients with serious illness, palliative care before hospice enrollment is associated with improved quality of life, reduced symptom burden, and earlier transitions to hospice. However, fewer than half of eligible patients receive specialty palliative care referrals. As most hospice clinicians and administrators have experience in specialty palliative care, several emerging programs propose engaging hospice clinicians to provide early palliative care.

Association of Remote Patient-Reported Outcomes and Step Counts With Hospitalization or Death Among Patients With Advanced Cancer Undergoing Chemotherapy: Secondary Analysis of the PROStep Randomized Trial.

Background: Patients with advanced cancer undergoing chemotherapy experience significant symptoms and declines in functional status, which are associated with poor outcomes. Remote monitoring of patient-reported outcomes (PROs; symptoms) and step counts (functional status) may proactively identify patients at risk of hospitalization or death.

Objective: The aim of this study is to evaluate the association of (1) longitudinal PROs with step counts and (2) PROs and step counts with hospitalization or death.

Clinician Perspectives on Virtual Specialty Palliative Care for Patients With Advanced Illnesses.

Patients with serious illnesses have unmet symptom and psychosocial needs. Specialty palliative care could address many of these needs; however, access varies by geography and health system. Virtual visits and automated referrals could increase access and lead to improved quality of life, health outcomes, and patient-centered care for patients with serious illness.