Background: In the US, rising rates of opioid abuse has led to regulatory policies designed to curb opioid prescribing. While these policies generally exclude hospice and palliative care from prescribing restrictions, it is not known if these policies have had unintended consequences that affect opioid prescribing within hospice and palliative care.
Methods: A qualitative, descriptive design, guided by the Theory of Planned Behaviour, was utilised to conduct a study to answer the following two research questions: 1) How has the opioid epidemic and related policies affected opioid prescribing practises among hospice and palliative care clinicians? and 2) How do hospice and palliative care clinicians perceive patients' end-of-life care has been impacted by the opioid epidemic and related policies?
Findings: Ten clinicians, comprising physicians and nurse practitioners working in hospice and palliative care settings, were directly interviewed one-on-one. Data analysis revealed that the opioid epidemic and related policies have had an impact on the patient, clinician, nursing and hospice and palliative care speciality.
Conclusions: As the broader medical community shifts away from opioid prescribing, care must be taken to ensure that hospice and palliative care patients still receive access to needed medications. Education is needed to assure that the relief of human suffering at end of life is prioritised.
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http://dx.doi.org/10.12968/ijpn.2022.28.9.426 | DOI Listing |
Eur J Oncol Nurs
January 2025
Clinical Research Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. Electronic address:
Purpose: This study aimed to identify and preliminary validate distinct clusters of patients with cancer based on demographics, clinical characteristics, and symptoms and to inform future research on sample size requirements for achieving sufficient power in clustering analyses.
Methods: This cross-sectional pilot study involved 114 patients with cancer from two hospitals in northern Italy. Data were collected on demographics, clinical characteristics, and 20 symptoms using the Edmonton Symptom Assessment System in October 2022.
BMC Palliat Care
January 2025
Department of Nursing, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, No. 599 Dayang East Road, Linhai, Zhejiang, 317000, China.
Background: Delirium frequently occurs in palliative care settings, yet its screening, identification, and management remain suboptimal in clinical practice. This review aims to elucidate the barriers preventing healthcare professionals from effectively screening, recognizing, and managing delirium in adult patients receiving specialist palliative care, with the goal of developing strategies to enhance clinical practice.
Methods: A mixed-methods systematic review was conducted (PROSPERO: CRD42024563666).
Value Health
January 2025
School of Healthcare Sciences, Bangor University, Bangor, Wales. LL57 2DG. Electronic address:
Objectives Hospice services offer invaluable support to individuals facing life-limiting illnesses, however, quantifying their positive impact presents a challenge. As the demand for palliative care rises due to complex illnesses and an aging population, hospices face the need to prove their value. With funding primarily reliant on charitable donations and limited statutory support, they must demonstrate their effectiveness to secure additional resources in a competitive landscape.
View Article and Find Full Text PDFJAMA
January 2025
Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis.
Importance: Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization.
Objective: To determine whether integrated dementia palliative care reduces dementia symptoms, caregiver depression and distress, and emergency department (ED) visits and hospitalizations compared with usual care in moderate to severe dementia.
Design, Setting, And Participants: A randomized clinical trial of community-dwelling patients with moderate to severe dementia and their caregivers enrolled from March 2019 to December 2020 from 2 sites in central Indiana (2-year follow-up completed on January 7, 2023).
West J Nurs Res
January 2025
UT Health San Antonio, San Antonio, TX, USA.
Background: Provision of palliative care in acute care settings is significantly lacking despite evidence that early integration leads to better patient/family-related outcomes and improved healthcare cost and efficiency.
Objective: This study investigated influencing factors that affect the nature and frequency of palliative care practices of acute care nurses.
Methods: A descriptive, cross-sectional design was used to examine the effects of personal and environmental factors on nurses' palliative care practices in the acute care setting.
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