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Iyengar P, Prause N, LeBrett W, Lee A, Chang L, Patel A. Opioid and Nonopioid Analgesic Prescribing Patterns of Hepatologists for Medicare Beneficiaries. Clin Transl Gastroenterol 2024:01720094-990000000-00295. [PMID: 39082613 DOI: 10.14309/ctg.0000000000000729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/06/2024] [Indexed: 08/17/2024] Open
Abstract
INTRODUCTION Opioids are commonly prescribed to patients with chronic liver disease, but little is known regarding medication prescribing patterns of hepatologists. Opioid use increased until national guidelines limited opioid prescriptions in early 2016. We aimed to describe rates of opioid and nonopioid analgesics to Medicare beneficiaries by hepatologists from 2013 to 2017 and identify demographic characteristics associated with higher prescribing. METHODS Prescription data from 2013 to 2017 by 761 hepatologists identified in the Centers for Medicare and Medicaid Services Part D Public Use File were analyzed. Annual prescription volumes were compared for providers with >10 annual prescriptions of a given drug type. Provider characteristics associated with opioid prescriptions were identified through multivariate logistic regression analyses. RESULTS The proportion of hepatologists prescribing >10 annual opioid prescriptions decreased from 29% to 20.6%. Median annual opioid prescriptions per hepatologist significantly decreased from 24 to 20. Tramadol remained the most prescribed analgesic. Nonopioid analgesic prescription volume did not increase significantly. Provider characteristics associated with increased opioid prescriptions included male sex, practice location in the South and Midwest (vs West), more years in practice, and a greater proportion of beneficiaries who are white or with low-income subsidy claims. Characteristics associated with fewer prescriptions included non-university-based practice, having a greater proportion of female beneficiaries, and later prescription year. DISCUSSION Hepatologists are prescribing less opioids. However, the prevalence of tramadol use and the lack of increase in nonopioid analgesic use highlights the need for advancing the science and training of pain management in chronic liver disease and targeted implementation of nonopioid treatment programs.
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Affiliation(s)
- Preetha Iyengar
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, California, USA
| | - Nicole Prause
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, California, USA
| | - Wendi LeBrett
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, California, USA
| | - Anna Lee
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, California, USA
| | - Lin Chang
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, California, USA
| | - Arpan Patel
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, California, USA
- Department of Gastroenterology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
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Wu X, Li X, Su T, Liang J, Wang L, Huang Q, Zhang J, Wang S, Wang N, Xiang R. Development and validation of a questionnaire to evaluate the knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care. Nurs Open 2022; 10:673-686. [PMID: 36114724 PMCID: PMC9834548 DOI: 10.1002/nop2.1334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/11/2022] [Accepted: 08/07/2022] [Indexed: 01/19/2023] Open
Abstract
AIM To develop and validate a questionnaire on knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care. DESIGN A descriptive study design and STROBE checklist were applied in this research. METHODS The theoretical framework of the questionnaire was knowledge-attitude-behaviour model. An additional dimension of palliative care preference of family members was set up in the questionnaire. Items were generated from a rapid review of international literature and interviews with 61 family members of the older adults living either in an aged care service organization or the community. The content validity was examined by five experts. A preliminary questionnaire with 69 items was then set up, and its psychometric property was assessed. RESULTS A final version of questionnaire with 42 items under four dimensions was constructed. The content validity index of the overall questionnaire was 0.93 and of each item ranged 0.80-1.00. The factor loading of all items was higher than 0.50 as per exploratory and confirmatory factor analysis; the average variance extracted for each dimension was higher than 0.50; the composite reliability was higher than 0.90; and the absolute value of the correlation coefficient of each dimension was <0.50 and less than the square root of the average variance extracted. The Cronbach's alpha value and the split-half reliability value of the overall questionnaire were 0.93 and 0.97, respectively. CONCLUSIONS This questionnaire has good validity and reliability, but needs further testing in multi-centered settings.
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Affiliation(s)
- Xiaofen Wu
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Xiran Li
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Ting Su
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Jin Liang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Lijie Wang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Qiuna Huang
- Shunde HospitalSouthern Medical UniversityFoshanChina
| | - Jiayi Zhang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Shuang Wang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Ning Wang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina
| | - Rihui Xiang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina
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Nga DT, Van Giang N, Thai DH, Hue HT, Lee BO. Factors Associated With Knowledge and Attitude Among Vietnamese Nursing Staff Regarding Pain Management in a Vietnam National Hospital. J Neurosci Nurs 2022; 54:136-142. [PMID: 35532331 DOI: 10.1097/jnn.0000000000000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT BACKGROUND: Nurses play an important role in providing holistic care and effective pain management, which is significantly associated with their knowledge and attitudes. Limited evidence is available from Vietnamese nursing studies evaluating the knowledge and attitudes of nurses toward pain management. The objectives of this study were to evaluate the knowledge and attitudes of Vietnamese nurses and identify factors associated with pain management. METHODS: This study used a descriptive and cross-sectional design and was conducted at a national hospital in Vietnam from May to June 2021. Nurses working in all clinical units were surveyed to collect demographic data and assessed using the structured Knowledge and Attitudes Survey Regarding Pain (KASRP) scale. Multiple linear regression analysis was conducted to identify factors associated with knowledge and attitudes. RESULTS: Two hundred seventy-nine nurses completed the survey, including 152 (54.5%) who read books or journals about pain, 25 (9.0%) who reported the use of unit-based pain guidelines, and 77 (27.6%) who used a numeric rating tool. The mean number of correct answers on the KASRP was 23.34 (mean KASRP correct percentage of 54.9%), and only 16 nurses (5.7%) had passing scores. Having a bachelor's degree or higher, reading books or journals about pain, using a numeric rating tool, and using unit-based pain guidelines were significantly associated with higher KASRP scores (P < .01) among nurses. CONCLUSIONS: The knowledge and attitudes of nurses regarding pain management were far from satisfactory. Regular pain management training, access to pain-related reading materials, and the frequent use of a numeric tool to assess pain intensity are recommended to enhance the quality of care for patients provided by clinical nurses.
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Zhong Y, Black BP, Kain VJ, Song Y. Facilitators and Barriers Affecting Implementation of Neonatal Palliative Care by Nurses in Mainland China. Front Pediatr 2022; 10:887711. [PMID: 35813382 PMCID: PMC9263274 DOI: 10.3389/fped.2022.887711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Neonatal nurses in mainland China encounter various challenges when it comes to delivering palliative care to neonates. The aim of this study was to determine the barriers and facilitators of neonatal nurses' attitudes to palliative care for neonates in mainland China. A simplified Chinese version of the Neonatal Palliative Care Attitude Scale was piloted, administered, and analyzed using survey methods. Nurses in neonatal intensive care units in mainland China regardless of experience in the field were invited to take part in. Over a five-month period in 2019, we surveyed neonatal nurses from 40 hospitals in five provinces of China. The response rate was 92.5% (N = 550). This study identified eight facilitators and four barriers to neonatal palliative care implementation. In terms of nurses' attitudes on providing palliative care, younger and older nurses were more positive, whereas middle-aged nurses were less so. Nurses' emotional wellbeing was rarely impacted by neonatal death. They considered neonatal palliative care, particularly pain management, to be just as important as curative treatment. Parents were invited to participate in decision-making by nurses. Nurses reported having access to professional counseling and talking about their concerns with other healthcare professionals. The following barriers to neonatal palliative care were identified in this study that were not observed in the original English version scale research in 2009: a lack of clinicians, time, clinical skills, systematic education, neonatal palliative care experience, and social acceptance. Future research is required to investigate each barrier in order to improve the implementation of neonatal palliative care in mainland China.
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Affiliation(s)
- Yajing Zhong
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
| | - Beth Perry Black
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Victoria J Kain
- School of Nursing and Midwifery, Griffith University, Nathan, QLD, Australia
| | - Yang Song
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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Patel AA, Woodrell C, Ufere NN, Hansen L, Tandon P, Verma M, Lai J, Pinotti R, Rakoski M. Developing Priorities for Palliative Care Research in Advanced Liver Disease: A Multidisciplinary Approach. Hepatol Commun 2021; 5:1469-1480. [PMID: 34510839 PMCID: PMC8435283 DOI: 10.1002/hep4.1743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/28/2021] [Accepted: 04/19/2021] [Indexed: 02/04/2023] Open
Abstract
Individuals with advanced liver disease (AdvLD), such as decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC), have significant palliative needs. However, little research is available to guide health care providers on how to improve key domains related to palliative care (PC). We sought to identify priority areas for future research in PC by performing a comprehensive literature review and conducting iterative expert panel discussions. We conducted a literature review using search terms related to AdvLD and key PC domains. Individual reviews of these domains were performed, followed by iterative discussions by a panel consisting of experts from multiple disciplines, including hepatology, specialty PC, and nursing. Based on these discussions, priority areas for research were identified. We identified critical gaps in the available research related to PC and AdvLD. We developed and shared five key priority questions incorporating domains related to PC. Conclusion: Future research endeavors focused on improving PC in AdvLD should consider addressing the five key priorities areas identified from literature reviews and expert panel discussions.
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Affiliation(s)
- Arpan A. Patel
- Vatche and Tamar Manoukian Division of Digestive DiseasesDepartment of MedicineDavid Geffen School of Medicine at University of California Los AngelesLos AngelesCAUSA
- Veterans Affairs Greater Los Angeles Healthcare SystemLos AngelesCAUSA
| | - Christopher Woodrell
- Brookdale Department of Geriatrics and Palliative MedicineIcahn School of Medicine at Mount SinaiNew YorkNYUSA
- James J. Peters Veterans Affairs Medical CenterBronxNYUSA
| | - Nneka N. Ufere
- Gastrointestinal UnitDepartment of MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA
| | - Lissi Hansen
- School of NursingOregon Health Sciences UniversityPortlandORUSA
| | - Puneeta Tandon
- Department of MedicineCirrhosis Care ClinicEdmontonALCanada
- Liver Transplant UnitUniversity of AlbertaEdmontonALCanada
| | - Manisha Verma
- Department of Digestive Diseases and TransplantationEinstein Healthcare NetworkPhiladelphiaPAUSA
| | - Jennifer Lai
- Division of Gastroenterology and HepatologyDepartment of MedicineUniversity of California San FranciscoSan FranciscoCAUSA
| | - Rachel Pinotti
- Gustave L. and Janet W. Levy LibraryIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Mina Rakoski
- Division of Gastroenterology and HepatologyLoma Linda University HealthLoma LindaCAUSA
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Kim H, Choi S, Kim S, Lee J, Kim SH, Lee I, Shin Y, Jang HY. The Knowledge, Attitudes, Performance, and Barriers of Nurses to Pain in Oncology Settings: A Multi-Center Study. ASIAN ONCOLOGY NURSING 2021. [DOI: 10.5388/aon.2021.21.1.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hyekyung Kim
- Cancer Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Soeun Choi
- Department of Nursing, Mokpo National University, Muan, Korea
| | - Sue Kim
- College of Nursing, Yonsei University, Seoul, Korea
| | - Jiyeon Lee
- College of Nursing, Yonsei University, Seoul, Korea
| | - Sun-Hee Kim
- Seoul Women's College of Nursing, Seoul, Korea
| | - Insook Lee
- Department of Nursing, Changwon National University, Changwon, Korea
| | - Yoonjung Shin
- Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea
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Issa MR, Awanis Muslim N, Mat Sharif Z. The Mediating Effect of Model-Based Learning on Attitude and Pain Management Awareness Among Nurses During COVID 19 Pandemic in Saudi Arabia. SAGE Open Nurs 2021; 7:23779608211065213. [PMID: 35155775 PMCID: PMC8832294 DOI: 10.1177/23779608211065213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background All hospitals are required to provide high-quality pain management; one of the most
critical issues in achieving high-quality pain management is that the hospitals have a
clear plan to manage the patients’ pain and improve the nurses’ awareness of pain
management during the COVID 19 pandemic. However, there is a significant gap in the
literature that this study can cover. Aim This study aimed to investigate the mediating effect of model-based learning on nurses’
attitudes toward nurses’ pain management awareness during the COVID 19 pandemic in Saudi
Arabia government hospitals. Method The Heath Beliefs Model was used, with a quasi-experimental design, with per
experimental one group pre-test post-test design, and a quantitative approach using
self-administered questionnaires obtained from 330 nurses working with patients
suffering from pain. IBM SPSS V23 and Analysis of Moment Structures (AMOS)V23 were
applied to analyze the causal relationships between the variables. Results A two-step approach to analyze the study: the first step was to test the measurement
models’ constructs’ reliability and validity. The second step was to test research
hypotheses in the structural models. The results show a significant positive
relationship between model-based learning and pain management awareness among nurses
during COVID 19 pandemic. Furthermore, model-based learning fully mediated the
relationship between nurses’ attitudes and pain management awareness. Conclusions The study successfully improved nurses’ attitudes toward pain management awareness
among nurses during COVID 19 pandemic. These findings will help strengthen the debate in
the existing literature, and this is a new development window in the pain management
area.
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Affiliation(s)
- Marwan Rasmi Issa
- King Saud Medical City, Riyadh, Saudi Arabia
- College of Graduate Studies (COGS), Universiti Tenaga Nasional(UNITEN), Kajang, Selangor, Malaysia
| | - Noor Awanis Muslim
- College of Graduate Studies (COGS), Universiti Tenaga Nasional(UNITEN), Kajang, Selangor, Malaysia
| | - Zainon Mat Sharif
- College of Graduate Studies (COGS), Universiti Tenaga Nasional(UNITEN), Kajang, Selangor, Malaysia
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Shondell L, Foli KJ, Erler C. Effects of Education on Nurses' Knowledge and Attitudes of Pain Management in a Postoperative Cardiovascular Unit. J Contin Educ Nurs 2020; 51:377-383. [PMID: 32722816 DOI: 10.3928/00220124-20200716-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 02/26/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND This project explores the impact of an educational in-service on nurses' knowledge and attitudes toward pain on a postoperative cardiovascular unit. METHOD A convenience sample of nurses employed on the postoperative cardiovascular intensive care unit (n = 82) were asked to participate in this project, with 74 nurses attending the in-service training. Surveys that were 70% complete were used for analysis (preeducation, n = 22; posteducation, n = 24). RESULTS The results from this project demonstrated that the use of a brief educational in-service is effective and efficient in increasing nurses' knowledge and attitudes related to pain management in this group of nurses. Posteducation survey scores were significantly higher than preeducation survey scores (p < .001). CONCLUSION These findings suggest that a brief educational in-service on pain management can improve nurses' knowledge and attitudes on pain management in this postoperative cardiovascular unit. [J Contin Educ Nurs. 2020;51(8):377-383.].
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Ou M, Xu X, Chen Y, Yan Y, Wang K, Zhou L. Factors Related to Nurses' Knowledge and Attitudes Toward Pain in Hospitals in Low-Income Areas. Pain Manag Nurs 2020; 22:386-393. [PMID: 32713684 DOI: 10.1016/j.pmn.2020.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/23/2020] [Accepted: 06/21/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Effective pain management is closely related to nurses' knowledge and attitudes toward pain. Limited studies have been performed related to nurses' knowledge and attitudes toward pain in hospitals in low-income areas. AIMS This study surveyed the knowledge and attitudes of nurses toward pain management in county hospitals from low-income areas in Hunan Province, China. SETTING AND PARTICIPANTS The study included 4,668 registered nurses working in 48 county hospitals in low-income areas in China. METHODS A cross-sectional study examined the knowledge and attitudes of nurses with regard to pain using the Chinese version of the Knowledge and Attitude Survey Regarding Pain (KASRP) via the WeChat application. RESULTS The 4,668 registered nurses completed the survey; of these, 43.6% indicated they had never received continuing education for pain. The mean percentage score for KASRP was (40.3 ± 7.95), and none of the respondents achieved a percentage score of >80%. Further, of the 40 items, only two had a correct rate of >80%. Continuing pain education did not significantly affect KASRP. Multiple stepwise linear regression showed that education level, ethnicity, professional title, position, and department were independent influencing factors for KASRP scores. CONCLUSION Almost all nurses in county hospitals of low-income areas had deficiencies in various aspects of pain management knowledge. Better educated nurses with higher professional title or management position, those from the Han ethnicity, and those from the oncology department had higher mean KASRP scores. Current continuing education programs for pain did not improve the pain management capability of the nurse. High-quality and standardized pain educational programs should be implemented to improve pain management.
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Affiliation(s)
- Meijun Ou
- Nursing Department, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P.R. China
| | - Xianghua Xu
- Hospital Administration Office, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P.R. China
| | - Yongyi Chen
- Hospital Administration Office, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P.R. China
| | - Yunying Yan
- Medical Examination Center, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P.R. China
| | - Ke Wang
- Intestinal Surgical Department, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P.R. China
| | - Lianqing Zhou
- Medical Examination Center, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P.R. China.
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Fricker ZP, Serper M. Current Knowledge, Barriers to Implementation, and Future Directions in Palliative Care for End-Stage Liver Disease. Liver Transpl 2019; 25:787-796. [PMID: 30758901 DOI: 10.1002/lt.25434] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/10/2019] [Indexed: 02/07/2023]
Abstract
End-stage liver disease (ESLD) is associated with a high degree of morbidity and mortality as well as symptom burden. Despite this, the rate of consultation with palliative care (PC) providers remains low, and invasive procedures near the end of life are commonplace. Studies show that involvement of PC providers improves patient satisfaction, and evidence from other chronic diseases demonstrates reduced costs of care and potentially increased survival. Better integration of PC is imperative but hindered by patient and provider misconceptions about its role in the care of patients with ESLD, specifically among candidates for liver transplantation. Additionally, reimbursement barriers and lack of provider knowledge may contribute to PC underutilization. In this review, we discuss the benefits of PC in ESLD, the variability of its delivery, and key stakeholders' perceptions about its use. Additionally, we identify barriers to more widespread PC adoption and highlight areas for future research.
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Affiliation(s)
- Zachary P Fricker
- Division of Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Marina Serper
- Division of Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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Leung YW, Wong J, Kiteley C, Ellis J, Esplen MJ. Addressing Educational Needs in Managing Complex Pain in Cancer Populations: Evaluation of APAM: An Online Educational Intervention for Nurses. Am J Hosp Palliat Care 2019; 36:587-597. [DOI: 10.1177/1049909119832819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Yvonne W. Leung
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jiahui Wong
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Cathy Kiteley
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
| | - Jerusha Ellis
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
| | - Mary Jane Esplen
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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