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Laura P. Gelfman - One of the best experts on this subject based on the ideXlab platform.
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An Update: NIH Research Funding for Palliative Medicine, 2011-2015.
Journal of palliative medicine, 2017Co-Authors: Elizabeth Brown, R Sean Morrison, Laura P. GelfmanAbstract:The evidence base to support Palliative care clinical practice is inadequate and opportunities to improve the Palliative care evidence base remain despite the field's rapid growth. To examine current NIH funding of Palliative Medicine research, changes since our 2013 report, and trends since our 2008 report. We sought to identify NIH funding of Palliative Medicine from 2011 to 2015 in two stages: (I) we searched the NIH grants database "RePorter" for grants with key words "Palliative care," "end-of-life care," "hospice," and "end of life" and (II) we identified Palliative care researchers likely to have secured NIH funding using three strategies. We abstracted (1) the first and last authors' names from original investigations published in major Palliative Medicine journals from 2013 to 2015; (2) these names from a PubMed-generated list of original articles published in major Medicine, nursing, and subspecialty journals using the above key words; and (3) Palliative Medicine journal editorial board members and key members of Palliative Medicine initiatives. We crossmatched the pooled names against NIH grants funded from 2011 to 2015. The author and NIH RePorter search identified 854 and 419 grants, respectively. The 461 grants categorized as relevant to Palliative Medicine represented 334 unique PIs. Compared to 2006-2010, the number of NIH-funded junior career development awards nearly doubled (6.1%-10%), articles published in nonPalliative care specialty journals tripled (13%-37%), published Palliative care researchers increased by 2.5-fold (839-2120), and NIH-funded original Palliative Medicine research articles doubled (21%-39%). Despite the challenging NIH funding climate, NIH funding to Palliative care remained stable. The increase in early stage career development funding, Palliative care investigators, and Palliative Medicine research published in nonPalliative Medicine journals reflects important advances to address the workforce and evidence gaps. Further support for Palliative care research is still needed.
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an update nih research funding for Palliative Medicine 2006 to 2010
Journal of Palliative Medicine, 2013Co-Authors: Laura P. Gelfman, Qingling Du, Sean R MorrisonAbstract:Abstract Background: Palliative care clinical and educational programs are expanding to meet the needs of seriously ill patients and their families. Multiple reports call for an enhanced Palliative care evidence base. Objective: To examine current National Institutes of Health (NIH) funding of Palliative Medicine research and changes since our 2008 report.1 Methods: We sought to identify NIH funding of Palliative Medicine from 2006 to 2010 in two stages. First, we searched the NIH grants database RePorter2 for grants with key words “Palliative care,” “end-of-life care,” “hospice,” and “end of life.” Second, we identified Palliative care researchers likely to have secured NIH funding using three strategies: (1) We abstracted the first and last authors' names from original investigations published in major Palliative Medicine journals from 2008 to 2010; (2) we abstracted these names from a PubMed generated list of all original articles published in major Medicine, nursing, and subspecialty journals using th...
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research funding for Palliative Medicine
Journal of Palliative Medicine, 2008Co-Authors: Laura P. Gelfman, Sean R MorrisonAbstract:Background: Medical care for seriously ill patients has been acknowledged to be inadequate and multiple reports have called for increased investment in Palliative Medicine research. Objective: To identify funding sources of Palliative Medicine research published form 2003–2005 and to examine National Institutes of Health (NIH) funding of Palliative Medicine research from 2001–2005. Methods: We sought to identify United States publications related to adult Palliative Medicine research from 2003–2005 and their funding sources. We reviewed all articles published in the major Palliative Medicine journals and additionally, we reviewed all articles published in major Medicine journals and relevant sub-specialty journals which were identified in Pub-Med using the key words “Palliative care,” “end-of-life care,” “hospice” and “end-of-life.” From all identified articles, we abstracted all sources of funding detailed. We then compiled a list of U.S. Palliative Medicine researchers from 2001–2005 using the published...
Wayne C. Mccormick - One of the best experts on this subject based on the ideXlab platform.
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report of the geriatrics hospice and Palliative Medicine work group american geriatrics society and american academy of hospice and Palliative Medicine leadership collaboration
Journal of the American Geriatrics Society, 2012Co-Authors: Wayne C. MccormickAbstract:Although the fields of hospice and Palliative Medicine and geriatrics have developed from separate origins, they share much in common. They share concerns for optimizing care of older adults with advanced illness. They both seek to address the common problem of care fragmentation for those with chronic illness. Both subspecialties see the patient and their loved ones as a unit requiring thoughtful, integrated care, rather than seeing the patient as a cluster of organ systems and conditions. The fields also share many core principles, including an emphasis on interdisciplinary care and care coordination. As increasing emphasis is placed on the medical home, chronic and advanced illness care, and systems changes to decrease care fragmentation, geriatrics and hospice and Palliative Medicine stand to benefit by blending efforts and common interests to improve care for patients and their loved ones. In 2009, a collaborative effort was begun involving the leadership of the American Geriatrics Society, the American Academy of Hospice and Palliative Medicine, and the John A. Hartford Foundation. The goal of the collaboration was to convene leaders in geriatrics and hospice and Palliative Medicine to identify areas of potential synergy between the two subspecialties and to design a plan for exploring and developing these areas of common interest. This article describes the progress of the collaborative effort to date.
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Report of the Geriatrics ― Hospice and Palliative Medicine Work Group: American Geriatrics Society and American Academy of Hospice and Palliative Medicine Leadership Collaboration
Journal of the American Geriatrics Society, 2012Co-Authors: Wayne C. MccormickAbstract:Although the fields of hospice and Palliative Medicine and geriatrics have developed from separate origins, they share much in common. They share concerns for optimizing care of older adults with advanced illness. They both seek to address the common problem of care fragmentation for those with chronic illness. Both subspecialties see the patient and their loved ones as a unit requiring thoughtful, integrated care, rather than seeing the patient as a cluster of organ systems and conditions. The fields also share many core principles, including an emphasis on interdisciplinary care and care coordination. As increasing emphasis is placed on the medical home, chronic and advanced illness care, and systems changes to decrease care fragmentation, geriatrics and hospice and Palliative Medicine stand to benefit by blending efforts and common interests to improve care for patients and their loved ones. In 2009, a collaborative effort was begun involving the leadership of the American Geriatrics Society, the American Academy of Hospice and Palliative Medicine, and the John A. Hartford Foundation. The goal of the collaboration was to convene leaders in geriatrics and hospice and Palliative Medicine to identify areas of potential synergy between the two subspecialties and to design a plan for exploring and developing these areas of common interest. This article describes the progress of the collaborative effort to date.
Sean R Morrison - One of the best experts on this subject based on the ideXlab platform.
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an update nih research funding for Palliative Medicine 2006 to 2010
Journal of Palliative Medicine, 2013Co-Authors: Laura P. Gelfman, Qingling Du, Sean R MorrisonAbstract:Abstract Background: Palliative care clinical and educational programs are expanding to meet the needs of seriously ill patients and their families. Multiple reports call for an enhanced Palliative care evidence base. Objective: To examine current National Institutes of Health (NIH) funding of Palliative Medicine research and changes since our 2008 report.1 Methods: We sought to identify NIH funding of Palliative Medicine from 2006 to 2010 in two stages. First, we searched the NIH grants database RePorter2 for grants with key words “Palliative care,” “end-of-life care,” “hospice,” and “end of life.” Second, we identified Palliative care researchers likely to have secured NIH funding using three strategies: (1) We abstracted the first and last authors' names from original investigations published in major Palliative Medicine journals from 2008 to 2010; (2) we abstracted these names from a PubMed generated list of all original articles published in major Medicine, nursing, and subspecialty journals using th...
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research funding for Palliative Medicine
Journal of Palliative Medicine, 2008Co-Authors: Laura P. Gelfman, Sean R MorrisonAbstract:Background: Medical care for seriously ill patients has been acknowledged to be inadequate and multiple reports have called for increased investment in Palliative Medicine research. Objective: To identify funding sources of Palliative Medicine research published form 2003–2005 and to examine National Institutes of Health (NIH) funding of Palliative Medicine research from 2001–2005. Methods: We sought to identify United States publications related to adult Palliative Medicine research from 2003–2005 and their funding sources. We reviewed all articles published in the major Palliative Medicine journals and additionally, we reviewed all articles published in major Medicine journals and relevant sub-specialty journals which were identified in Pub-Med using the key words “Palliative care,” “end-of-life care,” “hospice” and “end-of-life.” From all identified articles, we abstracted all sources of funding detailed. We then compiled a list of U.S. Palliative Medicine researchers from 2001–2005 using the published...
Charles F. Von Gunten - One of the best experts on this subject based on the ideXlab platform.
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textbook of Palliative Medicine
2009Co-Authors: Eduardo Bruera, Irene J Higginson, Carla Ripamonti, Charles F. Von GuntenAbstract:PART 1 The development of Palliative Medicine in: the UK and Ireland Europe Canada the USA Latin America Africa Australia and New Zealand Asia Palliative care versus Palliative Medicine Palliative care as a public heath issue The future of Palliative Medicine PART 2 Principles of bioethics Ethics Dignity PART 3 Dying in different cultures Palliative care global initiatives PART 4 Undergraduate Graduate Postgraduate and continuing education Public education PART 5 Challenges of research The patient population Research designs Outcomes Ethics in research Practical tips for successful research Audit and quality improvement PART 6 Standards of care The engineering of organizational change Financial issues in the delivery of Palliative care Organization and support of the multiprofessional / interdisciplinary team Needs assessment for patient care The Palliative care consult team Models for Palliative care delivery Home care Day hospitals Inpatient hospices The Palliative care unit Combined care models PART 7 Patient assessment Tools for pain and symptom assessment Quality of life assessment PART 8 The pathophysiology of chronic pain Causes & mechanisms of pain Opioid analgesics The assessment and management of opioid side effects Adjuvant analgesic drugs Alternative routes for systemic opiod delivery Epidural & intrathecal administration Topical administration of analgesics Non-pharmacological and non-invasive management of pain Pain in children Pain in the elderly Neuropathic pain Bone pain Incidental pain Somatization and pain expression Pain in patients with alcohol and drug dependence PART 9 Pathophysiology of anorexia-cachexia Nutritional and phamacological management of cachexia Nausea/vomiting Constipation/diarrhea Ascites Jaundice Bowel obstruction The endoscopic treatment of gastrointestinal symptoms PART 10 The pathophysiology of fatigue Assessment of fatigue The role of physical function on fatigue The treatment of fatigue PART 11 Dyspnea Other respiratory symptoms PART 12 Depression/anxiety Confusion/delirium Sleeping disorders Counseling Hope PART 13 Dehydration and re-hydration Fever and sweating Pruritus Infections Pressure ulcers and wounds Mouth care Fistulas The assessment and management of lymphedema PART 14 Hypercalcemia Hemorrhage Spinal cord compression Superior venacava syndrome Seizures Acute pain syndromes Suicide PART 15 Radiotherapy Chemotherapy Physical Medicine and rehabilitation Integrative and alternative Medicine AIDS Neurological diseases Congestive heart failure & other causes of terminal heart disease Palliative care in children Chronic obstructive pulmonary disease & other terminal respiratory conditions Other infectious diseases Practical aspects of Palliative care delivery in the developing world Prognostic indicators of survival Palliative sedation PART 16 Physiotherapy and occupational therapy Stress & burnout in health care givers Communication in Palliative care Spiritual care Family care Advanced directives Bereavement Children of Palliative care patients
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Development of a medical subspecialty in Palliative Medicine: progress report.
Journal of palliative medicine, 2004Co-Authors: Charles F. Von Gunten, Dale LupuAbstract:There is significant interest in seeking professional recognition of expertise in caring for people with serious life-threatening illness and their families through creation of a specialty in Palliative Medicine. Certification of physicians and accreditation of training programs are key elements for formal recognition. The American Board of Hospice and Palliative Medicine was established to achieve these goals. The next step in the maturation of the subspecialty of Palliative Medicine is to have both the certification and the accreditation recognized by the professional self-governing bodies in organized Medicine. This paper answers common questions about obtaining recognition by the Accreditation Council of Graduate Medical Education, the American Board of Medical Specialties and its member boards. Formal recognition of the subspecialty of Palliative Medicine is sought in order to extend the knowledge and skills inherent in the domains of Palliative Medicine. Such recognition will also encourage more phy...
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Initial voluntary program standards for fellowship training in Palliative Medicine.
Journal of palliative medicine, 2002Co-Authors: J. Andrew Billings, Susan B. Legrand, Ronald S. Schonwetter, Dale Lupu, Susan D. Block, John W. Finn, Ben Munger, Charles F. Von GuntenAbstract:Initial voluntary standards for fellowship programs in Palliative Medicine were developed through a collaborative process involving the directors of fellowship training programs, the American Academy of Hospice and Palliative Medicine (AAHPM), and the American Board of Hospice and Palliative Medicine (ABHPM). These groups worked with a consultant and representatives from the American Board of Medical Specialties (ABMS) and the Accreditation Council for Graduate Medical Education (ACGME) to create a training structure for the programs that will maximize the likelihood for recognition and accreditation of the subspecialty. An accreditation group modeled after an ACGME residency review committee will be formed to review and adopt the standards, then accredit programs voluntarily.
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Physician Board Certification in Hospice and Palliative Medicine
Journal of palliative medicine, 2000Co-Authors: Charles F. Von Gunten, Russell K. Portenoy, Paul A. Sloan, Ronald S. SchonwetterAbstract:The American Board of Hospice and Palliative Medicine (ABHPM) was formed in 1995 to establish and implement standards for certification of physicians practicing hospice and Palliative Medicine and, ultimately, accreditation of physician training in this discipline. The ABHPM has created a certification process that parallels other member boards of the American Board of Medical Specialties (ABMS). After 3½ years and the administration of seven examinations, 623 physicians have achieved board certification in hospice and Palliative Medicine. Those with ABMS primary board certifications have been certified by anesthesiology, 4%; family practice, 23%; internal Medicine, 55%; pediatrics, 1%; radiation oncology, 2%; and surgery, 2%. The majority describe their practice location as urban. Sixty-nine percent report more than 5 years of clinical experience in hospice/Palliative Medicine and 75% report an association with a hospice as medical director or hospice physician. Sixty-seven percent belong to the American...
Susan B. Legrand - One of the best experts on this subject based on the ideXlab platform.
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Delirium in Palliative Medicine: A Review
Journal of pain and symptom management, 2012Co-Authors: Susan B. LegrandAbstract:Delirium is a devastating complication of general medical and surgical populations but of particular importance in Palliative Medicine. It is a clinical syndrome that is often not recognized and, therefore, not treated appropriately. The presence of delirium is a predictor of increased morbidity and mortality, longer hospitalization, and more likely discharge to a nursing facility. This article reviews the pathophysiology, etiology, diagnosis, and treatment of delirium in the Palliative Medicine population.
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A syllabus for fellowship education in Palliative Medicine
The American journal of hospice & palliative care, 2003Co-Authors: Susan B. Legrand, Declan Walsh, Kristine A. Nelson, Mellar P. DavisAbstract:Recent years have seen significant growth in Palliative Medicine training programs and positions. There are plans to pursue Palliative Medicine specialty status with the American Board of Medical Specialties and accreditation of fellowship programs with the American College of Graduate Medical Education. A work group of program directors, supported initially by the Cleveland Clinic and then by the American Board of Hospice and Palliative Medicine, has recently published standards for fellowship training. Despite this, fundamental questions remain about defining the field and delineating the knowledge and skills expected following completion of specialty training. In this article, we describe the first fellowship program in Palliative Medicine (PMP) in the United States, developed and supported by the Cleveland Clinic Foundation. The program has been implemented as part of the Harry R. Horvitz Center for Palliative Medicine, founded in 1987 as the first comprehensive integrated US program in this field. This training program, in existence since 1989, features a traditional rotational structure with an inpatient primary care service, inpatient consult services, and an outpatient consult/hospice service. This article outlines the syllabus developed for this fellowship, given what we believe to be the essential knowledge base for the field of Palliative Medicine.
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Initial voluntary program standards for fellowship training in Palliative Medicine.
Journal of palliative medicine, 2002Co-Authors: J. Andrew Billings, Susan B. Legrand, Ronald S. Schonwetter, Dale Lupu, Susan D. Block, John W. Finn, Ben Munger, Charles F. Von GuntenAbstract:Initial voluntary standards for fellowship programs in Palliative Medicine were developed through a collaborative process involving the directors of fellowship training programs, the American Academy of Hospice and Palliative Medicine (AAHPM), and the American Board of Hospice and Palliative Medicine (ABHPM). These groups worked with a consultant and representatives from the American Board of Medical Specialties (ABMS) and the Accreditation Council for Graduate Medical Education (ACGME) to create a training structure for the programs that will maximize the likelihood for recognition and accreditation of the subspecialty. An accreditation group modeled after an ACGME residency review committee will be formed to review and adopt the standards, then accredit programs voluntarily.
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End-of-Life care: the death of Palliative Medicine?
Journal of palliative medicine, 2002Co-Authors: Mellar P. Davis, Declan Walsh, Susan B. Legrand, Ruth LagmanAbstract:813 THE DEVELOPMENT OF JOURNALS in Palliative Medicine are to be welcomed. We are concerned, however, about the extensive use of the term end-of-life care in your pages. We have found this phrase in 24% of article titles or subsections in Journal of Palliative Medicine between January 2000 and April 2002. We have philosophical and practical objections to the (mis-)use of this descriptor. We wish to take this opportunity to summarize our concerns. “End-of-life care” is an imprecise term but implies time-defined care. It is a quantitative rather than qualitative descriptor that excludes the purpose of care and fails to recognize the complex skill sets inherent in good Palliative Medicine. This unhappy label also stigmatizes the emerging field of Palliative Medicine1 while simultaneously minimizing the high case mix index and complexity of this challenging patient population. It advertises to the general public and our professional colleagues medical care limited to the imminently dying. We are concerned that the phrase will promote among potential referring physicians a transitional “discontinuous” care model rather than a more desirable seamless “collaborative” care with early referral. When everything else has been exhausted, the patient highly symptomatic, with social support collapsing, referred to an end-of-life care specialist. Patients who could and should be comanaged2 (for example by a Palliative Medicine specialist and oncologist) will naturally refuse services until actively dying when confronted with the end-of-life care referral label.2 Other subspecialties such as cardiology and pulmonary Medicine manage congestive heart failure and chronic obstructive lung disease without resorting to the term endof-life care during the final trajectory of the patient’s illness. It is a negative term lacking hope and describes only a part of the broad spectrum of Palliative care practice. We believe it is also an emotionally charged phrase and with more widespread use will emerge as a communication problem similar to the present difficulty of introducing the word “hospice” to patients or families. In contrast Palliative care (i.e., the philosophy of Palliative Medicine) is not time-confined but goal-oriented.4 We are here to help patients “live until they die” whenever that occurs.1 Palliative Medicine is a discipline4 that allows for close collaboration within the acute care medical system. To be effective and financially viable it must also be part of the acute medical care system and judged by the same standards.5 The term Palliative Medicine defines a professional practice without being exclusionary. Palliative Medicine may also be preventive Medicine in that early intervention in poorly controlled pain prevents the expansion and amplification of pain through neuroplasticity. Early intervention interrupts poor communication, limits anxiety and reduces psychosocial suffering which is amplified to intractablity in the dying.6 The World Health Organization (WHO) definition of Palliative care states that “many aspects of Palliative care are also applicable earlier in the course of illness in conjunction with anticancer treatment.”3 The Policy Framework for Commissioning Cancer Services (United Kingdom, 1994) states “Palliative care is required for many patients early in the course of their disease, sometimes from the time of diagnosis. It should not be associated with terminal care. The
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The business of Palliative Medicine: management metrics for an acute-care inpatient unit.
The American journal of hospice & palliative care, 2001Co-Authors: Mellar P. Davis, Declan Walsh, Kristine A. Nelson, Dale Konrad, Susan B. LegrandAbstract:For any Palliative Medicine inpatient unit to be economically viable, certain management metrics need to be followed. Palliative Medicine can provide both a compassionate and economical service within the current acute inpatient hospital environment. In this article, we will review the administrative and financial factors we have identified that influence the business of acute Palliative Medicine.
