Methadone with another opioid effective for cancer-related pain Adding a low dose of methadone to ongoing opioid therapy in patients with complex cancer-related pain seemed to produce good pain relief and was safe, according to a study in Journal of Palliative Medicine. Per Fürst, MD, at the Stockholms Sjukhem Foundation in Stockholm, Sweden, was the lead author of a paper describing the study, which involved 133 palliative care inpatient and home care units that responded to an add-on survey to the Swedish Register of Palliative Care mandatory end-of-life questionnaire. Methadone was started in 74% of the patients due to poor pain control. In 17% of the patients, clinicians started the patient on methadone as a primary therapy to treat neuropathic pain.

September 4, 2019

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People on the Move Spotlight: Cory Mertz, managing partner of the healthcare mergers-and-acquisitions (M&A) firm, Mertz Taggart of Fort Myers, FL, reported that hospice transactions were strong in the second quarter of 2019. Altogether, there were 25 home health, hospice and home care transactions. Mertz reported a growing interest by private-equity companies for hospice organizations. More People on the Move… Diane E. Meier, MD, FACP, FAAHPM, director of the Center to Advance Palliative Care (CAPC) at the Icahn School of Medicine at Mount Sinai in New York, was interviewed for HealthLeaders about clinician shortages in palliative care. Dr. Meier is a Senior Associate Editor of Journal of Palliative Medicine. … Richard Kennedy has been appointed interim president and CEO of Blue Ridge Hospice in Winchester, VA. … Maria I. Lapid, MD, at the Mayo Clinic, serves as the principal investigator of a study to evaluate massage and music therapy interventions for hospice patients. The researchers plan to enroll 120 participants and complete the study in December 2019. … Gov. Phil Murphy of New Jersey has signed into law Assembly bill 312, which will create The Palliative Care and Hospice Care Advisory Council and improve access to palliative care by raising awareness. … Rep. Bronna Kahle of Michigan has sponsored a bill that will make it easier for hospice providers to adjust analgesics for patients at the end of life. … Heath Bartness CEO of St. Croix Hospice in St. Paul, MN, announced the acquisition of Hometown Hospice & Homecare in Brookfield, WI. … Jane E. Brody wrote in The New York Times about the futility of cancer treatment at the end of life. … Maureen Lyon, PhD, a clinical psychologist at Children's National Health System in Washington, DC, was the lead author of a paper describing an innovative approach to palliative care for children with rare diseases. … Luai Al-Rabadi, MD, at the Oregon Health & Science University in Portland, reported in JAMA Network Open about trends in medical aid-in-dying in Washington state and Oregon. Please send us your People on the Move news. CMS finalizes Hospice Rule, requires unrelated-care disclosure The Centers for Medicare & Medicaid Services (CMS) has released the finalized 2020 Hospice Rule. Hospice payment rates will increase by 2.6%. However, hospices failing to meet quality reporting requirements will receive a 2 percentage point reduction to the annual market basket update for the year. The rule also will move funds from routine care to enhanced care levels.  Link to source>> Hospices also will be required to notify patients, their representatives, other healthcare providers, and Medicare contractors of items, drugs, and services that were deemed unrelated to the terminal illness and related conditions.  Link to source>> Study shows racial, ethnic disparities where stroke patients die Nonwhite or Hispanic patients who have a stroke were less likely to die in a hospice facility and more likely to die in a hospital or at home, according to a research letter in JAMA Neurology. Sarah H. Cross, MSW, MPH, at Duke University in Durham, NC, was the lead author of the research letter, which describes the methodology, using U.S. Centers for Disease Control and Prevention (CDC) data, and the results of the study. The researchers suggested conducting additional investigations to learn whether the disparities are due to a lack of access to supportive homes or hospice services, or whether they are related to cultural preferences.   Link to source(subscription required)>> Free NIH eBook highlights nonpharmaceutical management of pain The National Center for Complementary and Integrative Health, part of the National Institutes of Health, released the electronic book “Pain: Considering Complementary Approaches.” The free eBook discusses a variety of nonpharmaceutical approaches to pain, providing summaries about the evidence to support each modality, such as acupuncture, massage, meditation, and spinal manipulation.   Link to source>> Researchers, academics share perceptions about ‘palliative care’ Although palliative care is widely used, nearly half of the palliative care researchers and academics thought the term hindered the positioning of the specialty, but they did not think changing the term was a good idea, according to a study in Journal of Palliative Medicine. Sofia C. Zambrano, PhD, MGPCC, at the University Centre for Palliative Care at Inselspital, Bern University Hospital in Switzerland, was the lead author of the study, which explored how the term ‘palliative care’ was perceived. The researchers conducted a cross-sectional survey of attendees at the 10th World Research Congress of the European Association for Palliative Care, held last year in Bern.   Link to source>> NHPCO program ambassadors to engage with lawmakers The National Hospice and Palliative Care Organization (NHPCO) and its affiliate the Hospice Action Network announced a new My Hospice Ambassadors Program to increase federal lawmakers’ awareness of hospice and palliative care issues. NHPCO will select the ambassadors and provide advocacy training. The organization has appointed eight ambassadors, who will be expected to establish and maintain relationships with members of Congress, to develop a network of advocates, and to hold roundtable events with lawmakers.   Link to source>> New ‘Collaborative’ promotes palliative care expertise The Supportive Care Coalition, based in Hillsboro, OR, and the California State University Institute for Palliative Care in San Diego have formed the Total Learning Collaborative™. The Collaborative aims to help members of the Coalition gain skills and expertise in providing palliative care services to patients and their families. The Coalition is a membership organization with more than a dozen Catholic-based health systems that operate about 1,100 hospitals, 1,800 skilled nursing and senior care facilities, and 80 home care or hospice agencies across 37 states.   Link to source>> After shutdown, hospice house reopens in Florida’s Citrus County HPH Hospice, part of the Charters Health System, announced that its HPH Hospice House Citrus County in Lecanto, FL, will reopen. The eight-bed facility had closed in 2016 due to a reduction in new admissions. The hospice will hold a reopening event on September 19, 2019.   Link to source>> CAPC offers ‘best practices’ toolkits for palliative programs The Center to Advance Palliative Care offers toolkits developed from best practices. Topics range from starting programs to funding them, growing existing programs, building effective caregiving teams, and developing leadership skills.   Link to source>> TRICARE allows children to receive treatment and hospice TRICARE—the health care program for uniformed service members, retirees, and their families—now allows parents to choose both concurrent curative treatment and hospice care for their children up to age 21. The policy change was made possible by the 2018 National Defense Authorization Act and took effect in August. Adults covered by TRICARE still must choose between hospice and curative care.   Link to source>>