Palliative Care

Nurse-led telehealth in palliative oncology improves anxiety and quality of life for patients and caregivers

This meta-analysis of nine randomized trials (3177 participants) found nurse-led telehealth significantly reduced anxiety in palliative oncology patients (Hedges’ g = 0.46). Patient quality of life improved with a moderate effect size (Hedges’ g = 0.33), while effects on depressive symptoms were not statistically significant. For family caregivers, telehealth improved anxiety, depression, quality of life, and stress burden, with effect sizes around 0.30–0.45. Interventions with more than six sessions were more effective for selected outcomes, suggesting dose and structure matter for clinical impact. These findings support implementing structured, adequately intensive nurse-led telehealth programs as part of routine palliative cancer care. 1

State-of-the-art guidance for integrating palliative care across advanced cardiovascular disease

This European Heart Journal review argues that early palliative care in advanced cardiovascular disease improves quality of life and reduces psychological distress. It emphasizes integrating symptom management, advance care planning, and values-based shared decision-making throughout the disease trajectory, not only at end of life. The paper highlights gaps outside heart failure, particularly in patients with devices, valvular disease, pulmonary hypertension, arrhythmias, and congenital heart disease. Practical guidance includes referral triggers, disease-specific considerations, and communication frameworks, plus an algorithm for integrating palliative care into cardiology practice. The review also addresses ethical and legal issues such as advance directives and cardiac device deactivation conversations. 2

Consensus referral triggers to specialist palliative care for idiopathic pulmonary fibrosis

This international Delphi study established consensus palliative referral criteria for idiopathic pulmonary fibrosis, involving up to 46 respiratory and palliative experts. Seventeen major and forty minor criteria were agreed, spanning hospitalisation, respiratory therapies, symptom distress, comorbidities, exacerbations, time-based, and psychosocial factors. Patients and caregivers in a focus group generally supported the criteria but preferred even earlier referral indicators than many experts. The criteria promote systematic needs assessment and proactive communication rather than crisis-driven referrals in IPF. They offer a structured framework for respiratory and palliative teams to standardize, document, and justify earlier specialist palliative involvement. 3

Medicare Advantage status influences hospice use and setting in advanced cancer

This SEER-Medicare cohort of 196,536 older adults dying from advanced solid tumors examined hospice patterns by Medicare plan trajectory. Hospice enrollment was highest among continuous Medicare Advantage (MA) beneficiaries (74.8%) and lowest among those switching from MA to traditional Medicare (66.4%). Continuous MA beneficiaries had longer hospice stays than those in continuous traditional Medicare (48.3 vs 43.8 days). Continuous MA enrollees were slightly more likely to receive hospice at home, while MA-to-traditional switchers more often received hospice in nursing homes. Plan switchers were more often from racial and ethnic minority groups and dual-eligible populations, raising equity concerns around hospice access and setting. 4