Palliative Care

App-facilitated palliative care maintained HRQOL and lowered hospitalizations in advanced cancer.

In a multicenter RCT of 1,214 community-dwelling adults with advanced solid cancer not on systemic therapy, digital symptom monitoring plus nurse follow-up better maintained HRQOL at 18 weeks versus usual care. The intervention preserved self-efficacy and reduced unplanned hospitalizations and inpatient days compared with usual care. ECOG performance status deterioration and ED visits were similar between groups, so functional decline and emergency use effects were uncertain. Applicability is strongest for older, community-dwelling patients no longer receiving cancer treatment and for programs that can embed nurse follow-up and caregiver app access. 1

I‑SNP enrollment linked to fewer hospitalizations in dementia patients at end of life.

In a retrospective cohort of 1,415,265 long-stay nursing home residents with dementia, UHC I‑SNP enrollment was associated with a 9.0 percentage point lower hospitalization rate in the last 30 days of life. Non-UHC I‑SNPs showed a 5.9 percentage point reduction, and UHC facilities produced a 1.7 percentage point spillover reduction among nonenrollees. Reductions also appeared for ICU admission and mechanical ventilation, but hospice use was unchanged. These findings apply to long-stay nursing home residents with dementia and may reflect care-management models rather than patient-level selection alone. 2

Fever common in inpatient hospice; devices drive many cases and infections explain ~40%.

In 145 adults with limited prognosis in an inpatient hospice unit, fever occurred in 40% and typically began a median 5.5 days after admission. About 39.7% of fevers were attributed to infection, most often catheter-associated urinary tract infection. Bladder catheters were strongly associated with fever (adjusted OR 12.42), implicating devices as major contributors. Clinically, prioritize prognosis-driven symptom relief and reassess device necessity before routine escalation to diagnostics or antimicrobials. 3