Palliative Care

Lay coach telehealth ENABLE Cornerstone did not reduce caregiver distress at 24 weeks

In this randomized trial of 222 caregivers and 165 patients, six weekly lay coach telephonic sessions plus monthly follow-up did not change caregiver anxiety or depression at 24 weeks compared with usual care. Secondary outcomes including caregiver burden, patient distress, and patient quality of life showed small, nonsignificant differences. Exploratory analyses suggested possible benefits for anxiety and patient mental health QOL among already-distressed dyads, but these findings were hypothesis-generating. Apply these results to African American and rural‑dwelling caregivers; do not generalize beyond that population without more data. 1

Virtual nurse‑led ELICIT greatly increased advance care planning and needs reporting

In a 12‑month RCT of community‑dwelling older adults with cognitive impairment, the virtual nurse‑led intervention raised advance care planning rates to 89.1% versus 3.0% with usual care. Reporting of supportive care needs also increased (86.1% vs 29.3%). These results support using virtual nurse-led palliative workflows to document goals and uncover unmet needs in cognitively impaired older adults. 2

Mortality risk differs by sex, inpatient care, and convictions among youth in substance-use treatment

Among 23,709 adolescents and young adults in Swedish specialized substance use treatment, 229 deaths occurred, with a crude mortality rate of 1.68 per 1000 person‑years. Adjusted analyses showed higher mortality for males (HR 1.69), those with inpatient treatment (HR 1.89), and convicted individuals (HR 2.64). For convicted patients, more outpatient visits were associated with lower mortality, while inpatient care correlated with higher mortality in subgroup analyses. These findings highlight high excess mortality and the need to target follow-up and community supports for high‑risk subgroups. 3