Overview of Palliative Care
- Credit Type
- CME
- Credit Amount
- 1
- Release Date
- 02/16/2011
- Expiration Date
- 02/15/2012
- Activity Type
- Webcast
Jointly sponsored by Albert Einstein College of Medicine and Montefiore Medical Center, and Asante Communications, LLC
Activity Goal
Guided by comprehensive assessment of clinical knowledge gaps and needs, this educational activity is intended to provide an introduction to essential concepts in palliative care with a focus on pain management.
Intended Audiences
This activity is intended for pain specialists, oncologists, family practitioners, internal medicine physicians, and other healthcare providers who treat patients with advanced, life-threatening illness.
There are no prerequisites for this educational activity.
Statement of Need
Palliative care aims to improve quality of life and reduce suffering for patients with life-threatening illness and their families.1 Improved advocacy and practical strategies in this clinical area are particularly critical in light of the aging population and increasing number of people with incurable, progressive diseases.2-4 Unfortunately, substantial shortcomings have been identified in the level of care extended to seriously ill patients, including overuse of costly, ineffective therapies.5 Published evidence has highlighted significant physical and psychological distress in dying patients, yet palliative care utilization remains low despite increasingly available end-of-life services in the United States.1,6-8 Barriers to effective palliative care are multifactorial, including misconceptions that effective analgesic strategies may hasten death.9-12 In fact, appropriate palliative care can alleviate suffering, increase lifespans, and reduce hospitalizations.9, 13, 14 Healthcare providers should therefore strive to integrate their attempts at curative treatment with the clinical management of symptoms that affect patient comfort as death approaches.
Learner's Gap
Although palliative care is widely available, its underutilization contributes to increased healthcare costs and significant suffering for patients and family members.1,6-8 Too often physicians perceive palliative care to be an alternative to disease-focused treatment. Instead, palliative care should be viewed as active management of disease processes and essential psychosocial and spiritual support, at times delivered concurrently with curative therapies.15 Clinicians must also be prepared to discuss transitions from cure to comfort in the relative focus of care, and prevent feelings of abandonment in patients and families as they make end-of-life decisions.9,13,14
Learning Objectives
At the completion of this initiative, participants should be better prepared to:
- Identify barriers that adversely affect the quality of care given to terminally ill patients.
- Communicate with dying patients and their family members about potential outcomes and relative burdens of available therapeutic approaches.
- Formulate treatment plans that emphasize symptomatic management during end-of-life care.
- Provide appropriate analgesia in patients with progressive, life-threatening disease.
References
- Kelley AS, Meier DE. Palliative care—a shifting paradigm. N Engl J Med. 2010;363(8):781-782.
- Aging in the United States. Past, Present, and Future. Available at: http://www.census.gov/ipc/prod/97agewc.pdf. Accessed October 19, 2010.
- National Hospice and Palliative Care Organization data set. Available at: www.nhpco.org. Accessed October 19, 2010.
- Center for the Advancement of Palliative Care. Available at: www.capc.org. Accessed October 19, 2010.
- SUPPORT Principal Investigators. A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). JAMA. 1995;274(20):1591-1598.
- Desbiens NA, Mueller-Rizner N, Connors AF Jr, Wenger NS, Lynn J. The symptom burden of seriously ill hospitalized patients. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcome and Risks of Treatment. J Pain Symptom Manage. 1999;17(4):248-255.
- Covinsky KE, Goldman L, Cook EF, et al. The impact of serious illness on patients’ families. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. JAMA. 1994;272(23):1839-1844.
- Angus DC, Barnato AE, Linde-Zwirble WT, et al. Use of intensive care at the end of life in the United States: an epidemiologic study. Crit Care Med. 2004;32(3):638-643..
- Portenoy RK, Sibirceva U, Smout R, et al. Opioid use and survival at the end of life: a survey of a hospice population. J Pain Symptom Manage. 2006;32(6):532-540.
- Goepp JG, Meykler S, Mooney NE, Lyon C, Raso R, Julliard K. Provider insights about palliative care barriers and facilitators: results of a rapid ethnographic assessment. Am J Hosp Palliat Care. 2008;25(4):309-314.
- Nelson JE. Identifying and overcoming the barriers to high-quality palliative care in the intensive care unit. Crit Care Med. 2006;34(suppl 11):S324-S331.
- Feeg VD, Elebiary H. Exploratory study on end-of-life issues: barriers to palliative care and advance directives. Am J Hosp Palliat Care. 2005;22(2):119-124.
- Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363(8):733-742
- Dahlin C. Early palliative care for lung cancer: improving quality of life and increasing survival. Int J Palliat Nurs. 2010;16(9):420-423.
- Hui D, Elsayem A, De la Cruz M, et al. Availability and integration of palliative care at US cancer centers. JAMA. 2010;303(11):1054-1061.
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Albert Einstein College of Medicine and Montefiore Medical Center, and Asante Communications. Albert Einstein College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
Albert Einstein College of Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Conflict of Interest Statement
The Conflict of Interest Disclosure Policy of Albert Einstein College of Medicine requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical, product, or device company. Faculty whose disclosed relationships prove to create a conflict of interest with regard to their contribution to the activity will not be permitted to participate.
Albert Einstein College of Medicine also requires that faculty participating in any CME activity disclose to the audience when discussing any unlabeled or investigational use of any commercial product or device not yet approved for use in the United States.
Faculty of this program have indicated the following disclosure information:
Perry G. Fine, MD Alkermes, Inc. (consultant) ; Ameritox, Ltd. (consultant); Cephalon, Inc. (consultant); Forest Inc. (consultant) ; King Pharmaceuticals (consultant); NeuroAdjuvants, Inc.(consultant) ; PriCara [Ortho- McNeil-Janssen Pharmaceuticals] (consultant); Purdue Pharma L.P. (consultant); Wyeth (speakers bureau)
The staff of Albert Einstein College of Medicine and Montefiore Medical Center, Center for Continuing Medical Education (CCME), and the staff of Asante Communications have no conflicts of interest with commercial interests related directly or indirectly to this educational activity.
Steven Jay Feld of Albert Einstein College of Medicine, or a member of his household, owns securities in Bioheart, Inc., Chelsea Therapeutics, Inc., and Pharmacopeia, Inc.
David M. Kaufman, MD has no conflicts of interest with commercial interests related directly or indirectly to this educational activity.
James A. Kappler, PhD of Asante Communications, has no conflicts of interest with commercial interests related directly or indirectly to this educational activity.
Method of Participation
There are no fees for participating in and receiving credit for this activity. The Participant will have two opportunities to a score of atleast 70% to successfully complete this activity. Certificates will be mailed in approximately 6 to 8 weeks after the completion of the activity. Credit is available through February 15, 2012.
Credit Designation
Albert Einstein College of Medicine designates this educational activity for a maximum of 1.0 Category 1 Credit ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Disclaimer
The opinions, ideas, recommendations, and perspectives expressed in the accompanying materials are those of the authors and faculty only and do not necessarily reflect the opinions, ideas, recommendations, or perspectives of their affiliated institutions, Albert Einstein College of Medicine, Montefiore Medical Center, Asante Communications, or the activity’s commercial supporter.
Copyright Information
Copyright © 2011 Albert Einstein College of Medicine and Montefiore Medical Center, and Asante Communications. All rights reserved. No part of this report may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embedded in articles or reviews.
Faculty
