PURPOSE: Guidelines support early integration of palliative care (PC) into standard oncology practice; however, little is known as to whether outcomes can be improved by modifying health care delivery in a real-world setting. METHODS: We report our 6-year experience of embedding a nurse practitioner in an oncology clinic (March 2014-March 2020) to integrate early, concurrent advance care planning and PC. RESULTS: Compared with patients with advanced cancer not enrolled in the palliative care nurse practitioner program, in March 2020, patients who are enrolled are more likely to have higher quality of PC (eg, goals of care note documentation [82% v 15%; P < .01], referral to the psychosocial oncology program [67% v 37%; P < .01], and referral to hospice [61% v 34%; P < .01]) and less inpatient utilization in the last 6 months of life (eg, hospital days [12 v 18; P < .01] and intensive care unit days [1.2 v 2.3; P < .01]). The program expanded over time with the support of faculty skills training for advance care planning and PC, supporting a shared mental model of PC delivery within the oncology clinic. CONCLUSION: Embedding a trained palliative care nurse practitioner in oncology clinics to deliver early integrated PC can lead to improved quality of care for patients with advanced cancer.

Palliative care is a diverse multidisciplinary field that can provide significant benefit for patients with gynecologic malignancies.

The recent Supreme Court decision (ie, Dobbs v. Jackson Women’s Health Organization), revoking the constitutional right to abortion in the United States, has the potential to dramatically disrupt progress in women’s health research. The typical safeguards to ensure confidentiality and privacy of research participants in studies that collect certain types of personal health information may not hold against criminal investigations surrounding suspected pregnancy terminations. There are additional risks to participants in digital health research studies involving the use of wearable devices capable of tracking physiological measures, such as body temperature and heart rate, as these have shown promise for tracking conception and could be used to identify pregnancy termination signatures. There are strategies researchers can use to protect the safety of participants in health research who could get pregnant, while also maintaining integrity of research methods. The objective of this viewpoint is to discuss potential strategies to protect research participants’ privacy that include the minimization of nonessential sensitive personal health information and anonymization protocols in the event of miscarriage or termination of pregnancy. We invite others to join this discussion so as to not let the current political landscape impede progress in women’s health and reproductive research, while also protecting research participants.

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Hidradenitis suppurativa (HS) is a chronic, often debilitating skin condition that disproportionately impacts women in the United States and other Western nations. Dermatologists should consider incorporating palliative care principles into HS management to optimize care. Primary palliative care principles include utilizing evidence-based frameworks in serious illness communication, acknowledging and addressing physical and psychosocial suffering, recognizing and validating the burden of disease in partners, families, and caregivers, and engaging in collaborative care coordination. Certain patients may also benefit from outpatient, or sometimes inpatient, palliative care specialist collaboration, such as those with refractory HS and superimposed challenging psychosocial dynamics and symptom burden. Through integration of these palliative care domains into HS care, dermatologists can optimize their ability to provide comprehensive and compassionate care for patients suffering with this disease.