Recommendations Relevant to Physiatrists in New Clinical Practice Guidelines for Quality Palliative Care

Tolchin, Dorothy W.

doi:10.1097/phm.0000000000001381

Cited by 5 publications

(11 citation statements)

References 1 publication

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“…For the first time, these guidelines attend to the impact of functional status on quality of life, the provision of palliative care in post-acute care settings, and the role of disability as part of the patient experience. Rehabilitation clinicians hold expertise in all of these areas [65].…”

Section: Improving Interprofessional Collaborationmentioning

confidence: 99%

Rehabilitation for Symptom Management for Patients with Cancer at the End of Life: Current Evidence and Barriers to Care

Brooks

Keeney

Ritchie

et al. 2021

Curr Phys Med Rehabil Rep

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Purpose of ReviewThe goal of this review is to highlight recent literature that addresses the role of rehabilitation for managing symptoms for patients with cancer near the end of life. Recent Findings Current literature supports the integration of rehabilitation interventions as part of comprehensive symptom management in patients with advanced cancer near end of life. Research is needed to clarify the impact and timing of specific rehabilitation techniques. There is also a need for robust education for both palliative and rehabilitation clinicians about the role for rehabilitation. Summary In this article, we review evidence for the use of rehabilitation interventions to address symptoms commonly experienced by patients with advanced cancer -dyspnea, pain, depression, anxiety, and fatigue. We also touch on communication strategies important for assessing and addressing the complex needs of the patient and caregiver. Finally, we describe barriers to the use of palliative rehabilitation and explore strategies for improving implementation across care settings.

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Section: Improving Interprofessional Collaborationmentioning

confidence: 99%

Rehabilitation for Symptom Management for Patients with Cancer at the End of Life: Current Evidence and Barriers to Care

Brooks

Keeney

Ritchie

et al. 2021

Curr Phys Med Rehabil Rep

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“…Given an impending shortage of specialty-trained PC clinicians in the United States, 7 it is increasingly important that physiatrists, along with colleagues in all medical specialties, be able to provide primary PC and use specialty PC for the subset of patients with the most advanced PC needs. 1,2 Physiatrists can also become specialty PC providers themselves by pursuing formal HPM fellowship training, most commonly a 12-month postresidency program. On its Web site, the American Board of PM&R encourages diplomates to consider subspecialty certification in HPM.…”

mentioning

confidence: 99%

“…Comprehensive PM&R care for these patients, like all PM&R patients, includes attention to function, autonomy, and quality of life. Physical medicine and rehabilitation physicians can also apply a palliative care (PC) lens during encounters to enhance care for the most seriously ill and injured PM&R patients 1,2 . These patients include, but are not limited to, those with neurodegenerative disease, neurotrauma, stroke, vascular amputation, burns, congenital or developmental conditions associated with substantial disability across the lifespan, cancer, and multimorbidity.…”

mentioning

confidence: 99%

“…Physiatrists can provide primary PC synergistically with PM&R care by providing a focused layer of skilled communication and symptom management to relieve suffering and recognizing indications for referral to specialty PC, including refractory symptoms, complicated team or family dynamics, and end of life care. Given an impending shortage of specialty-trained PC clinicians in the United States, 7 it is increasingly important that physiatrists, along with colleagues in all medical specialties, be able to provide primary PC and use specialty PC for the subset of patients with the most advanced PC needs 1,2 …”

mentioning

confidence: 99%

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The State of Palliative Care Education in United States Physical Medicine and Rehabilitation Residency Programs: Heterogeneity and Opportunity for Growth

Tolchin

Brooks

Knowlton

2022

Am J Phys Med Rehabil

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Physical medicine and rehabilitation physicians routinely care for patients with serious illness and injury who could benefit from an integrated palliative care approach due to the propensity for high or complex symptom burden. Despite this, it has been unknown whether and how physical medicine and rehabilitation residency programs are equipping residents with a foundational palliative care skillset. We report national survey results characterizing the current status of palliative care education within US physical medicine and rehabilitation residency programs. Programs vary widely in the type and amount of palliative care education provided, with nearly a third of responding programs reporting no palliative care education at all. These findings suggest the need for nationally unifying palliative care education standards for physical medicine and rehabilitation residency programs to ensure that all physical medicine and rehabilitation residents have the opportunity to develop a robust palliative lens that can be applied across rehabilitation practice settings. An articulated set of standards could both facilitate achievement of palliative care-specific objectives and support achievement of foundational physical medicine and rehabilitation residency program objectives.

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“…2: primary palliative care skills for physiatrists). 6 Palliative care and physiatry have evolved separately and without significant overlap, despite the fact that both fields share an interdisciplinary, patient-centered clinical approach that extends beyond the traditional biomedical focus on discrete disease processes. Integration of each field's expertise within the other through deliberate sharing of knowledge, skills, and perspectives has the potential to enhance comprehensive care in both fields.…”

mentioning

confidence: 99%

Integrating Palliative Care into Physiatric Care: Perspective of the Association of Academic Physiatrists Physiatry Palliative Care Task Force

Tolchin

Kaplan

Smith

et al. 2022

Am J Phys Med Rehabil

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There are opportunities for physiatrists to apply a palliative care lens within clinical encounters across rehabilitation settings. The expanding population of patients with serious illness and injury cared for by physiatrists and the anticipated shortage of specialty palliative care clinicians make it important that physiatrists hone and apply basic palliative care skills as part of comprehensive physiatric care. In this article, four clinical vignettes highlight relevant palliative care communication skills and demonstrate the value of integrating these skills within physiatry encounters. Resources to support physiatrists in applying basic palliative skills are provided throughout.

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Recommendations Relevant to Physiatrists in New Clinical Practice Guidelines for Quality Palliative Care

Cited by 5 publications

References 1 publication

Rehabilitation for Symptom Management for Patients with Cancer at the End of Life: Current Evidence and Barriers to Care

Rehabilitation for Symptom Management for Patients with Cancer at the End of Life: Current Evidence and Barriers to Care

The State of Palliative Care Education in United States Physical Medicine and Rehabilitation Residency Programs: Heterogeneity and Opportunity for Growth

Integrating Palliative Care into Physiatric Care: Perspective of the Association of Academic Physiatrists Physiatry Palliative Care Task Force

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