A5000572590- Palliative Care and End-of-Life Issues
- Childhood Cancer Survivors' Quality of Life
- Cancer survivorship and care
- Grief, Bereavement, and Mental Health
- Geriatric Care and Nursing Homes
- Patient Dignity and Privacy
- Patient-Provider Communication in Healthcare
- Family and Patient Care in Intensive Care Units
- Pain Management and Opioid Use
- Frailty in Older Adults
- Psychedelics and Drug Studies
- Opioid Use Disorder Treatment
- Health Systems, Economic Evaluations, Quality of Life
- Chemical synthesis and alkaloids
- Dementia and Cognitive Impairment Research
- Family Caregiving in Mental Illness
- Healthcare Policy and Management
- Bladder and Urothelial Cancer Treatments
- Cultural Competency in Health Care
- Anesthesia and Pain Management
- Dialysis and Renal Disease Management
- Pharmacological Effects and Toxicity Studies
- Family Support in Illness
- Suicide and Self-Harm Studies
- Complementary and Alternative Medicine Studies
University of Colorado Denver
2016-2025
University of Colorado Anschutz Medical Campus
2016-2025
VA Eastern Colorado Health Care System
2024
Colorado School of Public Health
2024
Geriatric Research Education and Clinical Center
2024
University of Colorado System
2024
University of Colorado Hospital
2019-2023
University of Colorado Health
2005-2023
University of Virginia
2022
University of Colorado Cancer Center
2020
A recently published randomized controlled trial compared single-dose psilocybin with niacin in conjunction psychotherapy participants cancer-related psychiatric distress. Results suggested that psilocybin-assisted facilitated improvements and existential distress, quality of life, spiritual well-being up to seven weeks prior the crossover. At 6.5-month follow-up, after crossover, 60-80% continued meet criteria for clinically significant antidepressant or anxiolytic responses.The present...
The exclusion of undocumented immigrants from Medicare coverage for hemodialysis based on a diagnosis end-stage renal disease (ESRD) requires physicians in some states to manage chronic illness this population using emergent-only hemodialysis. Emergent-only dialysis is expensive and burdensome patients.To understand the experience with ESRD who lack access scheduled hemodialysis.A qualitative, semistructured, interview study was conducted Colorado safety-net hospital July 1 December 31,...
Importance Numerous studies show that early palliative care improves quality of life and other key outcomes in patients with advanced cancer their caregivers, although most lack access to this evidence-based model care. Objective To evaluate whether delivering via secure video vs in-person visits has an equivalent effect on non–small cell lung (NSCLC). Design, Setting, Participants Randomized, multisite, comparative effectiveness trial from June 14, 2018, May 4, 2023, at 22 US centers among...
LBA3 Background: National guidelines recommend the early integration of palliative and oncology care for patients with advanced cancer, given robust evidence showing that this model improves quality life (QOL) other important outcomes. However, most do not receive (EPC) in outpatient setting due to limited access resources. To overcome these barriers, we conducted a large-scale comparative effectiveness trial EPC delivered via secure video versus person among non-small cell lung cancer...
BACKGROUND Death in the U.S. frequently occurs institutions despite overwhelming majority of persons who state that they prefer to die at home. Little research date has examined how well individual preferences compare actual site death. OBJECTIVES Determine concordance between preferred and place death examine independent predictors for concordance. DESIGN Observational cohort study. SETTING Three area hospitals including a safety net hospital, veterans' academic tertiary referral center....
Psychedelic-assisted therapy (PAT) is a burgeoning treatment with growing interest across variety of settings and disciplines. Empirical evidence supports PAT as novel therapeutic approach that provides safe effective for people suffering from diagnoses, including treatment-resistant depression, substance use disorder, post-traumatic stress disorder. Within the palliative care (PC) field, one-time dosing may lead to sustained reductions in anxiety, demoralization—symptoms diminish quality...
Background: Medical care at the end of life remains poor. One approach to improving end-of-life is through education medical trainees. However, evidence regarding structure an ideal educational intervention sparse. Objective: To test innovative curriculum designed improve resident knowledge and decrease anxiety surrounding care. Methods: Quasiexperimental study trainees in a large academic internal medicine residency. Attitudes were measured baseline completion 1-month clinical ward rotation...
<h3>Importance</h3> Strategies to increase access palliative care, particularly for racial/ethnic minorities, must maximize primary care and community-based models meet the ever-growing need in a culturally sensitive congruent manner. <h3>Objective</h3> To investigate if tailored patient navigator intervention can improve outcomes Latino adults with advanced cancer. <h3>Design, Setting, Participants</h3> The<i>Apoyo con Cariño</i>(Support With Caring) randomized clinical trial was conducted...
Background and objectives Compared with non-Latino whites advanced illness, Latinos are less likely to have an advance directive or die hospice services. To improve palliative care disparities, international ESRD guidelines call for increased research on culturally responsive communication of planning (ACP). The objective our study was explore the preferences Latino patients receiving dialysis regarding symptom management ACP. Design, setting, participants, & measurements Qualitative...
Disparities persist across the trajectory of serious illness, including at end life. Patient navigation has been shown to reduce disparities and improve outcomes for underserved populations.
Context: Specialty palliative care has been associated with cost savings at the end of life, while patient navigators have independently due to screening and treatment early in course disease. Evidence is limited regarding life. Objectives: To determine cost-effectiveness a lay navigator intervention improving outcomes for Hispanic persons serious noncancer illness. Methods: Total health expenditures last 30, 90, 180 days life were compared randomized sample 56 persons. Expenditures included...
Background: Dementia clinical trials often fail to include diverse and historically minoritized groups. Objective: We sought adapt the Alzheimer's Disease Related Dementias-Palliative Care (ADRD-PC) trial improve enrollment address cultural needs of people with late-stage ADRD who identify as Hispanic or Latino their family caregivers. Design: Bilingual, bicultural research team members adapted study materials processes using Cultural Adaptation Process Model. Investigators staff held three...
Background: We present and describe tailored strategies to address known barriers minority participation in clinical trial research. The used allowed our team engage communities successfully recruit, enroll, retain a diverse underserved population of Latinos with advanced cancer for this trial. Methods: Participants were recruited from 3 urban 7 rural sites. identified 4 critical recruitment population: (1) mistrust; (2) language communication barriers; (3) lack access academic center; (4)...
Introduction: Early palliative care (PC) integrated with oncology improves quality of life (QOL), depression symptoms, illness understanding, and end-of-life (EOL) for patients advanced lung cancer. The aims this trial are to compare the effect delivering early PC through telehealth versus in-person on patient caregiver outcomes. We hypothesize that both modalities would be equivalent improving QOL, communication about EOL preferences their oncologist, length stay in hospice. Methods: For...
The Institute of Medicine recommends people with serious advanced illness have access to skilled palliative care. However, the predominant delivery model nonhospice care is inpatient, consultative focused on end life, a small specialist workforce.The study objective was understand organizational factors that could influence adoption and scale-up outpatient in chronic illness, using example heart failure.This cross-sectional qualitative study. Participants were 17 health providers local,...
Disparities in hospice and palliative care (PC) for African Americans have been linked to mistrust toward the healthcare system, racial inequalities, cultural preferences. Spirituality has identified as important general. Less is known about influence of spirituality on American illness experiences.The goal this study was understand older Americans' perspectives how influences chronic experiences inform development a culturally tailored PC intervention.In partnership with 5 churches Denver...
The issue of generalist versus specialist palliative care is on the minds healthcare leaders everywhere. We are amid changing demographics physicians. industrialization medicine well underway in US and around developing world. Is it important to identify patients who benefit most from care, given that currently a limited resource? Should we step out standard practice redesign using principles population management? COVID pandemic rapidly introduced virtual consults. better way promote wide...
Background: Previous studies have shown that minority populations low rates of documented advance directives and express preferences for more life-prolonging interventions at the end life. We sought to determine impact Latino ethnicity on patients' self-report having an directive discussion a completed in medical record index hospitalization serious illness. Methods: This was prospective observational cohort study 458 adults admitted general services safety net hospital, academic center,...
After discharge from an acute care hospitalization, patients with cancer may choose to pursue rehabilitative in a skilled nursing facility (SNF). The objective of this study was examine receipt anticancer therapy, death, readmission, and hospice use among who SNF compared those are functionally able home or healthcare the 6 months after hospitalization.A population-based cohort conducted using SEER-Medicare database stage II-IV colorectal, pancreatic, bladder, lung had hospitalization...