2024
Framework for Considering Primary and Subspecialty Palliative Care and Guiding Serious Illness Communication for Patients With Breast Cancer.
Dow L, Kapo J, Boyle F, Shin J. Framework for Considering Primary and Subspecialty Palliative Care and Guiding Serious Illness Communication for Patients With Breast Cancer. American Society Of Clinical Oncology Educational Book 2024, 44: e432554. PMID: 39018514, DOI: 10.1200/edbk_432554.Peer-Reviewed Original ResearchConceptsSubspecialty palliative carePalliative careCore components of palliative carePrimary palliative care skillsComponents of palliative careBreast cancerPalliative care skillsPrimary palliative carePalliative care specialistsType of careQuality of life of patientsCare of patientsResource-constrained settingsIllness communicationCare skillsCoordinated careIllness trajectoryLife of patientsOncology cliniciansCare specialistsManaging painOncology teamPhysical symptomsOncology practiceCare
2023
Expert consensus‐based guidance on approaches to opioid management in individuals with advanced cancer‐related pain and nonmedical stimulant use
Jones K, Khodyakov D, Han B, Arnold R, Dao E, Morrison J, Kapo J, Meier D, Paice J, Liebschutz J, Ritchie C, Merlin J, Bulls H. Expert consensus‐based guidance on approaches to opioid management in individuals with advanced cancer‐related pain and nonmedical stimulant use. Cancer 2023, 129: 3978-3986. PMID: 37691479, PMCID: PMC10910244, DOI: 10.1002/cncr.34921.Peer-Reviewed Original ResearchConceptsCancer-related painConsensus-based guidanceStimulant useUncertain appropriatenessOpioid taperingLonger prognosisShort prognosisPalliative careAddiction expertsNonmedical stimulant useRAND/UCLAStimulant use disorderHarm reduction measuresAdvanced cancerPatient prognosisClinical appropriatenessPainUse disordersPrognosisPatientsExpert consensusOpioidsCancerDelphi panelClinicians
2022
Integrating Palliative Care Into Self-management of Breast Cancer
Schulman-Green D, Linsky S, Jeon S, Holland ML, Kapo J, Blatt L, Adams C, Chagpar AB. Integrating Palliative Care Into Self-management of Breast Cancer. Cancer Nursing 2022, 46: e169-e180. PMID: 35353749, PMCID: PMC9519806, DOI: 10.1097/ncc.0000000000001078.Peer-Reviewed Original ResearchConceptsBreast cancer patientsPalliative careCancer careRace/ethnicityCancer patientsChronic Disease Self-Efficacy ScaleStage III/IV cancerSingle-blind pilotSymptom management educationSelf-management planFeasibility/acceptabilityAcademic cancer centerMedical Communication Competence ScaleSelf-management outcomesLate-stage cancerEthnic minority patientsEffect sizeClinical characteristicsCancer CenterHospital AnxietyMishel UncertaintyCancer stageIllness ScaleBreast cancerDepression ScaleQuality of Telehealth-Delivered Inpatient Palliative Care During the Early COVID-19 Pandemic
Soliman AA, Akgün KM, Coffee J, Kapo J, Morrison LJ, Hopkinson E, Schulman-Green D, Feder SL. Quality of Telehealth-Delivered Inpatient Palliative Care During the Early COVID-19 Pandemic. Journal Of Pain And Symptom Management 2022, 65: 6-15. PMID: 36206949, PMCID: PMC9532267, DOI: 10.1016/j.jpainsymman.2022.09.014.Peer-Reviewed Original ResearchConceptsEarly COVID-19 pandemicGoals of carePC consultationElectronic health record reviewCOVID-19 pandemicQuality of telehealthUnmet PC needsInpatient palliative careHealth record reviewPalliative care servicesPatients' social needsRate of assessmentNew England hospitalsCOVID-19 infection ratesSymptom controlRecord reviewPalliative carePC servicesMean agePC needsFamily burdenCare servicesInfection ratePsychological symptomsEngland hospitalsConsensus-Based Guidance on Opioid Management in Individuals With Advanced Cancer-Related Pain and Opioid Misuse or Use Disorder
Jones K, Khodyakov D, Arnold R, Bulls H, Dao E, Kapo J, Meier D, Paice J, Liebschutz J, Ritchie C, Merlin J. Consensus-Based Guidance on Opioid Management in Individuals With Advanced Cancer-Related Pain and Opioid Misuse or Use Disorder. JAMA Oncology 2022, 8: 1107-1114. PMID: 35771550, PMCID: PMC9247858, DOI: 10.1001/jamaoncol.2022.2191.Peer-Reviewed Original ResearchConceptsOpioid use disorderCancer-related painOpioid misuseUse disordersClinical scenariosUntreated opioid use disorderAddiction medicine specialistsCommon clinical scenariosDelphi panelImportant comorbidityAdvanced cancerPalliative careMAIN OUTCOMEMedicine specialistsAddiction specialistsPatientsLack of consensusPainAddiction cliniciansDisordersQualitative studyParticipantsComorbiditiesMisusePrognosisImproving Breast Cancer Family Caregivers’ Palliative Care Literacy: A Pilot Randomized Trial
Schulman-Green D, Linsky S, Blatt L, Jeuland J, Kapo J, Jeon S. Improving Breast Cancer Family Caregivers’ Palliative Care Literacy: A Pilot Randomized Trial. Journal Of Family Nursing 2022, 29: 99-114. PMID: 35670155, DOI: 10.1177/10748407221099541.Peer-Reviewed Original ResearchConceptsCancer family caregiversCaregiver burdenFamily caregiversPilot Randomized TrialRandomized trialsMean agePreliminary efficacyCancer carePatient goalsIntervention participantsCare conversationsCare communicationCaregiver activitiesFurther studiesTrialsCaregiversBurdenTraining programParticipantsPatientsEthnic minoritiesIllnessFamily managementActivityLack of goals
2021
Expert Panel Consensus on Management of Advanced Cancer–Related Pain in Individuals With Opioid Use Disorder
Merlin JS, Khodyakov D, Arnold R, Bulls HW, Dao E, Kapo J, King C, Meier D, Paice J, Ritchie C, Liebschutz JM. Expert Panel Consensus on Management of Advanced Cancer–Related Pain in Individuals With Opioid Use Disorder. JAMA Network Open 2021, 4: e2139968. PMID: 34962565, DOI: 10.1001/jamanetworkopen.2021.39968.Peer-Reviewed Original ResearchConceptsOpioid use disorderFull agonist opioidsAdvanced cancerUncertain appropriatenessCancer painPalliative careUse disordersCancer pain managementAppropriateness of managementExpert panel consensusConsensus-based guidanceImportant comorbidityOpioid medicationsPain managementMethadone clinicsPainPatientsPanel consensusPrognosisCancerMethadoneDelphi processExpert panelMonthsOpioids
2020
Developing a Triage Protocol for the COVID-19 Pandemic: Allocating Scarce Medical Resources in a Public Health Emergency.
Tolchin B, Latham SR, Bruce L, Ferrante LE, Kraschel K, Jubanyik K, Hull SC, Herbst JL, Kapo J, Moritz ED, Hughes J, Siegel MD, Mercurio MR. Developing a Triage Protocol for the COVID-19 Pandemic: Allocating Scarce Medical Resources in a Public Health Emergency. The Journal Of Clinical Ethics 2020, 31: 303-317. PMID: 32991327, DOI: 10.1086/jce2020314303.Peer-Reviewed Original ResearchConceptsPublic health emergencyTriage protocolScarce medical resourcesYale New Haven Health SystemMedical resourcesEthical challengesHealth emergencyCOVID-19 pandemicAllocating Scarce Medical ResourcesFuture wavesMajor ethical challengesChronic comorbiditiesPregnant patientsSimilar public health emergenciesHealthcare workersTriage assessmentClinical judgmentCoronavirus diseaseHealth systemSocioeconomic disparitiesRole of ageCOVID-19Less needPublic discussionSecondary goalMobilizing an institutional supportive response for healthcare workers and other staff in the context of COVID-19: The Yale experience
Krystal JH, Alvarado J, Ball SA, Fortunati FG, Hu M, Ivy ME, Kapo J, Olson KD, Rohrbaugh RM, Sinha R, Tebes JK, Vender RJ, Yonkers KA, Mayes LC. Mobilizing an institutional supportive response for healthcare workers and other staff in the context of COVID-19: The Yale experience. General Hospital Psychiatry 2020, 68: 12-18. PMID: 33254081, PMCID: PMC7680059, DOI: 10.1016/j.genhosppsych.2020.11.005.Peer-Reviewed Original ResearchSevere functional limitation due to pain & emotional distress and subsequent receipt of prescription medications among older adults with cancer
Presley CJ, Canavan M, Wang SY, Feder SL, Kapo J, Saphire ML, Sheinfeld E, Kent EE, Davidoff AJ. Severe functional limitation due to pain & emotional distress and subsequent receipt of prescription medications among older adults with cancer. Journal Of Geriatric Oncology 2020, 11: 960-968. PMID: 32169548, PMCID: PMC7346676, DOI: 10.1016/j.jgo.2020.02.006.Peer-Reviewed Original ResearchConceptsSevere functional limitationsCo-occurring symptomsFunctional limitationsOlder adultsPrescription medicationsEmotional distressOlder adult Medicare beneficiariesAdult Medicare beneficiariesPrescription claims dataStage IV diseaseSupportive care needsMultivariable logistic regressionPrescription medication useMedicare Part D enrollmentPart D enrollmentCertain cancer typesMedication useLung cancerClaims dataPainMedicare beneficiariesCare needsFunctional independenceParticipant characteristicsCancer
2019
Patterns of pain medication use associated with reported pain interference in older adults with and without cancer
Davidoff AJ, Canavan ME, Feder S, Wang S, Sheinfeld E, Kent EE, Kapo J, Presley CJ. Patterns of pain medication use associated with reported pain interference in older adults with and without cancer. Supportive Care In Cancer 2019, 28: 3061-3072. PMID: 31637515, PMCID: PMC7338979, DOI: 10.1007/s00520-019-05074-8.Peer-Reviewed Original ResearchConceptsSevere pain interferencePrescription pain medicationPain interferencePain medicationOlder adultsMedication receiptMedicare Part D prescription claimsNon-steroidal anti-inflammatory drugsModerate pain interferenceReceipt of opioidsPain medication useManagement of painHalf of adultsAnti-inflammatory drugsPart D low-income subsidyLow-income subsidyOpioid prescribingOpioid prescriptionsSevere painMedication usePain managementSurveillance EpidemiologyPrescription claimsCancer historyChronic conditions
2018
Managing Chronic Pain in Cancer Survivors Prescribed Long-Term Opioid Therapy: A National Survey of Ambulatory Palliative Care Providers
Merlin JS, Patel K, Thompson N, Kapo J, Keefe F, Liebschutz J, Paice J, Somers T, Starrels J, Childers J, Schenker Y, Ritchie CS. Managing Chronic Pain in Cancer Survivors Prescribed Long-Term Opioid Therapy: A National Survey of Ambulatory Palliative Care Providers. Journal Of Pain And Symptom Management 2018, 57: 20-27. PMID: 30342243, DOI: 10.1016/j.jpainsymman.2018.10.493.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyOpioid misuse behaviorsChronic painPalliative care providersCancer survivorsOpioid therapyCare providersAmbulatory palliative care settingAddiction treatmentOpioid treatment agreementsPalliative care settingCare providers' experiencesUrine drug testingMisuse behaviorsPalliative care organizationsPharmacologic treatmentTreatment agreementsCare settingsNurse practitionersPainProvider experienceSurvivorsDrug testingCare organizationsTherapyAdvance Care Planning in Cognitively Impaired Older Adults
Thomas J, Sanchez‐Reilly S, Bernacki R, O'Neill L, Morrison LJ, Kapo J, Periyakoil VS, Carey EC. Advance Care Planning in Cognitively Impaired Older Adults. Journal Of The American Geriatrics Society 2018, 66: 1469-1474. PMID: 30277566, DOI: 10.1111/jgs.15471.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAdvance care planningCognitive impairmentOlder adultsCare planningFuture careRates of ACPSite of careSystem-related factorsOwn health careCognitive impairment progressesAdvanced dementiaIllness trajectoryArtificial hydrationHospice careAnticipatory guidanceDecision-making capacityCareCliniciansHealth careImpairmentHealthcare challengesAdultsImportant outcomesSpecial considerationIndividuals
2017
Chaplains Working in Palliative Care: Who They Are and What They Do
Jeuland J, Fitchett G, Schulman-Green D, Kapo J. Chaplains Working in Palliative Care: Who They Are and What They Do. Journal Of Palliative Medicine 2017, 20: 502-508. PMID: 28146647, DOI: 10.1089/jpm.2016.0308.Peer-Reviewed Original ResearchConceptsPC teamSpiritual care needsPC patientsPatients' spiritual care needsPalliative care programsTime of deathPalliative careCare conversationsMAIN OUTCOMECare needsSpiritual distressCare programNational online surveyPatientsCritical rolePractice informationFirst descriptionUnited StatesOnline surveyExistential issuesChaplainsAverage numberHalfTeam
2016
Integrating palliative care into self-management of breast cancer: Protocol for a pilot randomized controlled trial
Schulman-Green D, Linsky S, Jeon S, Kapo J, Blatt L, Chagpar A. Integrating palliative care into self-management of breast cancer: Protocol for a pilot randomized controlled trial. Contemporary Clinical Trials 2016, 48: 133-138. PMID: 27107680, PMCID: PMC4937876, DOI: 10.1016/j.cct.2016.04.009.Peer-Reviewed Original ResearchConceptsPalliative careBreast cancerPsycho-educational interventionPatient knowledgeFamily caregiversAttention control groupBreast cancer patients' knowledgeSymptom management toolkitSelf-management interventionsCancer patients' knowledgePreliminary effectsLarge-scale trialsIntervention effectsMinority participantsClinical factorsCurative treatmentCancer careIntervention groupExploratory aimSerious illnessPatient behaviorPatientsLength of lifeCancerEffect of MCC
2010
Advance Care Planning and Hospice Enrollment: Who Really Makes the Decision To Enroll?
Hirschman KB, Corcoran AM, Straton JB, Kapo JM. Advance Care Planning and Hospice Enrollment: Who Really Makes the Decision To Enroll? Journal Of Palliative Medicine 2010, 13: 519-523. PMID: 20201667, DOI: 10.1089/jpm.2009.0370.Peer-Reviewed Original ResearchConceptsAdvance care planningCare planningNon-white respondentsHospice enrollment decisionLength of stayFamily membersHospice enrollmentMechanical ventilationACP discussionsCardiopulmonary resuscitationPatient participationPatientsHospiceWhite respondentsMajority of respondentsACP preferencesAdvance directivesAnonymous surveyRespondentsStayResuscitationDementiaGreater understandingCancerPhysicians
2008
Identifying the Factors That Facilitate or Hinder Advance Planning by Persons With Dementia
Hirschman KB, Kapo JM, Karlawish JH. Identifying the Factors That Facilitate or Hinder Advance Planning by Persons With Dementia. Alzheimer Disease & Associated Disorders 2008, 22: 293-298. PMID: 18580595, PMCID: PMC2666935, DOI: 10.1097/wad.0b013e318169d669.Peer-Reviewed Original Research
2006
Why Doesn't a Family Member of a Person With Advanced Dementia Use a Substituted Judgment When Making a Decision for That Person?
Hirschman KB, Kapo JM, Karlawish JH. Why Doesn't a Family Member of a Person With Advanced Dementia Use a Substituted Judgment When Making a Decision for That Person? American Journal Of Geriatric Psychiatry 2006, 14: 659-667. PMID: 16861370, DOI: 10.1097/01.jgp.0000203179.94036.69.Peer-Reviewed Original ResearchConceptsAdvanced dementiaHealthcare preferencesFamily membersLong-term care facilitiesMedical decisionsSubstituted judgmentAlzheimer's Disease CenterEarly-stage dementiaDisease CenterCare facilitiesPatient denialSubstituted judgment standardDementiaHealthcare professionalsPatientsSemistructured interviewsFamily consensusPersonsBest interestsUnrealistic expectations
2005
Is the Palliative Performance Scale a Useful Predictor of Mortality in a Heterogeneous Hospice Population?
Harrold J, Rickerson E, Carroll JT, McGrath J, Morales K, Kapo J, Casarett D. Is the Palliative Performance Scale a Useful Predictor of Mortality in a Heterogeneous Hospice Population? Journal Of Palliative Medicine 2005, 8: 503-509. PMID: 15992191, DOI: 10.1089/jpm.2005.8.503.Peer-Reviewed Original ResearchConceptsPalliative Performance ScaleNursing home residentsNon-cancer diagnosesHospice populationPPS scoreHome residentsPrognostic valueSix-month mortality rateCox proportional hazards modelStudy periodPredictors of mortalityProspective cohort studyPredictor of prognosisStrong independent predictorTime of enrollmentCommunity hospice programsProportional hazards modelSite of careStrong predictive valueCohort studyNoncancer diagnosesIndependent predictorsHospice eligibilityMedical recordsInpatient settingAre We Referring Patients to Hospice Too Late? Patients' and Families' Opinions
Kapo J, Harrold J, Carroll JT, Rickerson E, Casarett D. Are We Referring Patients to Hospice Too Late? Patients' and Families' Opinions. Journal Of Palliative Medicine 2005, 8: 521-527. PMID: 15992193, DOI: 10.1089/jpm.2005.8.521.Peer-Reviewed Original Research