Wednesday, June 15, 2005

This Month's Palliative Medicine; Update on subspecialty recognition

#1) This month's issue of Palliative Medicine contains an article by Julie Robinson & colleagues from Australia about an empirically derived screening algorithm for depression in the (in- & outpatient) hospice setting. They found it to be more sensitive & specific than the standard 2 question depression screen ("During the past two weeks have you often been bothered by feeling down, depressed or without hope?" & "During the past two weeks have you often been bothered by a lack of interest or pleasure in doing things?") that is used commonly in the primary care setting. It is a simple algorithm that could, for instance, be performed by a hospice nurse during an intake visit. The article's appendix has a graphic of the algorithm that could be directly printed & used as a screening tool. If anyone wants to algorithm I can email it on an individual basis. It doesn't seem to be listed in PubMed yet, here is the Ingenta link & citation:

TI: Identifying palliative care patients with symptoms of depression: an algorithm
AU: Robinson, Julie A.; Crawford, Gregory B.
JN: Palliative Medicine
PD: June 2005
VO: 19
NO: 4
PG: 278-287(10)
PB: Arnold
IS: 0269-2163
Click on the URL to access the article or to link to other issues of the publication.

Also in the issue is a review of whole brain radiation therapy for brain mets. Conclusion: overall quality of studies are poor (which perhaps should be stamped onto every critical review in the palliative medicine world) but it seems to be effective for improving quality of life & symptoms & perhaps longevity in those with relatively good functional status to begin with.

#2) According to the AAHPM's website, the ABIM has formally endorsed subspecialty status for Palliative Medicine & 2007 may be year zero of official recognition...

A Quote: In June 2005, the Board of Directors of the American Board of Internal Medicine (ABIM) agreed to begin the formal process of gaining permission from the American Board of Medical Specialties (ABMS) to offer a subspecialty certificate in Hospice and Palliative Medicine. Their next steps are to submit a letter of intent and then a formal application to ABMS. After consideration of the application—likely to happen at their March 2006 board of directors meeting—the application will undergo a year of review by all of the ABMS member boards. If no significant objections are raised, approval could be obtained in 2007.

(combined from two previous posts to make room for Pallimed Contributors post) - CSinclair Oct 22, 2007

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