Five things to question for physicians and patients in hospice and palliative medicine

Categories: Education.

The list was put together by the AAHPM and Choosing Wisely, an initiative from the ABIM Foundation that promotes communication between physicians and patients to support effective care choices, and to reduce unnecessary procedures and tests.

The “Five Things Physicians and Patients Should Question” for hospice and palliative medicine are as follows:

  • Don’t recommend percutaneous feeding tubes in patients with advanced dementia; instead, offer oral assisted feeding.
  • Don’t delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment.
  • Don’t leave an implantable cardioverter-defibrillator (ICD) activated when it is inconsistent with the patient/family goals of care.
  • Don’t recommend more than a single fraction of palliative radiation for an uncomplicated painful bone metastasis.
  • Don’t use topical lorazepam (Ativan), diphenhydramine (Benadryl), haloperidol (Haldol) (“ABH”) gel for nausea.

A more detailed list with explanations can be viewed on the Choosing Wisely website. This list forms part of a larger set of recommendations for other medical fields, which include radiology and clinical oncology.

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