Discussions about resuscitation preferences and hospice predominantly occurred during later visits. Initial visits focused on building relationships and rapport with patients and their families and on illness understanding, including prognostic awareness. Results Addressing symptoms and coping were the most prevalent components of the PC clinic visits. We performed content analysis on PC and oncologic visit notes from the electronic health records of these patients. Methods We randomly selected 20 patients who received early PC and survived within 4 periods: less than 3 months (n = 5), 3 to 6 months (n = 5), 6 to 12 months (n = 5), and 12 to 24 months (n = 5). Our objectives were to (1) identify key elements of early PC clinic visits, (2) explore the timing of key elements, and (3) compare the content of PC and oncologic visit notes at the critical time points of clinical deterioration and radiographic disease progression. We conducted a qualitative analysis of data from a randomized controlled trial that demonstrated improved quality of life, mood, and survival in patients with newly diagnosed metastatic non–small cell lung cancer who received early PC integrated with standard oncologic care vs standard oncologic care alone. Shared Decision Making and Communicationīackground Early ambulatory palliative care (PC) is an emerging practice, and its key elements have not been defined.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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