Historically, the majority of patients seen by palliative care specialists have been near the end of life, and the field of palliative care has emphasized the efficacy of opioids for alleviating pain in this context. Likewise, much of hospice and palliative medicine training focuses on the inpatient setting, and clinicians trained in this tradition are often most comfortable treating hospitalized patients with pain due to advanced cancer and other life-limiting illnesses. However, in some settings palliative care is now recommended earlier in the disease course. For example, recent guidelines from the American Society of Clinical Oncology recommend that patients with advanced cancer receive dedicated palliative care services within 8 weeks of diagnosis.1
Schenker Y, Merlin JS, Quill TE. Use of Palliative Care Earlier in the Disease Course in the Context of the Opioid EpidemicEducational, Research, and Policy Issues. JAMA. 2018;320(9):871–872. doi:10.1001/jama.2018.9739
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