The Center for Health Outcomes in Medicine Scholarship and Service (HOMES) has several active research projects helping people understand hardships relating to opioid use, end-of-life care and survivorship. Our interdisciplinary team aims to better understand and address patients’ needs while improving institutional processes through communication with individuals at the heart of these issues.
Within the Division of General Internal Medicine, research into opioid use is a rapidly growing focus area. Addiction medicine and chronic opioid use for pain management are being increasingly integrated into primary care clinics throughout the division. Physicians across the medical center are working to improve the process that patients with addiction go through as they enter different phases of treatment, from acute care through addiction psychiatry services and into ongoing lasting recovery. From our partnership with the Center for Bioethics and the College of Public Health, we’re examining the use of opioid use agreements in the above practice settings in an effort to promote patient-doctor trust. Since addiction is a problem with medical, behavioral and psychosocial complications, we believe that an interdisciplinary method of scientific inquiry is necessary to address the longitudinal care of people with opioid use disorders.
Interested in joining the team or wish to know more about opioid use disorders? Contact:
Palliative and End-of-Life Research
Our end-of-life research brings together clinicians from general internal medicine, palliative medicine, nursing and subspecialty medicine with health outcomes researchers. We explore big data and mixed methods exportable to fill knowledge and policy gaps in advance care planning (ACP) delivery. Our research group has been integrally involved in research on the analysis and identification of communication strategies in ACP. We’ve studied both micro- and macro-level communication practices — through both individual discourse and big data analysis — to identify communication influencing the quality of ACP.
Current projects in this domain include:
- Claims-based analyses of quality outcomes related to new ACP billing codes
- Survey of hospice caregivers to determine the association between early communication and live hospice discharge
- Qualitative interviews to probe deeper into issues around live hospice discharge
Live hospice discharge (when a patient discontinues hospice services while still alive) continues to be a problem for approximately 20% of hospice patients and can often prove traumatic for the patient and family caregivers. Our work seeks to further understand the complex scenarios around such discharges, and eventually provide a framework for preventing them.
Interested in joining the team or wish to know more about end-of-life care? Contact:
Research into Symptom Management for Cancer Survivors
With a growing population of cancer survivors, there’s an increasing recognition that focusing on drug therapeutics alone doesn’t address the spectrum of physical, emotional and spiritual concerns that many patients struggle with during and after treatment. As drug treatments expand, so have their cumulative toxicity burden. Symptom management is a critically important part of clinical care throughout the cancer continuum, from the earliest stage of cancer to the end of life in all ages, from young adults to the geriatric population.
Understanding how toxins harm the body can help us identify evidence-based, preventive treatment strategies. Management of toxicities or symptoms related to disease can improve quality of life and, in some instances, has improved disease outcomes and overall survival. In combination with symptom management, collaborative efforts in primary care and survivorship care will promote optimal health, prevent and treat diseases, and meet each individual’s unique physical, emotional and spiritual health goals.
A program that creates state-of-the-art research and promotes clinical excellence is needed to continue to make progress for our patients and caregivers. Competitive proposals from interested faculty members are anticipated, which will significantly increase extramural funding and advance our exploration.
Interested in joining the team or wish to know more about symptom management? Contact:
Maryam Lustberg, MD