Evidence map›Paper›PMID 42250861›Full record

ArticleJournal of pain and symptom management2026

Palliative Care for Older Adults With Hip Fracture: An Explanatory Sequential Mixed-Methods Study.

Daniel I Hoffman, Sydney Moore, Amanda J Reich, Christina Sheu, Mengyuan Ruan, Masami Tabata-Kelly, Kate Sciacca, Tamryn F Gray, Daniel Dohan, Charlotta Lindvall and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Daniel I HoffmanCenter for Surgery and Public Health (D.I.H., S.M., A.J.R., C.S., M.R., M.T., D.D., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Surgery (D.I.H., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA.
Sydney MooreCenter for Surgery and Public Health (D.I.H., S.M., A.J.R., C.S., M.R., M.T., D.D., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School (S.M., A.J.R., C.L., Z.C.), Boston, Massachusetts, USA.
Amanda J ReichCenter for Surgery and Public Health (D.I.H., S.M., A.J.R., C.S., M.R., M.T., D.D., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School (S.M., A.J.R., C.L., Z.C.), Boston, Massachusetts, USA.
Christina SheuCenter for Surgery and Public Health (D.I.H., S.M., A.J.R., C.S., M.R., M.T., D.D., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA.
Mengyuan RuanCenter for Surgery and Public Health (D.I.H., S.M., A.J.R., C.S., M.R., M.T., D.D., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA.
Masami Tabata-KellyCenter for Surgery and Public Health (D.I.H., S.M., A.J.R., C.S., M.R., M.T., D.D., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA; The Heller School for Social Policy (M.T.), Management, Brandeis University, Waltham, Massachusetts, USA.
Kate SciaccaDepartment of Supportive Oncology (K.S., T.F.G., C.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Medicine (K.S., C.L.), Brigham and Women's Hospital, Boston, Massachusetts, USA.
Tamryn F GrayDepartment of Supportive Oncology (K.S., T.F.G., C.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Phyllis F. Cantor Center for Research in Nursing and Patient Care Services (T.F.G.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; School of Nursing (T.F.G.), University of North Carolina, Chapel Hill, North Carolina, USA; UNC Lineberger Comprehensive Cancer Center (T.F.G.), Chapel Hill, North Carolina, USA.
Daniel DohanCenter for Surgery and Public Health (D.I.H., S.M., A.J.R., C.S., M.R., M.T., D.D., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA; Institute for Health Policy Studies (D.D.), University of California, San Francisco, San Francisco, California, USA.
Charlotta LindvallDepartment of Supportive Oncology (K.S., T.F.G., C.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Medicine (K.S., C.L.), Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School (S.M., A.J.R., C.L., Z.C.), Boston, Massachusetts, USA.
Zara CooperCenter for Surgery and Public Health (D.I.H., S.M., A.J.R., C.S., M.R., M.T., D.D., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Surgery (D.I.H., Z.C.), Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School (S.M., A.J.R., C.L., Z.C.), Boston, Massachusetts, USA. Electronic address: zcooper@mgb.org.

Funding

A Layered Examination of the Patient Experience to Elucidate the Role of Palliative Care in Surgical Care for Seriously Ill Older AdultsR01AG070252 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI COOPER, ZARA R · 2021 to 2025
$4.0M
Leadership to Enhance Aging Research and Innovation in Medical Culture (LEARN-MC)K07AG066814 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DOHAN, DANIEL P. · 2020 to 2024
$675k
NIA NIH HHS K07 AG066814NIA NIH HHS R01 AG070252
6 · The paper itself

Abstract

contextAfter hip fracture, older adults experience burdensome treatments and high mortality; they may therefore benefit from palliative care (PC). Best practices for PC integration during inpatient hip fracture care remain understudied.

objectivesTo determine frequency of inpatient PC process documentation for seriously ill older adults with hip fracture and explore clinicians' perspectives on observed documentation patterns.

methodsWe used an explanatory sequential mixed-methods design. In a cohort of seriously ill adults ≥66 years old admitted for hip fracture from 2016 to 2019 at an academic health system, natural language processing was used to measure documentation of inpatient PC processes: healthcare proxy designations, code status limitations, goals of care conversations (GOCC), hospice discussions, and specialty PC. We then conducted semi-structured interviews (n = 10) with clinicians, exploring perspectives on documentation rates. Transcripts were coded thematically using a mixed deductive-inductive approach.

resultsAmong 1433 hip fracture admissions, GOCC, hospice discussions, and specialty PC were documented in <25% each. Clinicians viewed these rates as reflective of under-documentation and under-delivery. Workflow barriers included lack of standardized processes and diffusion of responsibility across interdisciplinary teams. Emphasis on efficient perioperative optimization and minimizing prolonged hospitalizations competed with perceived time for delivery of GOCC and specialty PC. Clinicians described a rescue-oriented surgical culture in which the palliative value of surgical repair for hip fracture paradoxically limited surgeons' view on their role in GOCC.

conclusionPC process documentation during hip fracture admissions was low. Limited standardization, role uncertainty, and cultural factors limited PC documentation and delivery, highlighting opportunities to strengthen PC integration in surgical care.

Indexed as

Hip FracturesPalliative CareAgedAged, 80 and overAttitude of Health PersonnelDocumentationFemaleHospice CareHumansMalehip fracturenatural language processingPalliative careserious illnesssurgery

Identifiers

PMID42250861
PMCPMC13329801

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.