The Institute for Palliative Medicine at San Diego Hospice

Center for Research

Research in palliative medicine relieves suffering and helps to improve the quality of life for patients and their families. The Institute for Palliative Medicine (IPM) at San Diego Hospice combines both research and education and training on its campus. Researchers study how to improve patient/family care and enhance the training of health professionals in a variety of health care settings. In addition, researchers conduct drug studies and clinical trials. Physician specialists who participate in research include oncologists, anesthesiologists, neurologists, internists, pediatricians, psychiatrists, and family physicians.  Given the multidisciplinary approach to care, our researchers also include nurse practitioners, nurses, social workers, spiritual counselors and master and doctoral level graduate students, among others. Their work not only advances the art and science of palliative care, but it also develops new strategies to relieve suffering and improve the quality of life of patients and families.

Research Highlights

Hospice practice and patient care improvement. Many studies at the Center for Research focus on how to improve care for patients with advanced illness. A recent study (Irwin et al., 2008) showed depression is under-recognized in this population. Depression can interfere with a patient’s capacity to understand his or her situation, make decisions, interact with caregivers, or reach life goals. It can also result in the patient being sicker for a longer period of time. Improved depression assessment is needed to minimize its impact and improve the quality of life for these patients.

Studies show that 71% of patients at home in the last six months of life have shortness of breath and 50% have moderate to severe pain (reference needed). More research is needed to support physicians, nurses and other health professionals on addressing these issues. Studies are also needed to determine why families of hospice patients reported being more satisfied with the care of their loved one than families of patients in hospitals or long term care settings (reference needed). The identification of factors which contribute to a better hospice experience, such as better pain control and care management by interdisciplinary teams, could lead to the development of strategies for application in a variety of health care settings.

Educational research. Our researchers have conducted a number of studies to evaluate the effectiveness of the education of medical students and residents. For example, a study completed in 2008 evaluated the effectiveness of a four-day curriculum for third-year medical students on hospice, palliative care and symptom management. The curriculum included a two-hour session on breaking bad news, one day making home visits, one day in the SDHIPM Inpatient Care Center, and one day spent in a classroom reviewing cases they had seen with interdisciplinary faculty. The course improved knowledge, attitudes and skills to levels exceeding that in a national sample of physician faculty (reference needed).

Investigational medication and clinical trials.  Our researchers also conduct investigational medication and clinical trials that could benefit patients. All studies are reviewed and approved by the SDHIPM Institutional Review Board to ensure patients’ interests are protected. A new medication was recently demonstrated to relieve constipation from opioid pain medications. As opioids are often used to treat moderate-to-severe pain, patients worldwide will benefit from this innovative research. IPM participated in the design and conduct of Phase II and III clinical trials leading to the Federal Drug Administration’s approval of RELISTOR™ (methylnaltrexone bromide), a subcutaneous injection to restore normal bowel function in patients on opioid medication (articles published by Dr. Jay Thomas)