Palliative and Hospice Care: Symptom Management and Beyond

This course highlights the significance of palliative care and hospice interventions and includes a discussion of current, evidence-based data supporting best practices in the management of these vulnerable patient populations.

The interdisciplinary care team will learn how to effectively manage symptoms while supporting quality of life in palliative care and hospice settings. 

This course includes topics presented at the 2024 Palliative Care and Hospice Symposium.

  • Ketamine: A Second Look
  • Palliative Sedation Therapy
  • Buprenorphine in the Palliative Care Setting
  • Marijuana as Medicine

Commercial Supporter

Baptist Health gratefully acknowledges the educational grant provided by VITAS Healthcare.

Target Audience

Palliative Care Physicians, Critical Care Medicine Physicians, Hospitalists, Geriatric Medicine Specialists, Internal Medicine Physicians, Family Medicine Physicians, Advanced Practice Registered Nurses, Physician Assistants/Physician Associates, Nurses, Social Workers, Respiratory Therapists, Clinical Chaplains, Pharmacists, Pharmacy Technicians, Medical Students, Registered Dietitians and other interested healthcare professionals.

Learning Objectives

Ketamine: A Second Look

  • Explain the development of development for clinical use and review the mechanism of action of ketamine as N-methyl-D-aspartate (NMDA) receptor antagonist.
  • Recognize the advantages of using ketamine for symptoms in patients with serious illness at end of life. 

Palliative Sedation Therapy

  • Explain the term palliative sedation (PS) and the evidence-based data supporting PS. 
  • Differentiate between PS, physician-assisted suicide, and euthanasia.  
  • Recognize when PS may be viable option for patient care. 
  • Examine the medications used for PS and the processing leading up to PS.

Buprenorphine in the Palliative Care Setting

  • Examine the pharmacology of buprenorphine and evaluate its efficacy and safety profile. 
  • Assess benefits of buprenorphine compared to schedule II opioids. 
  • Explain FDA-approved formulations of buprenorphine. 
  • Outline initiation strategies for palliative care use of buprenorphine. 

Marijuana as Medicine

  • Review the pharmacology and formulations of cannabis. 
  • Identify adverse effects and delineate the harms of use of cannabis. 
  • Examine the data surrounding cannabis in cancer- related symptoms.
  • Explain how to start and titrate cannabis products for palliative care use.
     
Additional information
Bibliography: 
  • Griffith, S. (2022). Managing symptoms at the end of life: a guide for non-palliative care nurses. Nursing Standard (Royal College of Nursing (Great Britain): 1987).
  • Goldman, N., Frankenthaler, M., & Klepacz, L. (2019). The efficacy of ketamine in the palliative care setting: a comprehensive review of the literature. Journal of Palliative Medicine, 22(9), 1154-1161.
  • Doppen, M., Kung, S., Maijers, I., John, M., Dunphy, H., Townsley, H., ... & Braithwaite, I. (2022). Cannabis in palliative care: a systematic review of current evidence. Journal of Pain and Symptom Management, 64(5), e260-e284.
Course Summary
Available credit: 
  • 3.50 ABIM MOC II
  • 3.50 AMA PRA Category 1 Credit™
  • 3.50 General certificate of attendance
  • 3.50 Florida Board of Dietitians
  • 3.50 Florida Board of Clinical Social Workers, Marriage and Family Therapists and Mental Health Counselors
  • 3.50 Nurse Practitioners
  • 3.50 Florida Board of Nursing
  • 3.50 Florida Board of Pharmacy
  • 3.50 Florida Board of Respiratory Therapy
Course opens: 
05/01/2024
Course expires: 
04/30/2027

Ketamine: A Second Look
Andy Arwari, M.D., M.S., FACP, SFHM, FAAHPM, HMDC
Medical Director
VITAS Healthcare
Miami, Florida

Palliative Sedation Therapy
Ileana M. Leyva, M.D., FAAHPM
Regional Medical Director
VITAS Healthcare
Miami, Florida

Buprenorphine in the Palliative Care Setting
Suleyki Medina, M.D.
Palliative Medicine Specialist
Symptom Management and Palliative Medicine Service
Miami Cancer Institute
Baptist Health South Florida
Miami, Florida

Marijuana as Medicine
Sheena M. Zapata, M.D.
Palliative Medicine Specialist
Symptom Management and Palliative Medicine Service
Miami Cancer Institute
Baptist Health South Florida
Miami, Florida

Mayra Villalba, MSN, R.N., CMSRN
Clinical Educator II
Palliative Care and Well-being
Baptist Health South Florida
Miami, Florida

The following faculty have indicated that they do not have any relevant financial relationships with ineligible companies* to disclose and have indicated that their presentation or discussion will not include off-label or unapproved product usage.
Speakers:
Andy Arwari, M.D. 
Ileana Leyva, M.D.
Sheena M. Zapata, M.D.
Mayra A. Villalba

The following faculty have indicated that they do not have any relevant financial relationships with ineligible companies* to disclose and have indicated that their presentation or discussion will include off-label or unapproved product usage.

Speakers:
Suleyki Medina, M.D.

Brenda Daniels, M.D., conference director for this educational activity, has no relevant financial relationships with ineligible companies* to disclose.

Non-faculty contributors and others involved in the planning, development, and editing/review of the content have no relevant financial relationships to disclose with ineligible companies*.

*Ineligible companies - Companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. 

Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.
              
Baptist Health South Florida designates this enduring material for a maximum of 3.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.



American Board of Internal Medicine Maintenance of Certification

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 3.5 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Your participation information will be shared with specialty boards through the ACCME's PARS reporting system. Successful completion of a course examination is required. Submissions are recorded in approximately 48 hours. You will receive an email when your credits have been processed.

Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Available Credit

  • 3.50 ABIM MOC II
  • 3.50 AMA PRA Category 1 Credit™
  • 3.50 General certificate of attendance
  • 3.50 Florida Board of Dietitians
  • 3.50 Florida Board of Clinical Social Workers, Marriage and Family Therapists and Mental Health Counselors
  • 3.50 Nurse Practitioners
  • 3.50 Florida Board of Nursing
  • 3.50 Florida Board of Pharmacy
  • 3.50 Florida Board of Respiratory Therapy
Please login or register for a Baptist Health CME account to take this course.

Your participation information will be shared with specialty boards through the ACCME's PARS reporting system. Successful completion of a course examination is required. Submissions are recorded in approximately 48 hours. You will receive an email when your credits have been processed.

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