Chetna Malhotra
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View article: The final year for community-dwelling older adults with dementia in an Asian setting: admissions, interventions, and caregiver burden
The final year for community-dwelling older adults with dementia in an Asian setting: admissions, interventions, and caregiver burden Open
Background Current understanding of the last year of life with dementia is disproportionately informed by studies conducted in western contexts, primarily within long-term care settings. This study examines the last year of life experience…
View article: Outpatient Follow-Up and 30-Day Readmissions
Outpatient Follow-Up and 30-Day Readmissions Open
Importance Outpatient follow-up after discharge has been associated with reduced 30-day readmissions. Since universal follow-up is not feasible, identifying for whom and when outpatient follow-up is most beneficial is essential for optimiz…
View article: Psychological Risk Factors Associated With Mental Health Outcomes Among Bereaved Care Partners: A Meta-Regression Analysis of Prospective Studies
Psychological Risk Factors Associated With Mental Health Outcomes Among Bereaved Care Partners: A Meta-Regression Analysis of Prospective Studies Open
Predeath psychological factors influence care partners' postdeath mental health outcomes. Predeath grief offers some protection for spousal care partners against PGS highlighting its dual nature-both as a risk and protective factor. Assess…
View article: Adaptation of the serious illness conversation guide to a multicultural context in Singapore: a qualitative study
Adaptation of the serious illness conversation guide to a multicultural context in Singapore: a qualitative study Open
Objective To adapt the Serious Illness Conversation Guide (SICG), Ariadne Labs, Massachusetts USA, to a local Singapore version and evaluate its acceptability. Design Qualitative study using semistructured interviews. Participants 49 parti…
View article: An umbrella review of patient- and carer-reported measures for assessing adult end-of-life care quality outcomes
An umbrella review of patient- and carer-reported measures for assessing adult end-of-life care quality outcomes Open
View article: Digital Advance Care Planning for Dialysis Patients - Usability and Acceptability
Digital Advance Care Planning for Dialysis Patients - Usability and Acceptability Open
View article: Bias reduction method for prior event rate ratio, with application to emergency department visit rates in patients with advanced cancer
Bias reduction method for prior event rate ratio, with application to emergency department visit rates in patients with advanced cancer Open
Objectives: Prior event rate ratio (PERR) is a promising approach to control confounding in observational and real-world evidence research. One of its assumptions is that occurrence of outcome events does not influence later event rate, or…
View article: Measuring and monitoring the quality of dying in the UN Decade of Healthy Ageing
Measuring and monitoring the quality of dying in the UN Decade of Healthy Ageing Open
WHO aims to identify metrics to monitor the quality of dying, complementing those indicators proposed under the UN Decade of Healthy Ageing. However, the proposed criteria for a good death are contentious. Needs and priorities vary between…
View article: Patient experience with cancer care in low- and middle-income Asian countries: a cross-sectional study of patients with advanced cancer
Patient experience with cancer care in low- and middle-income Asian countries: a cross-sectional study of patients with advanced cancer Open
Introduction Despite the disproportionate burden of cancer morbidity and mortality in low- and middle-income countries (LMICs), little is known about patients’ care experiences in these settings. This study assesses which aspects of physic…
View article: Supporting dementia caregiving: Development and mixed methods pilot testing of a mobile care ecosystem (Preprint)
Supporting dementia caregiving: Development and mixed methods pilot testing of a mobile care ecosystem (Preprint) Open
View article: Optimal Filling Solution for the Double-Balloon Urinary Catheter: A Laboratory Analysis
Optimal Filling Solution for the Double-Balloon Urinary Catheter: A Laboratory Analysis Open
Purpose: To determine the glycerin concentration that best maintains the volume of the 5-cc and 10-cc balloons of the Duette double-balloon chronic indwelling catheter (DBCIC). Materials and Methods: Over the course of 2 experimental trial…
View article: “Wish to Die” Among Patients With Advanced Cancer: Does Institutional Quality of Care Matter?
“Wish to Die” Among Patients With Advanced Cancer: Does Institutional Quality of Care Matter? Open
Findings underscore that institutional quality of care is associated with reduced likelihood of patients expressing a WTD. Thus, enhancing institutional care quality - particularly improving access to palliative care - is critical for bett…
View article: Challenges to accessing community dementia care services: a qualitative study
Challenges to accessing community dementia care services: a qualitative study Open
The study highlights a range of challenges that hinder access to community dementia care services. There is an urgent need to redesign these services to better meet the needs of PWDs and their caregivers, thereby creating a more supportive…
View article: Breaking with the status quo in end‐of‐life care through de‐implementation
Breaking with the status quo in end‐of‐life care through de‐implementation Open
This paper addresses the challenge of de‐implementing low‐value care practices in the end‐of‐life (EOL) context, where burdensome interventions often offer marginal life‐extending benefits, incur substantial costs and diminish quality of l…
View article: Financial difficulties and well-being among caregivers of persons with severe dementia
Financial difficulties and well-being among caregivers of persons with severe dementia Open
Greater financial support and interventions to promote the use of emotion-focused coping strategies and enhancing caregiving gains may have beneficial effects in protecting caregivers' well-being.
View article: Development of the PRECIOUS Short-Form (PRECIOUS-SF) quality of care measure for children with serious illnesses
Development of the PRECIOUS Short-Form (PRECIOUS-SF) quality of care measure for children with serious illnesses Open
View article: Reverse Time‐to‐Death as Time‐Scale in Time‐to‐Event Analysis for Studies of Advanced Illness and Palliative Care
Reverse Time‐to‐Death as Time‐Scale in Time‐to‐Event Analysis for Studies of Advanced Illness and Palliative Care Open
Incidence of adverse outcome events rises as patients with advanced illness approach end‐of‐life. Exposures that tend to occur near end‐of‐life, for example, use of wheelchair, oxygen therapy and palliative care, may therefore be found ass…
View article: Caregivers influence preferred place of death for patients with an advanced cancer
Caregivers influence preferred place of death for patients with an advanced cancer Open
Objectives Family caregivers influence realization of home death among advanced cancer patients. However, little is known about the caregiver factors influencing patients’ preferred and actual place of death. We aimed to assess caregiver f…
View article: Inceptor binds to and directs insulin towards lysosomal degradation in β cells
Inceptor binds to and directs insulin towards lysosomal degradation in β cells Open
View article: Development and Usability of an Advance Care Planning Website (My Voice) to Empower Patients With Heart Failure and Their Caregivers: Mixed Methods Study
Development and Usability of an Advance Care Planning Website (My Voice) to Empower Patients With Heart Failure and Their Caregivers: Mixed Methods Study Open
Background Web-based advance care planning (ACP) interventions offer a promising solution to improve ACP engagement, but none are specifically designed to meet the needs of patients with heart failure and their caregivers. Objective We aim…
View article: Reimagining and rebranding advance care planning
Reimagining and rebranding advance care planning Open
Advance care planning (ACP) has traditionally aimed at ensuring that patients’ end-of-life (EOL) wishes are understood and respected. However, recent literature raises concerns about its effectiveness, with many trials indicating that ACP …
View article: Caregiver coping mediates the relationship between caregivers’ understanding of dementia as terminal and their distress
Caregiver coping mediates the relationship between caregivers’ understanding of dementia as terminal and their distress Open
We assessed which coping strategies (problem‐focused, emotion‐focused, dysfunctional) mediate the association between caregivers’ understanding of dementia as terminal and their distress. A total of 215 caregivers of community‐dwelling per…
View article: Reverse time-to-death as time-scale in time-to-event analysis for studies of advanced illness and palliative care
Reverse time-to-death as time-scale in time-to-event analysis for studies of advanced illness and palliative care Open
Background: Incidence of adverse outcome events rises as patients with advanced illness approach end-of-life. Exposures that tend to occur near end-of-life, e.g., use of wheelchair, oxygen therapy and palliative care, may therefore be foun…
View article: More competent informal caregivers reduce advanced cancer patients' unplanned healthcare use and costs
More competent informal caregivers reduce advanced cancer patients' unplanned healthcare use and costs Open
Background Patients with metastatic cancer experience high healthcare use and costs, most of which are unplanned. We aimed to assess whether patients with more competent informal caregivers have lower unplanned healthcare use and costs. Me…
View article: Empowering patients with heart failure and their caregivers: Development and usability of the “My Voice” advance care planning website (Preprint)
Empowering patients with heart failure and their caregivers: Development and usability of the “My Voice” advance care planning website (Preprint) Open
BACKGROUND Web-based advance care (ACP) interventions offer a promising solution to improve ACP engagement. However, there is lack of web-based ACP decision aids tailored for patients with heart failure, incorporating mechanisms to revisi…
View article: Do advanced cancer patients and their caregivers agree on preferred place of patient’s death?—a prospective cohort study of patient-caregiver dyads
Do advanced cancer patients and their caregivers agree on preferred place of patient’s death?—a prospective cohort study of patient-caregiver dyads Open
This study provides evidence of the dynamic changes in preference for home death among patient-caregiver dyads during last 3 years of patients' life. Understanding the EOL needs of older patients, optimizing home-based symptom control and …
View article: Goals of Care Among Patients With Advanced Cancer and Their Family Caregivers in the Last Years of Life
Goals of Care Among Patients With Advanced Cancer and Their Family Caregivers in the Last Years of Life Open
Importance Understanding goals of care for terminally ill patients at the end of life is crucial to ensure that patients receive care consistent with their preferences. Objectives To investigate the patterns of goals of care among patient-…
View article: Caregivers’ Burden and Anticipatory Grief Increases Acute Health Care Use in Older Adults with Severe Dementia
Caregivers’ Burden and Anticipatory Grief Increases Acute Health Care Use in Older Adults with Severe Dementia Open
View article: Development of the Parental Experience with Care for Children with Serious Illnesses (PRECIOUS) quality of care measure
Development of the Parental Experience with Care for Children with Serious Illnesses (PRECIOUS) quality of care measure Open
Background Parent-reported experience measures are part of pediatric Quality of Care (QoC) assessments. However, existing measures were not developed for use across multiple healthcare settings or throughout the illness trajectory of serio…
View article: Trajectories of negative and positive experiences of caregiving for older adults with severe dementia: application of group-based multi-trajectory modelling
Trajectories of negative and positive experiences of caregiving for older adults with severe dementia: application of group-based multi-trajectory modelling Open
Background Family caregivers of older adults with severe dementia have negative and positive experiences over the course of caregiving. We aimed to delineate joint trajectories (patterns over time) for negative and positive experiences, id…