Yvan Beaussant1,2, Justin Sanders1,3, Zachary Sager4, James A Tulsky1,3, Ilana M Braun1, Craig D Blinderman5, Anthony P Bossis6, Ira Byock7,8. 1. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA. 2. California Institute of Integral Studies, San Francisco, California, USA. 3. Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. 4. New England Geriatric Research, Education, and Clinical Center, Division of Geriatrics and Palliative Care, VA Boston Healthcare System, Boston, Massachusetts, USA. 5. Adult Palliative Care Service, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA. 6. Department of Psychiatry, New York University School of Medicine, New York, New York, USA. 7. Institute for Human Caring, Providence St. Joseph Health, Torrance, California, USA. 8. Department of Medicine and Community & Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
Abstract
Background: Recent and preprohibition studies show that patients with serious illness might benefit from psychedelic-assisted therapies for a range of symptoms, physical, psychosocial, and existential. Objective: To explore the potential roles and research priorities of these therapies in patients with serious illness. Design, Setting, and Participants: Qualitative study based on semistructured interviews with 17 experts in serious illness care and/or psychedelic research from the United States and Canada. Measurements: The interview guide elicited participants' perspectives on (1) the potential roles of psychedelic-assisted therapies in this setting, (2) research priorities relevant to this population, and (3) the potential for integrating psychedelic-assisted therapies into existing delivery models of serious illness care. We used thematic analysis until thematic saturation. Results: Domain I: Participants had polar views on the therapeutic potential of psychedelic-assisted therapies, ranging from strong beliefs in their medical utility to reluctance about their use in this patient population. They shared concerns related to the risks of adverse effects, such as delirium or worsening of psychological distress. Domain II: Research priorities primarily concerned patients with clinically diagnosed psychosocial distress, such as depression, anxiety, or demoralization. Participants also articulated potential roles extending beyond traditional medical diagnosis. Domain III: Participants emphasized essential safety and efficacy guidelines relevant to the integration of these therapies into existing models of care. Conclusion: This qualitative study highlights issues and priorities for research on psychedelic-assisted therapies in patients with serious illness and proposes a conceptual framework for integrating these therapies into existing delivery models of serious illness care.
Background: Recent and preprohibition studies show that patients with serious illness might benefit from psychedelic-assisted therapies for a range of symptoms, physical, psychosocial, and existential. Objective: To explore the potential roles and research priorities of these therapies in patients with serious illness. Design, Setting, and Participants: Qualitative study based on semistructured interviews with 17 experts in serious illness care and/or psychedelic research from the United States and Canada. Measurements: The interview guide elicited participants' perspectives on (1) the potential roles of psychedelic-assisted therapies in this setting, (2) research priorities relevant to this population, and (3) the potential for integrating psychedelic-assisted therapies into existing delivery models of serious illness care. We used thematic analysis until thematic saturation. Results: Domain I: Participants had polar views on the therapeutic potential of psychedelic-assisted therapies, ranging from strong beliefs in their medical utility to reluctance about their use in this patient population. They shared concerns related to the risks of adverse effects, such as delirium or worsening of psychological distress. Domain II: Research priorities primarily concerned patients with clinically diagnosed psychosocial distress, such as depression, anxiety, or demoralization. Participants also articulated potential roles extending beyond traditional medical diagnosis. Domain III: Participants emphasized essential safety and efficacy guidelines relevant to the integration of these therapies into existing models of care. Conclusion: This qualitative study highlights issues and priorities for research on psychedelic-assisted therapies in patients with serious illness and proposes a conceptual framework for integrating these therapies into existing delivery models of serious illness care.
Authors: William E Rosa; Zachary Sager; Megan Miller; Ilan Bernstein; Alden Doerner Rinaldi; Katie Addicott; Michael Ljuslin; Chris Adrian; Anthony L Back; Jamie Beachy; Anthony P Bossis; William S Breitbart; Mary P Cosimano; Stacy M Fischer; Jeffrey Guss; Emma Knighton; Janis Phelps; Brian D Richards; William A Richards; James A Tulsky; Monnica T Williams; Yvan Beaussant Journal: J Palliat Med Date: 2022-03-14 Impact factor: 2.947