Arif Kamal

Overview:

health services and outcomes research, information-technology enabled registries, supportive oncology and palliative care, quality assessment and improvement

Positions:

Associate Professor of Medicine

Medicine, Medical Oncology
School of Medicine

Associate Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Core Faculty in Innovation & Entrepreneurship

Duke Innovation & Entrepreneurship
Institutes and Provost's Academic Units

Member in the Duke Clinical Research Institute

Duke Clinical Research Institute
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2005

University of Missouri Kansas City, School of Medicine

M.H.S. 2015

Duke University

M.B.A. 2016

University of Massachusetts - Amherst

Resident, Internal Medicine

Mayo Clinic, Alix School of Medicine

Fellowship, Hematology/ Oncology

Mayo Clinic, Alix School of Medicine

Grants:

Validating TOGETHER CARE, a mobile application ("app") for caregivers to implement home-based follow-up care for cancer survivors

Administered By
Duke Cancer Institute
Awarded By
Medable Inc.
Role
Principal Investigator
Start Date
End Date

Randomized Trial of Stepped Palliative Care versus Early Integrated Palliative Care in Patients with Advanced Lung Cancer

Administered By
Duke Cancer Institute
Awarded By
Massachusetts General Hospital
Role
Principal Investigator
Start Date
End Date

Developing and testing a web-based tool to engage advanced cancer patients in palliative care (PCforMe-Upstream)

Administered By
Duke Cancer Institute
Awarded By
Mayo Clinic
Role
Principal Investigator
Start Date
End Date

Which palliative care quality measures improve patient-centered outcome?

Administered By
Duke Cancer Institute
Awarded By
Cambia Health Foundation
Role
Principal Investigator
Start Date
End Date

Development of national registry for patients receiving primary care in the home

Administered By
Duke Clinical Research Institute
Awarded By
University of California - San Francisco
Role
Principal Investigator
Start Date
End Date

Publications:

Compassion in a Crisis: The Role of Palliative Care During the COVID-19 Pandemic.

Authors
MLA Citation
Kamal, Arif H., et al. “Compassion in a Crisis: The Role of Palliative Care During the COVID-19 Pandemic.Mayo Clin Proc, vol. 95, no. 11, Nov. 2020, pp. 2325–26. Pubmed, doi:10.1016/j.mayocp.2020.08.032.
URI
https://scholars.duke.edu/individual/pub1464062
PMID
33153621
Source
pubmed
Published In
Mayo Clin Proc
Volume
95
Published Date
Start Page
2325
End Page
2326
DOI
10.1016/j.mayocp.2020.08.032

Trends and Characteristics of Medicare Hospice Beneficiaries in the USA.

Authors
Bhatia, V; Huang, Y; Tulsky, JA; Cross, SH; Kamal, AH; Warraich, HJ
MLA Citation
Bhatia, Vipul, et al. “Trends and Characteristics of Medicare Hospice Beneficiaries in the USA.J Gen Intern Med, Oct. 2020. Pubmed, doi:10.1007/s11606-020-06288-x.
URI
https://scholars.duke.edu/individual/pub1462806
PMID
33078298
Source
pubmed
Published In
J Gen Intern Med
Published Date
DOI
10.1007/s11606-020-06288-x

Case for Dual Training in Medical Oncology and Palliative Care.

Authors
Sedhom, R; Gupta, A; Kamal, AH
MLA Citation
Sedhom, Ramy, et al. “Case for Dual Training in Medical Oncology and Palliative Care.Jco Oncol Pract, vol. 16, no. 9, Sept. 2020, pp. 537–39. Pubmed, doi:10.1200/OP.20.00137.
URI
https://scholars.duke.edu/individual/pub1441163
PMID
32427538
Source
pubmed
Published In
Jco Oncol Pract
Volume
16
Published Date
Start Page
537
End Page
539
DOI
10.1200/OP.20.00137

Hospice Employees' Perceptions of Their Work Environment: A Focus Group Perspective.

Burnout in healthcare professionals can lead to adverse effects on physical and mental health, lower quality of care, and workforce shortages as employees leave the profession. Hospice professionals are thought to be at particularly high risk for burnout. The purpose of the study was to evaluate workplace perceptions of interdisciplinary hospice care workers who provide care to patients at end of life. Six focus groups and one semi-structured interview were conducted with mixed group of social workers, managers, nurses, hospice aides, chaplains, support staff, and a physician (n = 19). Findings from the groups depicted both rewards and challenges of hospice caregiving. Benefits included intrinsic satisfaction from the work, receiving positive patient and family feedback, and teamwork. Challenges reflected issues with workload, technology issues, administrative demands, travel-related problems, communication and interruptions, difficulties with taking time off from work and maintaining work-life integration, and coping with witnessing grief/loss. Hospice workers glean satisfaction from making meaningful differences in the lives of patients with terminal illness and their family members. It is an expected part of the job that certain patients and situations are particularly distressing; team support and targeted grief support is available for those times. Participants indicated that workload and administrative demands rather than dealing with death and dying were the biggest contributors to burnout. Participants reported episodic symptoms of burnout followed by deliberate steps to alleviate these symptoms. Notably, for all except one of the participants, burnout was cyclical. Symptoms would begin, they would take steps to deal with it (e.g., taking a mental health day), and they recovered. At an organizational level, a multipronged approach that includes both personal and occupational strategies is needed to support professional caregivers and help mitigate the stressors associated with hospice work.
Authors
Lehto, RH; Heeter, C; Forman, J; Shanafelt, T; Kamal, A; Miller, P; Paletta, M
MLA Citation
Lehto, Rebecca H., et al. “Hospice Employees' Perceptions of Their Work Environment: A Focus Group Perspective.Int J Environ Res Public Health, vol. 17, no. 17, Aug. 2020. Pubmed, doi:10.3390/ijerph17176147.
URI
https://scholars.duke.edu/individual/pub1459936
PMID
32847036
Source
pubmed
Published In
International Journal of Environmental Research and Public Health
Volume
17
Published Date
DOI
10.3390/ijerph17176147

Index Symptoms and Prognosis Awareness of Patients With Pancreatic Cancer: A Multi-Site Palliative Care Collaborative.

BACKGROUND: Pancreatic cancer has a poor 5-year survival and carries significant morbidity. Pain is a commonly studied symptom in pancreatic cancer; however, few studies examine the frequency of multiple patient-reported symptoms. Our aim is to ascertain patient-reported symptom burden at initial consultation with a palliative care provider and compare patient prognostic awareness to provider estimation of prognosis. METHODS: Data were extracted from the standardized Quality Data Collection Tool (QDACT). Adults with pancreatic cancer seen by a palliative care provider were included. Descriptive statistics were used to describe demographic features, symptom prevalence and burden, as well as assess patient prognosis awareness defined by congruence or incongruence with provider estimated prognosis. RESULTS: 285 patients were included in our analysis. The average age was 68 years (SD: 12.4), 87.2% were white, 50% male. The mean number of moderate/severe symptoms was 2.6 (SD: 2) out of 9 symptoms. Tiredness (66.7%), appetite (64.5%) and pain (46.2%) had the highest rates of moderate/severe symptom burden. Patients with a prognosis of 1-6 months had the lowest proportion of congruence with provider estimation (56.5%). CONCLUSION: Our study suggests targets to improve patient-centered care of pancreatic cancer. Patients commonly have multiple symptoms that are moderate/severe at time of palliative care referral. While pain has been well-reported, tiredness and decreased appetite are more prevalent at initial visit. This emphasizes the importance of assessing multiple symptoms and working closely with palliative care for early referral. Overall, one third of patient prognosis estimates differed from the provider assessment of prognosis. Our data support the importance of early referral to palliative care to manage symptoms and better prepare patients for end-of-life care.
Authors
Johnson, AM; Wolf, S; Xuan, M; Samsa, G; Kamal, A; Fisher, DA
MLA Citation
Johnson, Alyson M., et al. “Index Symptoms and Prognosis Awareness of Patients With Pancreatic Cancer: A Multi-Site Palliative Care Collaborative.J Palliat Care, Mar. 2021, p. 8258597211001596. Pubmed, doi:10.1177/08258597211001596.
URI
https://scholars.duke.edu/individual/pub1476651
PMID
33730892
Source
pubmed
Published In
J Palliat Care
Published Date
Start Page
8258597211001596
DOI
10.1177/08258597211001596