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

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 at Amherst

Resident, Internal Medicine

Mayo Medical School

Fellowship, Hematology/ Oncology

Mayo Medical School

Grants:

Validating TOGETHER CARE, a mobile application ("app") for caregivers to implement home-based

Administered By
Duke Cancer Institute
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
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:

Letter to the Editor Regarding "Prevalence and Predictors of Burnout Among Hospice and Palliative Care Professionals".

Authors
Kamal, A; Bull, JH; Wolf, SP; Swetz, KM; Shanafelt, TD; Ast, K; Kavalieratos, D; Sinclair, CT
MLA Citation
Kamal, Arif, et al. “Letter to the Editor Regarding "Prevalence and Predictors of Burnout Among Hospice and Palliative Care Professionals"..” J Pain Symptom Manage, Nov. 2019. Pubmed, doi:10.1016/j.jpainsymman.2019.11.001.
URI
https://scholars.duke.edu/individual/pub1422021
PMID
31734409
Source
pubmed
Published In
J Pain Symptom Manage
Published Date
DOI
10.1016/j.jpainsymman.2019.11.001

Prevalence and Predictors of Burnout among Hospice and Palliative Care Clinicians in the US.

CONTEXT: Many clinical disciplines report high rates of burnout, which leads to low quality of care. Palliative care clinicians routinely manage patients with significant suffering, aiming to improve quality of life. As a major role of palliative care clinicians involves educating patients and caregivers regarding identifying priorities and balancing stress, we wondered how clinician self-management of burnout matches against the emotionally exhaustive nature of the work. OBJECTIVES: We sought to understand the prevalence and predictors of burnout using a discipline-wide survey. METHODS: We asked American Academy of Hospice and Palliative Medicine clinician members to complete an electronic survey querying demographic factors, job responsibilities, and the Maslach Burnout Inventory. We performed univariate and multivariable regression analyses to identify predictors of high rates of burnout. RESULTS: We received 1357 responses (response rate 30%). Overall, we observed a burnout rate of 38.7%, with higher rates reported by non-physician clinicians. Most burnout stemmed from emotional exhaustion, with depersonalization comprising a minor portion. Factors associated with higher odds of burnout include non-physician clinical roles, working in smaller organizations, working longer hours, being younger than 50 years of age, and working weekends. We did not observe different rates between palliative care clinicians and hospice clinicians. Higher rated self-management activities to mitigate burnout include participating in interpersonal relationships and taking vacations. CONCLUSIONS: Burnout is a major issue facing the palliative care clinician workforce. Strategies at the discipline-wide and individual levels are needed to sustain the delivery of responsive, available, high quality palliative care for all patients with serious illness.
Authors
Kamal, AH; Bull, JH; Wolf, SP; Swetz, KM; Shanafelt, TD; Ast, K; Kavalieratos, D; Sinclair, CT
MLA Citation
Kamal, Arif H., et al. “Prevalence and Predictors of Burnout among Hospice and Palliative Care Clinicians in the US..” J Pain Symptom Manage, Nov. 2019. Pubmed, doi:10.1016/j.jpainsymman.2019.11.017.
URI
https://scholars.duke.edu/individual/pub1422330
PMID
31778784
Source
pubmed
Published In
J Pain Symptom Manage
Published Date
DOI
10.1016/j.jpainsymman.2019.11.017

Specialized care of the terminally ill

Authors
Krouse, RS; Kamal, AH
MLA Citation
Krouse, R. S., and A. H. Kamal. “Specialized care of the terminally ill.” DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology, 2018, pp. 2242–48.
URI
https://scholars.duke.edu/individual/pub1370906
Source
scopus
Published Date
Start Page
2242
End Page
2248

Identifying Palliative Care Champions to Promote High-Quality Care to Those with Serious Illness.

Leading medical authorities advocate for routine integration of palliative care for all major causes of death in the United States. With rapid growth and acceptance, the field of palliative care is tasked with addressing a compelling question of its time: "Who will deliver timely, evidence-based palliative care to all who should benefit?" The current number of palliative care specialists will not suffice to meet the needs of persons with serious illness. In 2010, initial estimates quantified the shortage at 6000 to 18 000 additional palliative care physicians needed to fully staff existing programs. Unfortunately, the predicted number of specialty physicians in 2030 will likely not be larger than the workforce in existence today. These findings result in a physician-to-serious-illness-person ratio of about 1:28 000 in 2030.1 To address the workforce shortage, stronger alignment is needed between intensity of patient needs and provision of palliative care services. Such an alignment better harnesses the talents of those in a position to deliver core palliative care services (such as discussing goals of care with patients or managing their symptoms) while engaging palliative care specialists to address more complex issues. We introduce the concept of "Palliative Care Champions," who sit at the nexus between specialty palliative care and the larger clinical workforce. Acknowledging that the needs of most patients can be met by clinicians who have received basic palliative care training, and that specialty palliative care is not always available for those with more complex needs, there exists an important opportunity for those with additional interest to scale training and quality improvement to fill this void. J Am Geriatr Soc 67:S461-S467, 2019.
Authors
Kamal, AH; Bowman, B; Ritchie, CS
MLA Citation
Kamal, Arif H., et al. “Identifying Palliative Care Champions to Promote High-Quality Care to Those with Serious Illness..” J Am Geriatr Soc, vol. 67, no. S2, May 2019, pp. S461–67. Pubmed, doi:10.1111/jgs.15799.
URI
https://scholars.duke.edu/individual/pub1383594
PMID
31074852
Source
pubmed
Published In
Journal of the American Geriatrics Society
Volume
67
Published Date
Start Page
S461
End Page
S467
DOI
10.1111/jgs.15799

Hospice Use Among Patients with Heart Failure.

Despite its many benefits, hospice care is underused for patients with heart failure. This paper discusses the factors contributing to this underuse and offers recommendations to optimise use for patients with heart failure and proposes metrics to optimise quality of hospice care for this patient group.
Authors
Cross, SH; Kamal, AH; Taylor, DH; Warraich, HJ
MLA Citation
Cross, Sarah H., et al. “Hospice Use Among Patients with Heart Failure..” Card Fail Rev, vol. 5, no. 2, May 2019, pp. 93–98. Pubmed, doi:10.15420/cfr.2019.2.2.
URI
https://scholars.duke.edu/individual/pub1386537
PMID
31179019
Source
pubmed
Published In
Cardiac Failure Review
Volume
5
Published Date
Start Page
93
End Page
98
DOI
10.15420/cfr.2019.2.2