Effect of Palliative Care on Aggressiveness of End-of-Life Care Among Patients With Advanced Cancer

Triplett, Daniel P.; LeBrett, Wendi; Bryant, Alex K.; Bruggeman, Andrew; Matsuno, Rayna K.; Hwang, Larn; Boero, Isabel J.; Roeland, Eric; Yeung, H.; Murphy, James D.

doi:10.1200/jop.2017.020883

Cited by 71 publications

(64 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Those aggressive EOL treatments raised EOL-care costs, regardless of the healthcare system examined, without any significant benefit for the patient or his/her family in terms of improved quality of life 89. Early access to palliative care lowered the number of patients given aggressive treatments 90. Unfortunately, in most healthcare systems, early access to palliative care during the course of these cancers remains limited.…”

Section: Discussionmentioning

confidence: 99%

Lung cancer and end-of-life care: a systematic review and thematic synthesis of aggressive inpatient care

Bylicki

Didier

Rivière

et al. 2019

BMJ Support Palliat Care

View full text Add to dashboard Cite

ObjectivesDespite recent advances in thoracic oncology, most patients with metastatic lung cancer die within months of diagnosis. Aggressiveness of their end-of-life (EOL) care has been the subject of numerous studies. This study was undertaken to evaluate the literature on aggressive inpatient EOL care for lung cancer and analyse the evolution of its aggressiveness over time.MethodsA systematic international literature search restricted to English-language publications used terms associated with aggressiveness of care, EOL and their synonyms. Two independent researchers screened for eligibility and extracted all data and another a random 10% sample of the abstracts. Electronic Medline and Embase databases were searched (2000–20 September 2018). EOL-care aggressiveness was defined as follows: 1) chemotherapy administered during the last 14 days of life (DOL) or new chemotherapy regimen during the last 30 DOL; 2) >2 emergency department visits; 3) >1 hospitalisation during the last 30 DOL; 4) ICU admission during the last 30 DOL and 5) palliative care started <3 days before death.ResultsAmong the 150 articles identified, 42 were retained for review: 1 clinical trial, 3 observational cohorts, 21 retrospective analyses and 17 administrative data-based studies. The percentage of patients subjected to aggressive therapy seems to have increased over time. Early management by palliative care teams seems to limit aggressive care.ConclusionsOur analysis indicated very frequent aggressive EOL care for patients with lung cancer, regardless of the definition used. The extent of that aggressiveness and its impact on healthcare costs warrant further studies.

show abstract

Section: Discussionmentioning

confidence: 99%

Lung cancer and end-of-life care: a systematic review and thematic synthesis of aggressive inpatient care

Bylicki

Didier

Rivière

et al. 2019

BMJ Support Palliat Care

View full text Add to dashboard Cite

show abstract

“…71 In contrast, in the USA a similar population-based study examining use of palliative care services in Medicare patients with advanced cancer reported that only 4.5% of patients had had a palliative care encounter. 72…”

Section: End-of-life Carementioning

confidence: 99%

Understanding Survival Disparities in Gastric Cancer

La¹,

Merchant²

2019

Oncology &Amp; Hematology Review (US)

View full text Add to dashboard Cite

“…In a recent review Dalal and Bruera have reported that the magnitude of hospital cost savings with PC involvement ranged from 9% to 32% and these savings were higher when a PC team was involved earlier (within two days from the patient’s admission) [ 50 ]. Two recent studies [ 62 , 63 ] have pointed out that cancer patients’ care was characterized by high-cost and low-value interventions, high hospital readmission rates, prolonged length of stay, hospital deaths, and frequent use of chemotherapy and other disease-centered interventions near the EoL. These data are indicative of poor care coordination and inadequate EoL planning, and such a management translates into cost escalation, while patients continue to receive non-beneficial and burdensome health interventions at the EoL.…”

Section: What Is the Impact Of In-hospital Palliative Care Servicementioning

confidence: 99%

In-Hospital Palliative Care: Should We Need to Reconsider What Role Hospitals Should Have in Patients with End-Stage Disease or Advanced Cancer?

Cotogni

2018

JCM

View full text Add to dashboard Cite

Traditionally, palliative care (PC) systems focused on the needs of advanced cancer patients, but most patients needing PC have end-stage organ diseases. Similarly, PC models focus on the needs of patients in hospices or at home; however, in most cases PC is provided in acute hospitals. Indeed, the symptom burden that these patients experience in the last year of life frequently forces them to seek care in emergency departments. The majority of them are admitted to the hospital and many die. This issue poses important concerns. Despite the efforts of attending healthcare professionals, in-hospital patients do not receive optimal care near the end-of-life. Also, evidence is emerging that delay in identifying patients needing PC have a detrimental impact on their quality of life (QoL). Therefore, there is an urgent need to identify, early and properly, these patients among those hospitalized. Several trials reported the efficacy of PC in improving the QoL in these patients. Each hospital should ensure that a multidisciplinary PC team is available to support attending physicians to achieve the best QoL for both PC patients and their families. This review discusses the role and the impact of in-hospital PC in patients with end-stage disease or advanced cancer.

show abstract

Effect of Palliative Care on Aggressiveness of End-of-Life Care Among Patients With Advanced Cancer

Cited by 71 publications

References 29 publications

Lung cancer and end-of-life care: a systematic review and thematic synthesis of aggressive inpatient care

Lung cancer and end-of-life care: a systematic review and thematic synthesis of aggressive inpatient care

Understanding Survival Disparities in Gastric Cancer

In-Hospital Palliative Care: Should We Need to Reconsider What Role Hospitals Should Have in Patients with End-Stage Disease or Advanced Cancer?

Contact Info

Product

Resources

About