Cancer care near the end‐of‐life in Austria: A retrospective data analysis

Robausch, Martin; Grössmann, N.; Wild, Claudia

doi:10.1111/ecc.13423

Cited by 7 publications

(8 citation statements)

References 13 publications

(22 reference statements)

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“…Our study supports the evidence from previous investigations that PC admission has a relevant role in reducing various indicators of EOL aggressive care 5–14. In particular, we found that PC reduced hospitalisations by over 70%, long hospital stay by 75%, ED visit by 65%, and use of chemotherapy by 35% during the last month.…”

Section: Discussionsupporting

confidence: 91%

“…With reference to the indicators of aggressive EOL care analysed in our study, we found that about 45% of patients were hospitalised during the last 30 days of life, a value that is within the range between 40% and 65% reported in previous investigations 10–14 28. About 30% of patients with cancer in Lombardy died in hospital, a value among the lowest reported in other studies (between 30% and 70%) 4 10 11 13–15 17 28.…”

Section: Discussionsupporting

confidence: 74%

“…Patients treated with chemotherapy in our population were 8.5% in the last 30 days and 2.3% in the last 14 days. Although there is some variability in the data reported in previous studies (with values between 5% and 20% in the last 30 days, and between 2% and 10% in the last 14 days), chemotherapy exposure in our study appears quite low, particularly in the last 14 days 4 10–12 14 17 28 29. Although it is possible that we had somehow underestimated chemotherapy use, this is a favourable indicator of the practice of EOL in patients with cancer in this Italian region.…”

Section: Discussioncontrasting

confidence: 54%

“…Hospice and home palliative care (PC)—which has been fostered during the last decades in many high-income countries in order to better care (cancer) patients in the EOL—have been associated to a reduction of aggressive treatments in the EOL 5–14. Evidence also indicates that the earlier the admission to PC the less aggressive EOL care 10 15–18.…”

Section: Introductionmentioning

confidence: 99%

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Palliative medicine favourably influences end-of-life cancer care intensity: a large retrospective database study

Chiaruttini

Corli

Pizzuto

et al. 2022

BMJ Support Palliat Care

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ObjectivesHospice and home palliative care have been associated to a reduction of aggressive treatments in the end-of-life, but data in the Italian context are scanty. Therefore, we aim to investigate the role of palliative care on indicators of end-of-life intensity of care among patients with cancer in Lombardy, the largest Italian region.MethodsWithin a retrospective study using the healthcare utilisation databases of Lombardy, Italy, we selected all residents who died in 2019 with a diagnosis of cancer. We considered as exposure variables admission to palliative care and time at palliative care admission, and as indicators of aggressive care hospitalisations, diagnostic/therapeutic procedures, in-hospital death, emergency department visits and chemotherapy over a time window of 30 days before death; chemotherapy in the last 14 days was also considered.ResultsOur cohort included 26 539 individuals; of these, 14 320 (54%) were admitted to palliative care before death. Individuals who were admitted to palliative care had an odds ratio (OR) of 0.27 for one hospitalisation, 0.14 for ≥2 hospitalisations, 0.25 for hospital stay ≥12 days, 0.38 for minor diagnostic/therapeutic procedures, 0.18 for major diagnostic/therapeutic procedures, 0.02 for in-hospital death, 0.35 for one emergency department visit, 0.29 for ≥2 emergency department visits and 0.66 for chemotherapy use in the last 30 days; the OR was 0.56 for chemotherapy use in the last 14 days.ConclusionsThis large real-world analysis confirms and further support the importance of palliative care assistance for patients with cancer in the end- of- life; this is associated to a significant reduction in unnecessary treatments.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 74%

Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

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Palliative medicine favourably influences end-of-life cancer care intensity: a large retrospective database study

Chiaruttini

Corli

Pizzuto

et al. 2022

BMJ Support Palliat Care

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“…6 The treatment aggressiveness is not high or increasing universally. There are examples of low levels of aggressiveness in Austria 11 and even decreasing aggressiveness, although still at a high level. 7 It may be argued that the introduction of immunotherapy and targeted therapy allowed treating patients less aggressively and prolonged survival.…”

Section: Discussionmentioning

confidence: 99%

Aggressiveness in systemic anticancer therapy at the end of life in an oncology center

Ferraz-Gonçalves,

Silva,

Redondo

et al. 2024

Porto Biomedical Journal

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Introduction: An increasing aggressiveness in cancer treatment at the end of life (EoL) has been reported in several, but not all, countries. This study aimed to see how aggressive cancer treatment is at the EoL in an oncology center. Methods: Retrospective study of patients 18 years or older with a solid cancer diagnosis who died in 2017. The focus was systemic anticancer therapy (SACT), excluding hormonotherapy. Results: In 2017, 2024 patients with solid tumors died. Of those patients, 1262 (62%) were male, and the median age was 69 (range 19–97) years. The most frequent primary cancer was lung cancer, followed by colorectal and stomach cancers, and 740 (37%) patients had metastatic disease. The median interval between SACT and death was 61 days. Of the patients undergoing SACT, 216 (27%) did it in the last month of life, 174 (22%) between 8 and 30 days from death, and 42 (5%) in the last week. On multivariable analysis, head and neck, colorectal, breast, and melanoma primaries; age group (older than 65 years); and metastatic disease had statistical significance associated with SACT. Of these variables, only metastatic disease is more likely to undergo SACT. Conclusion: This study confirms the relatively frequent aggressiveness in cancer treatment at the EoL. Taking into consideration previously published data, it can be tentatively concluded that the use of SACT increased in the last month and the last week of life.

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The prevalence of end-of-life chemotherapy and targeted therapy in Japan, assessed using a health claims database

Tsuchiya

Obara

Kikuchi

et al. 2023

Cancer Chemother Pharmacol

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Cancer care near the end‐of‐life in Austria: A retrospective data analysis

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 7 publications

References 13 publications

Palliative medicine favourably influences end-of-life cancer care intensity: a large retrospective database study

Palliative medicine favourably influences end-of-life cancer care intensity: a large retrospective database study

Aggressiveness in systemic anticancer therapy at the end of life in an oncology center

The prevalence of end-of-life chemotherapy and targeted therapy in Japan, assessed using a health claims database

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