Effect of Palliative Care Services on the Aggressiveness of End-of-Life Care in the Veteran's Affairs Cancer Population

Gonsalves, Wilson I.; Tashi, Tsewang; Krishnamurthy, Jairam; Davies, T I; Ortman, Stephanie; Thota, Ramya; Aldoss, Ibrahim; Ganta, A.; Kalaiah, M.; Didwaniya, Neha; Eberle, Catherine; Ganti, Apar Kishor; Silberstein, Peter T.; Subbiah, Shanmuga

doi:10.1089/jpm.2011.0131

Cited by 69 publications

(80 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A previous retrospective study [30] showed that patients with advanced gynecologic malignancies followed up by PC teams, especially when follow-up occurred for more than two weeks before death, received less chemotherapy, sought emergency care less often and had lower rates of hospital and Intensive Care Unit stay for more than 14 days compared with patients not receiving PC. In a multivariate analysis involving age, staging, tumor type and race, receiving PC in a timely manner was the only significant predictor of fewer invasive measures at the end of life.…”

Section: Discussionmentioning

confidence: 99%

Early integration of palliative care facilitates the discontinuation of anticancer treatment in women with advanced breast or gynecologic cancers

Rugno

Paiva

2014

Gynecologic Oncology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Early integration of palliative care facilitates the discontinuation of anticancer treatment in women with advanced breast or gynecologic cancers

Rugno

Paiva

2014

Gynecologic Oncology

View full text Add to dashboard Cite

“…The VAMC has embarked on an ambitious training program to have palliative care available in all regions and settings (http://www.va.gov/GERIATRICS/guide/longtermcare/ Hospice_and_Palliative_Care.asp). Long-term data on outcomes from the VAMC expansion are not yet available, but preliminary data suggest that palliative care consultations can reduce the growing aggressiveness of care and use of critical care services, but only if given early in the disease trajectory and not during the terminal admission (40).…”

Section: Models That Workmentioning

confidence: 99%

The Growth of Palliative Care in the United States

Hughes

Smith

2014

Annu. Rev. Public Health

204

146

View full text Add to dashboard Cite

Palliative care has been one of the most rapidly growing fields of health care in the United States in the past decade. The benefits of palliative care have now been shown in multiple clinical trials, with increased patient and provider satisfaction, equal or better symptom control, more discernment of and honoring choices about place of death, fewer and less intensive hospital admissions in the last month of life, less anxiety and depression, less caregiver distress, and cost savings. The cost savings come from cost avoidance, or movement of a patient from a high cost setting to a lower cost setting. Barriers to expanded use include physician resistance, unrealistic expectations of patients and families, and lack of workforce. The future of palliative care includes more penetration into other fields such as nephrology, neurology, and surgery; further discernment of the most effective and cost-effective models; and establishment of more outpatient services.

show abstract

“…8,9 However, rates have been slowly rising over the last decade, and 5% to 22% of all patients with advanced cancer receive chemotherapy within 2 weeks of death. [2][3][4][10][11][12][13][14][15][16][17][18] Previous research on chemotherapy administration at EOL has primarily focused on predictors and outcomes. Although these studies have helped to identify the scope of the problem, few have examined when and how oncologists discontinue chemotherapy, including how the timing influences patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Processes of Discontinuing Chemotherapy for Metastatic Non–Small-Cell Lung Cancer at the End of Life

Pirl

Greer

Irwin

et al. 2015

JOP

View full text Add to dashboard Cite

Purpose: Administration of chemotherapy close to death is widely recognized as poor-quality care. Prior research has focused on predictors and outcomes of chemotherapy administration at the end of life. This study describes processes of chemotherapy discontinuation and examines their relationships with timing before death, hospice referral, and hospital death. Patients and Methods:We reviewed health records of a prospective cohort of 151 patients with newly diagnosed metastatic nonsmall-cell lung cancer who participated in a trial of early palliative care. Chemotherapy treatments during final regimen were qualitatively analyzed to identify categories of discontinuation processes. We then quantitatively compared predictors and outcomes of the process categories.

show abstract

Effect of Palliative Care Services on the Aggressiveness of End-of-Life Care in the Veteran's Affairs Cancer Population

Cited by 69 publications

References 14 publications

Early integration of palliative care facilitates the discontinuation of anticancer treatment in women with advanced breast or gynecologic cancers

Early integration of palliative care facilitates the discontinuation of anticancer treatment in women with advanced breast or gynecologic cancers

The Growth of Palliative Care in the United States

Processes of Discontinuing Chemotherapy for Metastatic Non–Small-Cell Lung Cancer at the End of Life

Contact Info

Product

Resources

About