End-of-life patterns of symptom management and cancer-directed care among Medicare beneficiaries with lung cancer: a claims-based analysis

Davidoff, Amy J.; Canavan, Maureen; Prsic, Elizabeth Horn; Saphire, Maureen; Wang, Shiyi; Presley, Carolyn J.

doi:10.1007/s00520-020-05964-2

Cited by 7 publications

(4 citation statements)

References 25 publications

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“…In a SEER-Medicare database study, decedents diagnosed with lung cancer at age ≥ 66 years between January 2007 and December 2013, who survived ≥ 6 months from diagnosis were included [ 26 ]. Between 6 months and one month before death, full-month hospice and inpatient/skilled nursing increased.…”

Section: Discussionmentioning

confidence: 99%

Days at home in the last three months of life: patterns-of-care analysis in patients with non-small cell lung cancer

Nieder¹,

Aanes²,

Haukland³

2023

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Introduction To calculate the number of days patients with terminal non-small cell lung cancer (NSCLC) spent at home in the last 3 months of life, and to identify factors that predict a lower proportion of days at home. Material and methods Retrospective study of 434 deceased patients with NSCLC. The number of days spent in a hospital or nursing home was identified from electronic health records. Results Most patients received primary chemotherapy. Only 45% received palliative care provided by a dedicated palliative care team (PCT). In the last 3 months of life, only 39 patients (9%) were not hospitalized. The median number of days spent in hospital was 17, range 0–61. Hospital death occurred in 48%. Admission to a nursing home was recorded in 45%. Overall, the patients spent a median of 64 days at home. Both, older patients and females spent fewer days at home. Family network and aspects of palliative care, possibly reflecting the symptom duration or burden, also impacted days at home. Conclusions Long-lasting need for PCT support (not just the final 3 months) and earlier necessity for opioid analgesics were predictive for a reduced number of days at home. However, modifiable factors such as sex were identified too.

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Section: Discussionmentioning

confidence: 99%

Days at home in the last three months of life: patterns-of-care analysis in patients with non-small cell lung cancer

Nieder¹,

Aanes²,

Haukland³

2023

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“…Literature evidence shows that terminally-ill individuals may experience high burden of intractable pain and other distressing symptoms as they approach the final moments of life (Davidoff et al, 2021; Drageset et al, 2014; Saphire et al, 2020). International Association for the Study of Pain (IASP) Subcommittee on Taxonomy defined pain as “ an unpleasant sensory and emotional experience associated with actual or potential tissue damage or is described in terms of such damage ” (Raja et al, 2020).…”

Section: Clinical Signs and Symptoms That Show Eol Is Imminent In Ind...mentioning

confidence: 99%

A Review of Clinical Signs and Symptoms of Imminent End-of-Life in Individuals With Advanced Illness

Ijaopo

Zaw

Ijaopo

et al. 2023

Gerontology and Geriatric Medicine

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Background: World population is not only aging but suffering from serious chronic illnesses, requiring an increasing need for end-of-life care. However, studies show that many healthcare providers involved in the care of dying patients sometimes express challenges in knowing when to stop non-beneficial investigations and futile treatments that tend to prolong undue suffering for the dying person. Objective: To evaluate the clinical signs and symptoms that show end-of-life is imminent in individuals with advanced illness. Design: Narrative review. Methods: Computerized databases, including PubMed, Embase, Medline,CINAHL, PsycInfo, and Google Scholar were searched from 1992 to 2022 for relevant original papers written in or translated into English language that investigated clinical signs and symptoms of imminent death in individuals with advanced illness. Results: 185 articles identified were carefully reviewed and only those that met the inclusion criteria were included for review. Conclusion: While it is often difficult to predict the timing of death, the ability of healthcare providers to recognize the clinical signs and symptoms of imminent death in terminally-ill individuals may lead to earlier anticipation of care needs and better planning to provide care that is tailored to individual’s needs, and ultimately results in better end-of-life care, as well as a better bereavement adjustment experience for the families.

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“…9 Treatment with docetaxel, which has been considered the conventional approach of treating patients who have progressed after a platinum-based regimen, has not produced significant benefits in HRQoL via reduction in symptom burden. 10,11 Clinical trials conducted recently on therapies that aim at the programmed cell death protein-1 (PD-1) and programmed death-ligand 1 (PD-L1) pathway, known as PD-(L)1 inhibitors, have exhibited clinical benefit compared to docetaxel for patients who have advanced refractory NSCLC. [12][13][14][15][16][17] Along with clinical improvements, a reduction in some of the lung cancerrelated symptoms and improved HRQoL have also been reported in patients who received a PD-(L)1 inhibitor as a second-line therapy compared to those who were treated with docetaxel.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment with docetaxel, which has been considered the conventional approach of treating patients who have progressed after a platinum‐based regimen, has not produced significant benefits in HRQoL via reduction in symptom burden 10,11 . Clinical trials conducted recently on therapies that aim at the programmed cell death protein‐1 (PD‐1) and programmed death‐ligand 1 (PD‐L1) pathway, known as PD‐(L)1 inhibitors, have exhibited clinical benefit compared to docetaxel for patients who have advanced refractory NSCLC 12–17 .…”

Section: Introductionmentioning

confidence: 99%

The effects of tislelizumab treatment on the health‐related quality of life of patients with advanced non‐small cell lung cancer

Huang,

Zhou,

Barnes

et al. 2023

Cancer Medicine

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This study examined the health‐related quality of life (HRQoL) of patients with advanced non‐small cell lung cancer (NSCLC) receiving tislelizumab versus docetaxel in the open‐label, multicenter, Phase 3 trial called RATIONALE‐303 (NCT03358875). HRQoL was assessed with the EORTC QLQ‐C30, EORTC QLQ‐LC13, and the EQ‐5D‐5L instruments. A longitudinal analysis of covariance assessed the change from baseline to Week 12 and from baseline to Week 18. A time to deterioration analysis was also performed using the Kaplan–Meier method. Eight hundred and five patients were randomized to either tislelizumab (n = 535) or docetaxel, respectively (535 and 270 to tislelizumab and docetaxel, respectively). The tislelizumab arm improved while the docetaxel arm worsened in the QLQ‐C30 global health status/QoL scale score (difference LS mean change Week 18: 5.7 [95% CI: 2.38, 9.07, p = 0.0008]), fatigue (Week 12: ‐3.2 [95% CI: −5.95, −0.37, p < 0.0266]; Week 18: −4.9 [95% CI: −8.26, −1.61, p = 0.0037]), and QLQ‐LC13 symptom index score (Week 12: −5.5 [95% CI: −6.93, −4.04, P < 0.0001]; Week 18: −6.6 [95% CI: −8.25, −4.95, p < 0.0001]). The tislelizumab arm had improvements in coughing versus the docetaxel arm (Week 12: −4.7 [95% CI: −8.57, −0.78, p = 0.0188]; Week 18: −8.3 [95% CI: −13.02, −3.51, p = 0.0007]). The patients who received tislelizumab were less at risk for clinically meaningful worsening in the overall lung cancer symptom index scale (hazard ratio (HR): 0.24 [95% CI: 0.162, 0.356], p < 0.0001), dyspnea (HR: 0.74 [95% CI: 0.567, 0.958], p = 0.0109), coughing (HR: 0.74 [95% CI: 0.534, 1.019], p = 0.0309), and peripheral neuropathy (HR: 0.55 [95% CI: 0.370, 0.810] p = 0.0011). In general, tislelizumab versus docetaxel was associated with improved HRQoL and symptoms of lung cancer in patients who previously failed treatment with platinum‐containing chemotherapy.

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End-of-life patterns of symptom management and cancer-directed care among Medicare beneficiaries with lung cancer: a claims-based analysis

Cited by 7 publications

References 25 publications

Days at home in the last three months of life: patterns-of-care analysis in patients with non-small cell lung cancer

Days at home in the last three months of life: patterns-of-care analysis in patients with non-small cell lung cancer

A Review of Clinical Signs and Symptoms of Imminent End-of-Life in Individuals With Advanced Illness

The effects of tislelizumab treatment on the health‐related quality of life of patients with advanced non‐small cell lung cancer

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