Equal receipt of specialized palliative care in breast and prostate cancer: a register study

Abstract

Purpose There are inequalities in cancer treatment. This study aimed to investigate whether receipt of specialized palliative care (SPC) is affected by typical female and male diagnoses (breast and prostate cancer), age, socioeconomic status (SES), comorbidities as measured by the Charlson Comorbidity Index (CCI), or living arrangements (home vs nursing home residence). Furthermore, we wanted to investigate if receipt of SPC affects the place of death, or correlated with emergency department visits, or hospital admissions. Methods All breast and prostate cancer patients who died with verified distant metastases during 2015–2019 in the Stockholm Region were included (n = 2516). We used univariable and stepwise (forward) logistic multiple regression models. Results Lower age, lower CCI score, and higher SES significantly predicted receipt of palliative care 3 months before death (p = .007–p < .0001). Patients with prostate cancer, a lower CCI score, receiving palliative care services, or living in a nursing home were admitted to a hospital or visited an emergency room less often during their last month of life (p = .01 to < .0001). Patients receiving palliative care services had a low likelihood of dying in an acute care hospital (p < .001). Those who died in a hospital were younger, had a lower CCI score, and had received less palliative care or nursing home services (p = .02– < .0001). Conclusion Age, comorbidities, and nursing home residence affected the likelihood of receiving SPC. However, the diagnosis of breast versus prostate cancer did not. Emergency room visits, hospital admissions, and hospital deaths are registered less often for patients with SPC.

Patients with both cancer and psychosis—to what extent do they receive specialized palliative care

“…This descriptive registry study focused on patients who died from metastatic cancer and aimed to explore received SPC for those with a concomitant diagnosis of psychosis. The findings revealed that patients with psychosis were less likely to receive SPC, despite its proven benefits in reducing emergency room visits and deaths at acute hospitals for all patients 15–19 . This unequal access to SPC highlights a crucial issue.…”

“…The findings revealed that patients with psychosis were less likely to receive SPC, despite its proven benefits in reducing emergency room visits and deaths at acute hospitals for all patients. [15][16][17][18][19] This unequal access to SPC highlights a crucial issue.…”

A Review on the Application of Hospice Care in Patients with Advanced Cancer

“… 77 Multiple organ metastasis often occurs in patients with advanced breast cancer, which exacerbates the patient ‘s physical pain and seriously affects the quality of life of patients and their families. 78 A retrospective analysis by Bergqvist et al 79 found that hospice care for advanced breast cancer patients was influenced by multiple factors, whereas emergency room visits, hospitalizations, and in-hospital deaths were registered less frequently for advanced breast cancer patients receiving hospice care. Wan et al 80 analyzed 5481 patients with advanced breast cancer receiving palliative care and found that the effect of hospice care became more obvious with increasing patient age, and hospice care specifically significantly improved patients with advanced breast cancer.…”

Cuidados paliativos en adultos mayores con cáncer de próstata

“…Para mejorar la calidad de vida de todos los pacientes con cáncer de mama y de próstata metastásico, debemos garantizar que reciban los mismos cuidados paliativos especializados. (Bergqvist et al, 2022).…”