OHP-080 Use of Chemotherapy Near the End of Life

Martín, A. León; Ibáñez, Sergio José; Blázquez, C.; Muñoz, BM; Franco, M.; Fernández, AI; Rodríguez, María Librada Rozas; Pérez, Rafael López; Encinas, Carmen

doi:10.1136/ejhpharm-2013-000276.453

Cited by 2 publications

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“…In our study, female gender was also associated with higher odds of receiving chemotherapy during the last 14 days before death, which has not been confirmed by other authors. 6,9 Furthermore, in contrast to other studies, the prescribing unit was not a predictive factor. 18 When we examined the proportion of patients starting a new chemotherapy regimen in the last 30 days of life, we also looked at the use of off-label medicines (those used in conditions different to those authorized).…”

Section: Discussioncontrasting

confidence: 86%

“…Taberner Bonastre et al found that 21.7% of patients received chemotherapy in the last 2 weeks of life, 8 while Martín et al reported a total of 27.5% of patients. 9 Recently, Baena-Cañ ada et al showed that 15.3% of patients in an oncological setting in Spain received systemic anticancer therapy in the last 2 weeks of life, and 32.6% did in the last month of life. 10 On the other hand, only 11.3% of patients received chemotherapy in the last 2 weeks of life in a French cohort study.…”

Section: Discussionmentioning

confidence: 99%

“…5 Despite the scarcity of data at a European level, it seems that end-of-life treatment is aggressive in many cases. [7][8][9][10] The purpose of this study is to analyze the proportion of onco-hematological patients who received chemotherapy within their last 2 weeks of life and the proportion of patients who started a new chemotherapy regimen in the 30 days prior to their death in hospital. The secondary objectives are to describe the clinical variables of those patients receiving chemotherapy in the final stage of their lives and the type of treatment they received.…”

Section: Introductionmentioning

confidence: 99%

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Chemotherapy Near the End of Life in Onco–Hematological Adult Patients

Sánchez-Cuervo

García-Basas

Silanes

et al. 2020

Am J Hosp Palliat Care

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Objective: The use of chemotherapy near the end of life is not advisable. There are scarce data in Europe but shows signs of aggressiveness. We designed this study to analyze the proportion of onco–hematological patients receiving chemotherapy within their last 2 weeks of life as well as starting a new chemotherapy regimen in the 30 days prior to death. Methods: A retrospective observational study was conducted in a tertiary hospital. Adults who died of an onco-hematological neoplasia while hospitalized between April 2017 and March 2018 were included. We assessed the use of chemotherapy over the course of the last 14 days of life, defined as the administration of at least one dose of chemotherapy. We also examined the proportion of patients starting a new chemotherapy regimen in the last 30 days of life. Results: A total of 298 inpatients died in the Hematology and Oncology units. During the last 14 days, 28.2% (n = 11) of hematological and 26.3% (n = 68) of oncological patients received chemotherapy; the overall rate was 26.5% (n = 79). Furthermore, the proportion of patients starting a new chemotherapy regimen in the last 30 days of life was high (20.5% and 20.8%, respectively). Female gender (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 1.18-3.35) and age <45 (OR = 2.68, 95% CI = 1.05-6.88) were associated with higher rates of chemotherapy. Conclusion: The proportion of patients receiving chemotherapy in the last 14 days of life was high, as well as the proportion of patients starting a new regimen in their last 30 days. This was indicative of excessive aggressiveness at the end-of-life care.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chemotherapy Near the End of Life in Onco–Hematological Adult Patients

Sánchez-Cuervo

García-Basas

Silanes

et al. 2020

Am J Hosp Palliat Care

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Evaluating aggressiveness of end-of-life care in patients with advanced cancer: A retrospective single-center analysis

Iglesias-Santamaría

2022

J Oncol Pharm Pract

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Introduction Overuse of anti-cancer therapy near end of life is an important quality-of-care issue. An aggressive approach to treatment can have negative effects on the quality of life and cost of hospital-based resources. The objective of this study was to measure indicators of potential aggressiveness of end-of-life care in a cohort of adult patients with advanced solid tumor. The secondary objective was to analyze the association between clinicopathological variables and indicators of aggressiveness. Methods Retrospective data analysis was performed on adult patients with solid tumors who received palliative chemotherapy for advanced cancer and died in our hospital between 2017 and 2019. Indicators of aggressiveness of end of life care included chemotherapy use in the last days of life, emergency room visits and hospitalizations (including intensive care unit admissions) in this period, and referral to a palliative care unit before death. Univariate and multivariate analyses were conducted to identify the variables that independently predicted the use of palliative chemotherapy near end of life. Results Of the 571 patients included, 128 (22.4%) received chemotherapy within the last 2 weeks of life and 102 (17.8%) start a new chemotherapy regimen 30 days before death. During the last month of life, 168 patients (32.9%) visited emergency room more than once and 117 (20.5%) were hospitalized more than once. A total of 294 patients (51.5%) died in the acute care unit and 285 (49.9%) were referred to the palliative care unit. 24 of them (8.4%) died within 72h after referral. Conclusions The percentage of patients receiving chemotherapy near the end of life as well as the rate of emergency room visits and hospitalizations during this period are much higher than the value of the quality standard established in the literature. According to these indicators, cancer patient care at end of life can be considered overly aggressive. Optimization of palliative care at end of life is necessary.

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OHP-080 Use of Chemotherapy Near the End of Life

Cited by 2 publications

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Chemotherapy Near the End of Life in Onco–Hematological Adult Patients

Chemotherapy Near the End of Life in Onco–Hematological Adult Patients

Evaluating aggressiveness of end-of-life care in patients with advanced cancer: A retrospective single-center analysis

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