Palliative Care is Associated with Reduced Aggressive End-of-Life Care in Patients with Gastrointestinal Cancer

Abstract

The majority of patients received PC within 2 years of death. A larger number of days of PC was associated with a greater reduction in aggressive EOLC.

Management and intensity of medical end‐of‐life care in people with colorectal cancer during the year before their death in 2015: A French national observational study

“…More specifically, a Canadian study on patients with CRC as cause of death (2006‐2010), reported 50% of deaths in SSH, a lower proportion than that observed in this study, with variations according to the zone of residence . The proportion of each place of death and the mode of management can vary according to the definition of the cases included, either people who died while being managed for cancer or people for whom cancer was the main cause of death, the study period, but also according to age, the type of cancer, its stage and its history, and comorbidities, including associated cancers, as well as the development and organization of palliative care . Observed frequencies vary according to organization of end‐of‐life care or palliative care in each country, either mainly in short‐stay hospitals, as in France, or by preferring discharge from hospital and management at home or in hospices.…”

“…The use of palliative care, especially at an early stage, had a positive impact on the patient's quality of life and was associated with decreased intensity of medical health-care utilization and decreased use of aggressive treatments during the last month of life. 11,17 In this study, the presence of HPC during the year preceding death or at the time of death was identified for 60% of patients. As in other studies, patients managed by palliative care were younger and presented fewer comorbidities.…”

“…15 The proportion of each place of death and the mode of management can vary according to the definition of the cases included, either people who died while being managed for cancer or people for whom cancer was the main cause of death, the study period, but also according to age, the type of cancer, its stage and its history, and comorbidities, including associated cancers, as well as the development and organization of palliative care. [10][11][12][13][14][15][16][17] Observed frequencies vary according to organization of end-of-life care or palliative care in each country, either mainly in short-stay hospitals, as in France, or by preferring discharge from hospital and management at home or in hospices. In France, nursing home care or hospice care are not developed as in countries with management at home or in a hospice before dearth, as in the United States where an increasing number of deaths in hospices has been reported (42% of patients 65 years and older with cancer, chronic obstructive pulmonary disease, or dementia in 2009) or Taiwan (47% in 2010-2).…”

“…Nevertheless, few individual data were available and analyzed together. About colorectal cancer (CRC), there is a lack of data available for the end‐of‐life care pathways and intensity of medical care, their causes of death and associated expenditure, and they are mainly derived from studies based on small sample sizes . The incidence of CRC in France was estimated to be 23 200 cases in 2018 with 9200 deaths (46% of women each) .…”

Does early palliative identification improve the use of palliative care services?

“…Palliative care is focused on managing the physical, psychosocial, and spiritual needs of patients with life-threatening illnesses [1]. Early identification of patients who may benefit from a palliative approach to care has led to improved clinical outcomes, symptom control, quality of life and more efficient target use of health system resources across different populations of cancer patients [2][3][4][5][6].…”