Trends in the Aggressiveness of Cancer Care Near the End of Life

Earle, Craig C.; Neville, Bridget A.; Landrum, Mary Beth; Ayanian, John Z.; Block, Susan D.; Weeks, Jane C.

doi:10.1200/jco.2004.08.136

Cited by 860 publications

(894 citation statements)

References 31 publications

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“…In Ontario, there are nine such indicators, and five in NS. 43 Five (indicators 7, 9-11 and 13) are simple proportions showing prevalence across the population. Indicators 6 and 12 are described in Johnston et al 44 Finally, continuity of care (indicator 5) is represented by the Modified Modified Continuity Index (MMCI), 45 which is shown together with its components.…”

Section: Resultsmentioning

confidence: 99%

Towards using administrative databases to measure population-based indicators of quality of end-of-life care: testing the methodology

et al. 2006

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This study is concerned with methods to measure population-based indicators of quality end-oflife care. Using a retrospective cohort approach, we assessed the feasibility, validity and reliability of using administrative databases to measure quality indicators of end-of-life care in two Canadian provinces. The study sample consisted of all females who died of breast cancer between 1 January 1998 and 31 December 2002, in Nova Scotia or Ontario, Canada. From an initial list of 19 quality indicators selected from the literature, seven were determined to be fully measurable in both provinces. An additional seven indicators in one province and three in the other province were partially measurable. Tests comparing administrative and chart data show a high level of

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Section: Resultsmentioning

confidence: 99%

Towards using administrative databases to measure population-based indicators of quality of end-of-life care: testing the methodology

et al. 2006

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“…As many as 18% of advanced cancer patients in the United States are receiving chemotherapy within 14 days of death, a number that is increasing over time (Earle et al, 2004). Although misunderstanding or denial may contribute to this phenomenon, there are alternate explanations.…”

Section: Discussionmentioning

confidence: 99%

Enhancing treatment decision-making: pilot study of a treatment decision aid in stage IV non-small cell lung cancer

et al. 2008

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We developed a decision aid (DA) for patients with metastatic non-small cell lung cancer (NSCLC), to better inform patients of their prognosis and treatment options, and facilitate involvement in decision-making. In a pilot study, 20 patients with metastatic NSCLC attending outpatient clinics at a major cancer centre, who had already made a treatment decision, reviewed acceptability of the DA. The median age of the patients was 61 years (range 37 -77 years), 35% were male, 20% had a university education, and most (75%) had English as a first language. Most had received chemotherapy, with 65% currently on treatment. Patients were not anxious at baseline and had clear understanding of the goals and toxicity of chemotherapy in advanced NSCLC. After reviewing the DA, patients' anxiety decreased slightly (P ¼ 0.04) and knowledge scores improved by 25% (Po0.001). Most improvements in understanding were of prognosis with and without chemotherapy, although patients still believed advanced NSCLC to be curable. Patients rated the DA highly with respect to information clarity, usefulness and were positive about its use in practice, although 40% found the prognostic information slightly upsetting. The DA for advanced NSCLC is feasible, acceptable to patients and improves understanding of advanced NSCLC without increasing patient anxiety.

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“…Increasing use of chemotherapy at the end of life is associated with higher rates of in-hospital deaths and later admission to hospice, which are linked to lower quality end-of-life care. [72][73][74][75] When comparing male VA patients and Medicare patients with lung and colorectal cancer, VA patients were less likely to receive chemotherapy within 14 days of death or to be admitted to an ICU within 30 days of death, and they were similarly likely to have more than one emergency room visit within 30 days of death. 76 Among veterans who died in VA facilities, palliative care consults (67 % vs. 21 %, P < 0.001) and death in a dedicated palliative care, hospice unit, or intensive care unit were more common (47 % vs. 16 %, P < 0.001), and death in a nursing home was less common (10 % vs. 26 %, P < 0.001) than among veterans who died in non-VA facilities (all unadjusted results).…”

Section: Safetymentioning

confidence: 99%

Comparing VA and Non-VA Quality of Care: A Systematic Review

et al. 2016

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Trends in the Aggressiveness of Cancer Care Near the End of Life

Abstract: The treatment of cancer patients near death is becoming increasingly aggressive over time.

Cited by 860 publications

References 31 publications

Towards using administrative databases to measure population-based indicators of quality of end-of-life care: testing the methodology

Towards using administrative databases to measure population-based indicators of quality of end-of-life care: testing the methodology

Enhancing treatment decision-making: pilot study of a treatment decision aid in stage IV non-small cell lung cancer

Comparing VA and Non-VA Quality of Care: A Systematic Review

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