1. A Multicenter Retrospective Review of Systemic Anti-Cancer Treatment and Palliative Care Provided to Solid Tumor Oncology Patients in the 12 Weeks Preceding Death in Ireland
- Author
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Janice M. Walshe, Ray McDermott, Catherine M. Kelly, Laura Healy, Des Carney, Anna Linehan, Stephen P Higgins, Karen Ryan, John McCaffrey, M. Higgins, Fergal C. Kelleher, Orla Burke, Sara Picardo, and Victoria Mallett
- Subjects
medicine.medical_specialty ,Palliative care ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Neoplasms ,Medicine ,Humans ,030212 general & internal medicine ,Hospital Mortality ,Solid tumor ,Intensive care medicine ,Retrospective Studies ,Chemotherapy ,Terminal Care ,business.industry ,Palliative Care ,Retrospective cohort study ,General Medicine ,Immunotherapy ,Cancer treatment ,030220 oncology & carcinogenesis ,Oncology patients ,business ,End-of-life care ,Ireland - Abstract
Background: Systemic anti-cancer treatment (SACT) can improve symptoms and survival in patients with incurable cancer but there may be harmful consequences. Information regarding the use of SACT at the end-of-life and its impact on patients has not been described in Ireland. Aims: The study aimed to quantify and describe the use of SACT at end-of-life. The primary outcome of interest was the number of patients who received treatment in the last 12, 4 and 2 weeks of life. Secondary outcomes included the frequency of admissions and procedures, location of death, and timing of specialist palliative care (SPC) referral. Methods: Retrospective review. Fisher exact testing was used for analyses. Patients were included if they died between January 2015 and July 2017 and received at least 1 dose of treatment for a solid tumor malignancy. Results: Five hundred and eighty two patients were included. Three hundred and thirty eight (58%), 128 (22%) and 36 (6%) received treatment in the last 12, 4 and 2 weeks of life respectively. Patients who received chemotherapy in the last 12 weeks of life were more likely to be admitted to hospital, undergo a procedure, and die in hospital than those who did not (P < 0.001 for all). Median time of SPC referral before death was shorter in those patients who received chemotherapy than those who did not (61 v129 days, p = 0.0001). Conclusion: Patients who received chemotherapy had a higher likelihood of hospital admission, invasive procedure, and in-hospital death. They were less likely to have been referred early to SPC services.
- Published
- 2021