Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study
Ensuring high quality end of life (EOL) care is necessary for people with advanced non-small-cell lung cancer (NSCLC), given its high incidence, mortality and symptom burden. Aggressive EOL care can adversely affect the quality of life of NSCLC patients without providing meaningful oncologic benefit...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/28/5/286 |
| _version_ | 1797514924370427904 |
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| author | Catherine L. Goldie Paul Nguyen Andrew G. Robinson Craig E. Goldie Colleen E. Kircher Timothy P. Hanna |
| author_facet | Catherine L. Goldie Paul Nguyen Andrew G. Robinson Craig E. Goldie Colleen E. Kircher Timothy P. Hanna |
| author_sort | Catherine L. Goldie |
| collection | DOAJ |
| description | Ensuring high quality end of life (EOL) care is necessary for people with advanced non-small-cell lung cancer (NSCLC), given its high incidence, mortality and symptom burden. Aggressive EOL care can adversely affect the quality of life of NSCLC patients without providing meaningful oncologic benefit. Objectives: (1) To describe EOL health services quality indicators and timing of palliative care consultation provided to patients dying of NSCLC. (2) To examine associations between aggressive and supportive care and patient, disease and treatment characteristics. Methods: This retrospective population-based cohort study describes those who died of NSCLC in Ontario, Canada from 2009–2017. Socio-demographic, patient, disease and treatment characteristics as well as EOL health service quality and use of palliative care consultation were investigated. Multivariable logistic regression models examined factors associated with receiving aggressive or supportive care. Results: Aggressive care quality indicators were present in 50.3% and supportive care indicators in 60.3% of the cohort (N = 37,203). Aggressive care indicators decreased between 2009 and 2017 (57.4% to 45.3%) and increased for supportive care (54.2% to 67.5%). Benchmarks were not met by 2017 in 3 of 4 cases. Male sex and greater comorbidity were associated with more aggressive EOL care and less supportive care. Older age was negatively associated and rurality positively associated with aggressive care. No palliative care consultation occurred in 56.0%. Conclusions: While improvements in the use of supportive rather than aggressive care were noted, established Canadian benchmarks were not met. Moreover, there is variation in EOL quality between groups and use of earlier palliative care must improve. |
| first_indexed | 2024-03-10T06:38:26Z |
| format | Article |
| id | doaj.art-4e88419e0226404c81bb2e68db846052 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T06:38:26Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-4e88419e0226404c81bb2e68db8460522023-11-22T17:54:23ZengMDPI AGCurrent Oncology1198-00521718-77292021-08-012853297331510.3390/curroncol28050286Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based StudyCatherine L. Goldie0Paul Nguyen1Andrew G. Robinson2Craig E. Goldie3Colleen E. Kircher4Timothy P. Hanna5School of Nursing, Queen’s University, Kingston, ON K7L 3N6, CanadaICES Queen’s, Queen’s University, Kingston, ON K7L 3L4, CanadaSchool of Medicine, Queen’s University, Kingston, ON K7L 3N6, CanadaSchool of Medicine, Queen’s University, Kingston, ON K7L 3N6, CanadaSchool of Nursing, Queen’s University, Kingston, ON K7L 3N6, CanadaICES Queen’s, Queen’s University, Kingston, ON K7L 3L4, CanadaEnsuring high quality end of life (EOL) care is necessary for people with advanced non-small-cell lung cancer (NSCLC), given its high incidence, mortality and symptom burden. Aggressive EOL care can adversely affect the quality of life of NSCLC patients without providing meaningful oncologic benefit. Objectives: (1) To describe EOL health services quality indicators and timing of palliative care consultation provided to patients dying of NSCLC. (2) To examine associations between aggressive and supportive care and patient, disease and treatment characteristics. Methods: This retrospective population-based cohort study describes those who died of NSCLC in Ontario, Canada from 2009–2017. Socio-demographic, patient, disease and treatment characteristics as well as EOL health service quality and use of palliative care consultation were investigated. Multivariable logistic regression models examined factors associated with receiving aggressive or supportive care. Results: Aggressive care quality indicators were present in 50.3% and supportive care indicators in 60.3% of the cohort (N = 37,203). Aggressive care indicators decreased between 2009 and 2017 (57.4% to 45.3%) and increased for supportive care (54.2% to 67.5%). Benchmarks were not met by 2017 in 3 of 4 cases. Male sex and greater comorbidity were associated with more aggressive EOL care and less supportive care. Older age was negatively associated and rurality positively associated with aggressive care. No palliative care consultation occurred in 56.0%. Conclusions: While improvements in the use of supportive rather than aggressive care were noted, established Canadian benchmarks were not met. Moreover, there is variation in EOL quality between groups and use of earlier palliative care must improve.https://www.mdpi.com/1718-7729/28/5/286lung cancerend-of-life carequality indicatorspalliative carehealth services researchCanada |
| spellingShingle | Catherine L. Goldie Paul Nguyen Andrew G. Robinson Craig E. Goldie Colleen E. Kircher Timothy P. Hanna Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study Current Oncology lung cancer end-of-life care quality indicators palliative care health services research Canada |
| title | Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study |
| title_full | Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study |
| title_fullStr | Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study |
| title_full_unstemmed | Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study |
| title_short | Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study |
| title_sort | quality of end of life care for people with advanced non small cell lung cancer in ontario a population based study |
| topic | lung cancer end-of-life care quality indicators palliative care health services research Canada |
| url | https://www.mdpi.com/1718-7729/28/5/286 |
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