Association between Consultation by a Comprehensive Integrated Palliative Care Program and Quality of End-of-Life Care in Patients with Advanced Cancer in Edmonton, Canada
Literature assessing the impact of palliative care (PC) consultation on aggressive care at the end of life (EOL) within a comprehensive integrated PC program is limited. We retrospectively reviewed patients with advanced cancer who received oncological care at a Canadian tertiary center, died betwee...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/30/1/68 |
| _version_ | 1827626943947735040 |
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| author | Cara Robertson Sharon M. Watanabe Aynharan Sinnarajah Alexei Potapov Viane Faily Yoko Tarumi Vickie E. Baracos |
| author_facet | Cara Robertson Sharon M. Watanabe Aynharan Sinnarajah Alexei Potapov Viane Faily Yoko Tarumi Vickie E. Baracos |
| author_sort | Cara Robertson |
| collection | DOAJ |
| description | Literature assessing the impact of palliative care (PC) consultation on aggressive care at the end of life (EOL) within a comprehensive integrated PC program is limited. We retrospectively reviewed patients with advanced cancer who received oncological care at a Canadian tertiary center, died between April 2013 and March 2014, and had access to PC consultation in all healthcare settings. Administrative databases were linked, and medical records reviewed. Composite score for aggressive EOL care was calculated, assigning a point for each of the following: ≥2 emergency room visits, ≥2 hospitalizations, hospitalization >14 days, ICU admission, and chemotherapy administration in the last 30 days of life, and hospital death. Multivariable logistic regression was adjusted for age, sex, income, cancer type and PC consultation for ≥1 aggressive EOL care indicator. Of 1414 eligible patients, 1111 (78.6%) received PC consultation. In multivariable analysis, PC consultation was independently associated with lower odds of ≥1 aggressive EOL care indicator (OR 0.49, 95% CI 0.38–0.65, <i>p</i> < 0.001). PC consultation >3 versus ≤3 months before death had a greater effect on lower aggressive EOL care (mean composite score 0.59 versus 0.88, <i>p</i> < 0.001). We add evidence that PC consultation is associated with less aggressive care at the EOL for patients with advanced cancer. |
| first_indexed | 2024-03-09T13:04:41Z |
| format | Article |
| id | doaj.art-5721832aa09c4c78b92ccf73a07734dd |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T13:04:41Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-5721832aa09c4c78b92ccf73a07734dd2023-11-30T21:49:49ZengMDPI AGCurrent Oncology1198-00521718-77292023-01-0130189790710.3390/curroncol30010068Association between Consultation by a Comprehensive Integrated Palliative Care Program and Quality of End-of-Life Care in Patients with Advanced Cancer in Edmonton, CanadaCara Robertson0Sharon M. Watanabe1Aynharan Sinnarajah2Alexei Potapov3Viane Faily4Yoko Tarumi5Vickie E. Baracos6Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, AB T6G 1Z2, CanadaDivision of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, AB T6G 1Z2, CanadaDivision of Palliative Medicine, Queen’s University, Kingston, ON L1G 2B9, CanadaDivision of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, AB T6G 1Z2, CanadaMedical College of Wisconsin Affiliated Hospitals, Milwaukee, WI 53226, USADivision of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, AB T6G 1Z2, CanadaDivision of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, AB T6G 1Z2, CanadaLiterature assessing the impact of palliative care (PC) consultation on aggressive care at the end of life (EOL) within a comprehensive integrated PC program is limited. We retrospectively reviewed patients with advanced cancer who received oncological care at a Canadian tertiary center, died between April 2013 and March 2014, and had access to PC consultation in all healthcare settings. Administrative databases were linked, and medical records reviewed. Composite score for aggressive EOL care was calculated, assigning a point for each of the following: ≥2 emergency room visits, ≥2 hospitalizations, hospitalization >14 days, ICU admission, and chemotherapy administration in the last 30 days of life, and hospital death. Multivariable logistic regression was adjusted for age, sex, income, cancer type and PC consultation for ≥1 aggressive EOL care indicator. Of 1414 eligible patients, 1111 (78.6%) received PC consultation. In multivariable analysis, PC consultation was independently associated with lower odds of ≥1 aggressive EOL care indicator (OR 0.49, 95% CI 0.38–0.65, <i>p</i> < 0.001). PC consultation >3 versus ≤3 months before death had a greater effect on lower aggressive EOL care (mean composite score 0.59 versus 0.88, <i>p</i> < 0.001). We add evidence that PC consultation is associated with less aggressive care at the EOL for patients with advanced cancer.https://www.mdpi.com/1718-7729/30/1/68palliative careend of life carequality indicatorsaggressive care |
| spellingShingle | Cara Robertson Sharon M. Watanabe Aynharan Sinnarajah Alexei Potapov Viane Faily Yoko Tarumi Vickie E. Baracos Association between Consultation by a Comprehensive Integrated Palliative Care Program and Quality of End-of-Life Care in Patients with Advanced Cancer in Edmonton, Canada Current Oncology palliative care end of life care quality indicators aggressive care |
| title | Association between Consultation by a Comprehensive Integrated Palliative Care Program and Quality of End-of-Life Care in Patients with Advanced Cancer in Edmonton, Canada |
| title_full | Association between Consultation by a Comprehensive Integrated Palliative Care Program and Quality of End-of-Life Care in Patients with Advanced Cancer in Edmonton, Canada |
| title_fullStr | Association between Consultation by a Comprehensive Integrated Palliative Care Program and Quality of End-of-Life Care in Patients with Advanced Cancer in Edmonton, Canada |
| title_full_unstemmed | Association between Consultation by a Comprehensive Integrated Palliative Care Program and Quality of End-of-Life Care in Patients with Advanced Cancer in Edmonton, Canada |
| title_short | Association between Consultation by a Comprehensive Integrated Palliative Care Program and Quality of End-of-Life Care in Patients with Advanced Cancer in Edmonton, Canada |
| title_sort | association between consultation by a comprehensive integrated palliative care program and quality of end of life care in patients with advanced cancer in edmonton canada |
| topic | palliative care end of life care quality indicators aggressive care |
| url | https://www.mdpi.com/1718-7729/30/1/68 |
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