Palliative care needs, symptoms, and treatment intensity along the disease trajectory in medical oncology outpatients: A retrospective chart review
Bükki J, Scherbel J, Stiel S, Klein C, Meidenbauer N, Ostgathe C (2013)
Publication Status: Published
Publication Type: Journal article, Original article
Publication year: 2013
Journal
Publisher: Springer Verlag (Germany)
Book Volume: 21
Pages Range: 1743-1750
Journal Issue: 6
DOI: 10.1007/s00520-013-1721-y
Abstract
Background: Early integration of palliative care into cancer disease management is beneficial for patients with advanced tumors. However, little is known about the association of palliative care interventions with symptom burden and treatment aggressiveness at the end of life (EoL). Methods: To assess determinants of symptom burden and treatment intensity at the EoL, a retrospective chart review was conducted in university cancer clinic outpatients who died between July 2009 and June 2011. The objective was the correlation of place of death, palliative care utilization, prior EoL discussion, and social background (determinant variables) with symptom burden and treatment intensity (outcome variables). Results: Ninety-six patients (61 men and 35 women) died; the mean age at death was 62.4 years (range 24-83). Mean duration of treatment was 17.9 months (range 1-129). Data on the last 14 days (3) of life were available for 62 (44) patients. Forty-seven patients received aggressive EoL care which was strongly associated with hospital death (p = 0.000, χ test). The 15 patients having used palliative care services or dying in a palliative care unit (PCU) had fewer symptoms (p = 0.006, t test) and interventions (p = 0.000, t test) at the EoL. Having addressed EoL issues was correlated with fewer procedures during the last 3 days (p = 0.035, t test). Conclusions: Most cancer patients receive aggressive EoL care interfering with quality of life. Despite limitations by small sample size and missing data, the results suggest that palliative care utilization is associated with reduced symptom burden and intensity of treatment at the EoL. Timely discussion of EoL issues may reduce the number of unnecessary interventions and facilitate referral to the PCU. © 2013 Springer-Verlag Berlin Heidelberg.
Authors with CRIS profile
Carsten Klein
Department of Palliative Medicine
Norbert Meidenbauer
Department of Medicine 5 – Haematology and Oncology
Christoph Ostgathe
Department of Palliative Medicine
Involved external institutions
Germany (DE)How to cite
APA:
Bükki, J., Scherbel, J., Stiel, S., Klein, C., Meidenbauer, N., & Ostgathe, C. (2013). Palliative care needs, symptoms, and treatment intensity along the disease trajectory in medical oncology outpatients: A retrospective chart review. Supportive Care in Cancer, 21(6), 1743-1750. https://doi.org/10.1007/s00520-013-1721-y
MLA:
Bükki, Johannes, et al. "Palliative care needs, symptoms, and treatment intensity along the disease trajectory in medical oncology outpatients: A retrospective chart review." Supportive Care in Cancer 21.6 (2013): 1743-1750.
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