Care provided and care setting transitions in the last three months of life of cancer patients: a nationwide monitoring study ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-12-16

AUTHORS

Winne Ko, Luc Deliens, Guido Miccinesi, Francesco Giusti, Sarah Moreels, Gé A Donker, Bregje Onwuteaka-Philipsen, Oscar Zurriaga, Aurora López-Maside, Lieve Van den Block,

ABSTRACT

BACKGROUND: This is an international study across four European countries (Belgium[BE], the Netherlands[NL], Italy[IT] and Spain[ES]) between 2009 and 2011, describing and comparing care and care setting transitions provided in the last three months of life of cancer patients, using representative GP networks. METHODS: General practitioners (GPs) of representative networks in each country reported weekly all non-sudden cancer deaths (+18y) within their practice. GPs reported medical end-of-life care, communication and circumstances of dying on a standardised questionnaire. Multivariate logistic regressions (BE as a reference category) were conducted to compare countries. RESULTS: Of 2,037 identified patients from four countries, four out of five lived at home or with family in their last year of life. Over 50% of patients had at least one transition in care settings in the last three months of life; one third of patients in BE, IT and ES had a last week hospital admission and died there. In the last week of life, a treatment goal was adopted for 80-95% of those having palliation/comfort as their treatment goal. Cross-country differences in end-of-life care provision included GPs in NL being more involved in palliative care (67%) than in other countries (35%-49%) (OR 1.9) and end-of-life topics less often discussed in IT or ES. Preference for place of death was less often expressed in IT and ES (32-34%) than in BE and NL (49-74%). Of all patients, 88-98% were estimated to have distress from at least one physical symptom in the final week of life. CONCLUSION: Although palliative care was the main treatment goal for most cancer patients at the end of life in all four countries, frequent late hospital admissions and the symptom burden experienced in the last week of life indicates that further integration of palliative care into oncology care is required in many countries. More... »

PAGES

960

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1471-2407-14-960

DOI

http://dx.doi.org/10.1186/1471-2407-14-960

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1042701819

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25510507


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