Palliative Care Involvement Is Associated with Less Intensive End-of-Life Care in Adolescent and Young Adult Oncology Patients

2017 ◽  
Vol 20 (5) ◽  
pp. 509-516 ◽  
Author(s):  
Jennifer M. Snaman ◽  
Erica C. Kaye ◽  
Jessie J. Lu ◽  
April Sykes ◽  
Justin N. Baker
Keyword(s):  
Palliative Care ◽  
Young Adult ◽  
End Of Life ◽  
End Of Life Care ◽  
Adolescent And Young Adult ◽  
Life Care ◽  
Oncology Patients ◽  
Young Adult Oncology

The effect of a multidisciplinary palliative care initiative on end-of-life care in gynecologic oncology patients

2017 ◽  
Vol 145 ◽  
pp. 23
Author(s):  
M.M. Mullen ◽  
L.M. Divine ◽  
B. Porcelli ◽  
I. Wilkinson-Ryan ◽  
M. Dans ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Gynecologic Oncology ◽  
Life Care ◽  
Oncology Patients

ICU utilization among oncology patients at the end of life.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 118-118
Author(s):  
Jennifer Hong ◽  
Christine Kurian ◽  
Jared Minetola ◽  
Valerie Pracilio Csik ◽  
Adam Binder
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Academic Medical Center ◽  
Cancer Type ◽  
Life Care ◽  
Oncology Patients ◽  
Code Status ◽  
Care Plans

118 Background: Patients with advanced cancer have high rates of hospitalizations as a result of their oncologic care. Furthermore, these patients receive aggressive end of life care despite evidence that aggressive end of life care does not improves quality of life or outcomes for patients and is associated with worse bereavement adjustment for caregivers. The American Society of Clinical Oncology has endorsed several indicators of aggressive end of life care, but most striking is intensive care unit (ICU) admission within 30 days before death. Methods: Adult oncology patients who died within 30 days of hospitalization and/or admitted to the ICU from 10/2018-3/2019 at an academic medical center were evaluated. The cohort was identified using ICD-10 codes, EMR systems support, and manual chart review. Patient demographic data, cancer type, stage, line of therapy, code status, advanced care plan, prior admissions as well as other clinical characteristics were collected. Results: In total, 180 patients were included for analysis; 106 of which were admitted to the ICU. Of patients admitted to the ICU, 58 patients died (54.7%). Mean ECOG performance status was 1.24. Average number of admissions 3 and 6 months prior to death was 0.71 and 1.26. Thirty six percent of patients were on first or second-line chemotherapy. 41.37% of patients who died in the ICU had prolonged length of stay (>1 week). Only 34.48% were known to palliative care prior to admission and 12.06% of patients had advanced care plans in place at time of hospitalization. Palliative care was consulted on 32.75% of patients who died in the ICU. Ninety Three percent had their code status changed prior to death. Conclusions: Despite established recommendations to support otherwise, at our institution there continues to be high utilization of ICU care near the end of life. Previous admissions and ECOG status are poor predictors of death in this cohort. The majority of patients had relapsed and refractory disease. There was a low rate of advanced care planning or palliative care involvement prior to the patient’s hospitalization. Further interventions are underway to improve end of life planning in order to improve our quality of care.

The effect of a multidisciplinary palliative care initiative on end of life care in gynecologic oncology patients

2017 ◽  
Vol 147 (2) ◽  
pp. 460-464 ◽  
Author(s):  
Mary M. Mullen ◽  
Laura M. Divine ◽  
Bree P. Porcelli ◽  
Ivy Wilkinson-Ryan ◽  
Maria C. Dans ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Gynecologic Oncology ◽  
Life Care ◽  
Oncology Patients

Assessing the Unique Experiences and Needs of Muslim Oncology Patients Receiving Palliative and End-of-Life Care: An Integrative Review

2018 ◽  
Vol 34 (1) ◽  
pp. 52-61 ◽  
Author(s):  
Carolina Gustafson ◽  
Mark Lazenby
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Delivery ◽  
Data Extraction ◽  
Integrative Review ◽  
Life Care ◽  
Oncology Patients ◽  
Care Models ◽  
Patient Care Delivery

The objective of this review was to detail the experiences of Muslim oncology patients receiving palliative and end-of-life care and identify where gaps in the providing of culturally aware care occur. We also sought to examine ways in which providers could be better educated on the needs of Muslim patients at the end-of-life and identify barriers Muslims faced when being treated with hospice and palliative care models developed for non-Muslim populations. We conducted a search in April 2018 in the National Library of Medicine and CINAHL databases using the search terms “palliative care,” “Muslim,” and “cancer.” Included were articles with focuses on adult Muslims with palliative and end-of-life care experiences. We then followed the PRISMA guidelines for an integrative review and used a data extraction matrix to identify 20 papers that met the inclusion criteria of the review. We identified four major themes patient experiences, patient care delivery suggestions, Muslim provider experiences, and definitions of death, present in all 20 papers of the review. Each of the included papers was categorized based on the dominant theme in the paper. This review ultimately found that the care provided to Muslim patients is subpar for the standard of culturally competent care and that the needs of Muslim patients at the end-of-life, as well as the needs of their families, are not being met. Moving forward further research on this topic is needed with a particular focus on examining the experiences of terminally ill Muslim patients receiving treatment in non-Muslim majority settings.

Evaluating risk characteristics for patients who die within 30 days of hospitalization.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 161-161
Author(s):  
Christine Kurian ◽  
Jennifer Hong ◽  
Andrea Sweeney ◽  
Laetitia N'Dri ◽  
Karen Walsh ◽  
...  
Keyword(s):  
Palliative Care ◽  
Logistic Regression ◽  
Length Of Stay ◽  
End Of Life ◽  
End Of Life Care ◽  
Nutrition Status ◽  
Care Planning ◽  
Life Care ◽  
Oncology Patients ◽  
Code Status

161 Background: Advanced cancer patients often receive aggressive end of life care despite questionable benefit. As a result, there are ongoing efforts to improve end of life care and coordinate palliative care supportive services. This study is an expansion of a previous study performed examining descriptive data in a population of oncology patients who died within 30 days of admission. Here, we compare patients who died within 30 days of admission against those who survived to evaluate differences in patient characteristics and healthcare utilization. Methods: Adult oncology patients who were admitted from 10/1/2018-3/30/2019 at an academic medical center were evaluated. Two groups of patients were studied–oncology patients who died within thirty days of admission and those who survived. The patients were selected using ICD-10 codes, EMR systems support, and manual chart review. Additionally, we examined demographic (i.e. gender, ethnicity, cancer diagnosis) and clinical characteristics (i.e. level of care, code status, previous palliative care consult, palliative care consult in the hospital, nutrition status, clinical trial status, advance care planning, hospice enrollment). Statistical analysis included chi-squared and ANOVA tests, and logistic regression models. Results: A total of 267 patients were included in the analysis. For all patients in the study, 38% had a change in code status during their admission. 26% of patients had palliative care involvement and 23% were known to palliative care prior to admission. Twenty three percent spent the duration of their admission in the ICU for their end of life care. Significant mortality-level variation was found compared to overall mean number of admissions for the past 6 months (ANOVA F=25.3, p<0.0001). We conducted a logistic regression and adjusted for ethnicity, number of admits in the last 6 months, and length of stay to identify the outcome of patients who died within 30 days of admission vs. those who did not. Factors associated with increased odds of mortality included the number of admits in the last 6 months (OR 1.753, 95% CI: 1.397-2.200). Length of stay did not increase one’s odds for mortality (OR 0.989, 95% CI: 0.965-1.014). Conclusions: Low utilization of palliative care and advanced care planning was seen widely in both populations. Previous hospitalization in the last 6 months was a predictor of mortality in this patient population.

scholarly journals End‐of‐life care among adolescent and young adult patients with cancer living in poverty

Cancer ◽  
2019 ◽  
Vol 126 (4) ◽  
pp. 886-893 ◽  
Author(s):  
Eric J. Roeland ◽  
Lisa C. Lindley ◽  
Stephanie Gilbertson‐White ◽  
Seyedehtanaz Saeidzadeh ◽  
Erin R. Currie ◽  
...  
Keyword(s):  
Young Adult ◽  
End Of Life ◽  
End Of Life Care ◽  
Adult Patients ◽  
Adolescent And Young Adult ◽  
Life Care ◽  
Patients With Cancer

Improving the Quality of End-of-Life Care in Pediatric Oncology Patients Through the Early Implementation of Palliative Care

2017 ◽  
Vol 34 (6) ◽  
pp. 374-380 ◽  
Author(s):  
Lauren Ranallo
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
End Of Life ◽  
Pediatric Oncology ◽  
End Of Life Care ◽  
Terminal Phase ◽  
Clear Understanding ◽  
Life Care ◽  
Oncology Patients ◽  
Children With Cancer

Providing end-of-life care to children with cancer is most ideally achieved by initiating palliative care at the time of diagnosis, advocating for supportive care throughout the treatment trajectory, and implementing hospice care during the terminal phase. The guiding principles behind offering palliative care to pediatric oncology patients are the prioritization of providing holistic care and management of disease-based symptoms. Pediatric hematology-oncology nurses and clinicians have a unique responsibility to support the patient and family unit and foster a sense of hope, while also preparing the family for the prognosis and a challenging treatment trajectory that could result in the child’s death. In order to alleviate potential suffering the child may experience, there needs to be an emphasis on supportive care and symptom management. There are barriers to implementing palliative care for children with cancer, including the need to clarify the palliative care philosophy, parental acknowledgement and acceptance of a child’s disease and uncertain future, nursing awareness of services, perception of availability, and a shortage of research guidance. It is important for nurses and clinicians to have a clear understanding of the fundamentals of palliative and end-of-life care for pediatric oncology patients to receive the best care possible.

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