TY - JOUR
T1 - Intensity of Cancer Care Near the End of Life at a Tertiary Care Cancer Center in Jordan
AU - Abdel-Razeq, Hikmat
AU - Shamieh, Omar
AU - Abu-Nasser, Mahmoud
AU - Nassar, Moath
AU - Samhouri, Yazan
AU - Abu-Qayas, Bashar
AU - Asfour, Joud
AU - Jarrah, Joud
AU - Abdelrahman, Zaid
AU - Ameen, Zaid
AU - Al-Hawamdeh, Abdel Rahman
AU - Alomari, Mohammad
AU - Al-Tabba', Amal
AU - Al-Rimawi, Dalia
AU - Hui, David
N1 - Publisher Copyright:
© 2019 American Academy of Hospice and Palliative Medicine
PY - 2019/6
Y1 - 2019/6
N2 - Context: Chemotherapy use in the last month of life is an indicator of poor quality of end-of-life care. Objectives: We assessed the frequency of chemotherapy use at the end of life at our comprehensive cancer center in Jordan and identified the factors associated with chemotherapy use. Methods: We conducted a retrospective chart review to examine the use of chemotherapy in the last 30 days and 14 days of life in consecutive adult patients with cancer seen at King Hussein Cancer Center (KHCC) who died between January 1, 2010, and December 31, 2012. We collected data on patient and disease characteristics, palliative care referral, and end-of-life care outcome indicators. Results: Among the 1714 decedents, 310 (18.1%) had chemotherapy use in the last 30 days and 142 (8.3%) in the last 14 days of life. Over half (910; 53.1%) had a palliative care referral. Chemotherapy use in the last 30 and 14 days of life were associated with younger age (odds ratio [OR] 0.99/yr, P = 0.01, and OR 0.99/yr, P = 0.01, respectively) and hematological malignances (OR 1.98, P < 0.001, and OR 2.85, P < 0.001, respectively). Palliative care referral was significantly associated with decreased use of chemotherapy in the last 30 (OR 0.30, P < 0.001) and 14 (OR 0.15, P < 0.001) days of life. Conclusions: A sizable minority of patients with cancer at KHCC received chemotherapy at the end of life. Younger patients and those with hematological malignancies were more likely to receive chemotherapy, whereas those referred to palliative care were significantly less likely to receive chemotherapy at the end of life.
AB - Context: Chemotherapy use in the last month of life is an indicator of poor quality of end-of-life care. Objectives: We assessed the frequency of chemotherapy use at the end of life at our comprehensive cancer center in Jordan and identified the factors associated with chemotherapy use. Methods: We conducted a retrospective chart review to examine the use of chemotherapy in the last 30 days and 14 days of life in consecutive adult patients with cancer seen at King Hussein Cancer Center (KHCC) who died between January 1, 2010, and December 31, 2012. We collected data on patient and disease characteristics, palliative care referral, and end-of-life care outcome indicators. Results: Among the 1714 decedents, 310 (18.1%) had chemotherapy use in the last 30 days and 142 (8.3%) in the last 14 days of life. Over half (910; 53.1%) had a palliative care referral. Chemotherapy use in the last 30 and 14 days of life were associated with younger age (odds ratio [OR] 0.99/yr, P = 0.01, and OR 0.99/yr, P = 0.01, respectively) and hematological malignances (OR 1.98, P < 0.001, and OR 2.85, P < 0.001, respectively). Palliative care referral was significantly associated with decreased use of chemotherapy in the last 30 (OR 0.30, P < 0.001) and 14 (OR 0.15, P < 0.001) days of life. Conclusions: A sizable minority of patients with cancer at KHCC received chemotherapy at the end of life. Younger patients and those with hematological malignancies were more likely to receive chemotherapy, whereas those referred to palliative care were significantly less likely to receive chemotherapy at the end of life.
KW - Drug therapy
KW - neoplasms
KW - palliative care
KW - quality of health care
KW - terminal care
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U2 - 10.1016/j.jpainsymman.2019.02.016
DO - 10.1016/j.jpainsymman.2019.02.016
M3 - Article
C2 - 30802634
AN - SCOPUS:85063059447
SN - 0885-3924
VL - 57
SP - 1106
EP - 1113
JO - Journal of pain and symptom management
JF - Journal of pain and symptom management
IS - 6
ER -