Advance Care Planning and Patient Preferences in a Feasibility Pilot Study to Improve End-of-Life Communication among Men with Metastatic Urological Malignancies

Pannell, Stephanie C.; Laviana, Aaron A.; Huen, Kathy H.; Shelton, Jeremy B.; Kwan, Lorna; Bennett, Carol J.; Lorenz, Karl; Bergman, Jonathan

doi:10.1016/j.urpr.2017.11.001

Cited by 3 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our prior work, we demonstrated 85% of patients who were enrolled in the integrated palliative care-urology clinic completed either an advanced directive or Physician Order for Life-Sustaining Treatment form, and that 98% of the participants who had advance care planning chose to withhold cardiopulmonary resuscitation, advanced cardiac life support, and artificially administered nutrition. 8 The high rate of advance care planning is in contrast to a similar veteran population with advanced cancer from another VA Medical Center. Half of the participants in this peer navigator and social work intervention study had advanced genitourinary cancer, and only 35% had advance care planning documentation at baseline without intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Our previously results investigated clinician satisfaction with the integrated clinic model through several semi-structured interviews and examined advance care planning rates. 7,8 In this phase of our study, we aim to assess the effect of a multidisciplinary early palliative care intervention on healthrelated quality of life (HRQOL) and satisfaction of patients with metastatic urological cancers. We hypothesize a priori that patients enrolled in an integrated palliative care-urology clinic would experience improvements in patient satisfaction, stability in mental health and screening depression scores, declines in physical health with worsening pain scores, and high rates of hospice utilization at the end of life.…”

Section: Introductionmentioning

confidence: 99%

“…Our previously results investigated clinician satisfaction with the integrated clinic model through several semi-structured interviews and examined advance care planning rates. 7,8…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of an Integrated Urology-Palliative Care Clinic for Patients With Advanced Urological Cancers: Maintenance of Quality of Life and Satisfaction and High Rate of Hospice Utilization Through End of Life

Huen

Huang

Liu

et al. 2019

Am J Hosp Palliat Care

Self Cite

View full text Add to dashboard Cite

Introduction: Systematic integration of palliative care in a surgical setting is important, but has yet to be achieved. Despite evidence of early palliative care improving patients’ quality of life, hospice utilization remains low. Through an integrated palliative care-urology clinic, we aim to assess the effect of early outpatient palliative care on hospice utilization, health-related quality of life (HRQOL) and satisfaction in patients with advanced urological cancers. Methods: Participants were recruited from 2012 through 2016 in the Greater Los Angeles Veterans Affairs Hospital. We partnered with palliative care clinicians to develop an integrated urology-palliative care clinic, where participants were seen by the palliative care team on the same day as their urological visit. The 12-item Short-Form Survey, Patient Satisfaction Questionnaire Short-Form, Patient Health Questionnaire, and Brief Pain Inventory were administered at initial and subsequent visits. Follow-up questionnaire results were compared between baseline and the 2 follow-up visits, and hospice utilization rates were assessed. Results: Fifty-three participants completed baseline questionnaires. Of those 22 (42%) patients completed at least one follow-up assessment. The median time for the first and second follow-up visits was 2.9 and 7.8 months, respectively. There were no significant differences in HRQOL and satisfaction between baseline and subsequent follow-up visits. A total of 36 (68%) of 53 participants who were enrolled at the start of the study were deceased. Of those, 29 (81%) expired within a home or inpatient hospice. Conclusions: Rates of hospice use were high in an integrated palliative care-urology model. Health-related quality of life and satisfaction did not worsen over time.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of an Integrated Urology-Palliative Care Clinic for Patients With Advanced Urological Cancers: Maintenance of Quality of Life and Satisfaction and High Rate of Hospice Utilization Through End of Life

Huen

Huang

Liu

et al. 2019

Am J Hosp Palliat Care

Self Cite

View full text Add to dashboard Cite

show abstract

Trends in palliative care interventions among patients with advanced bladder, prostate, or kidney cancer: A retrospective cohort study

Lec

Brisbane

Sharma

et al. 2020

Urologic Oncology: Seminars and Original Investigations

View full text Add to dashboard Cite

Trends and Determinants of Palliative Care Utilization Among Patients With Metastatic Upper Tract Urothelial Carcinoma in the National Cancer Database

Connors,

Omidele,

Levy

et al. 2024

J Palliat Care

View full text Add to dashboard Cite

Objective To identify patterns of palliative care usage and identify determinants of palliative intervention using a large contemporary cohort of patients with metastatic upper tract urothelial carcinoma (mUTUC). Methods: The National Cancer Database was queried from 2004 to 2020 for patients with mUTUC. Patients with a prior malignancy, non-mUTUC, and missing follow up or palliative care information were excluded. Demographics and baseline characteristics were compared between patients with mUTUC who received palliative care and those that did not. Trends in annual palliative care usage were assessed via logistic regression. Univariate and multivariate logistic regression models were used to identify predictors of receipt of palliative care. Results: Four thousand and forty-four patients with mUTUC were included in the final cohort, among which 908 received palliative care (22.5%) and 3136 did not (77.5%). We found that the utilization of palliative care increased significantly from 2004 (15.0%) to 2019 (23.1%), P < .001. Additionally, on multivariate analysis we found that a recent year of diagnosis, receipt of a prior nonsurgical treatment paradigm, and an overall survival <6 months were independent predictors of palliative intervention, all P < .001. On the other hand, undergoing treatment at a minority serving hospital and older age were associated with lower likelihood of receiving palliative care, both P < .001. Conclusions: There is a low but increasing trend of utilization of palliative care among patients with mUTUC. Expansion of palliative care services, particularly among older patients and those at minority-serving hospitals, remains a key opportunity to improve quality of life and enhance patient-centered care among those with mUTUC.

show abstract

Advance Care Planning and Patient Preferences in a Feasibility Pilot Study to Improve End-of-Life Communication among Men with Metastatic Urological Malignancies

Cited by 3 publications

References 16 publications

Outcomes of an Integrated Urology-Palliative Care Clinic for Patients With Advanced Urological Cancers: Maintenance of Quality of Life and Satisfaction and High Rate of Hospice Utilization Through End of Life

Outcomes of an Integrated Urology-Palliative Care Clinic for Patients With Advanced Urological Cancers: Maintenance of Quality of Life and Satisfaction and High Rate of Hospice Utilization Through End of Life

Trends in palliative care interventions among patients with advanced bladder, prostate, or kidney cancer: A retrospective cohort study

Trends and Determinants of Palliative Care Utilization Among Patients With Metastatic Upper Tract Urothelial Carcinoma in the National Cancer Database

Contact Info

Product

Resources

About