An Analysis of Emergency Department Visits and the Survival Rate for Colorectal Cancer Patients: A Nationwide Population-based Study

Tang, Pei-Ling; Chang, Hong‐Tai; Cheng, Chin-Chang; Chen, Hung-Chih; Kuo, Shyh-Ming; Hsiao, Kuan-Yin; Chang, Kuo-Chen

doi:10.2169/internalmedicine.7629-16

Cited by 8 publications

(6 citation statements)

References 18 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As patients' disease burden changes over the course of living with, and dying from, cancer, their medication requirements will also change, both with regards to starting new medication for new symptoms, and stopping existing medication which may no longer be of benefit to them. Pain is the most commonly-reported symptom in patients who go on to die from cancer, and is a significant catalyst for unplanned escalations in care, particularly towards the end of life [10][11][12][13][14][15][16][17][18][19][20]. Most important priorities for people with life-limiting illness, such as advanced cancer, are centred around being comfortable and free from pain and maximising quality of life [6,[21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Community prescribing trends and prevalence in the last year of life, for people who die from cancer

et al. 2022

View full text Add to dashboard Cite

Background People who die from cancer (‘cancer decedents’) may latterly experience unpleasant and distressing symptoms. Prescribing medication for pain and symptom control is essential for good-quality palliative care; however, such provision is variable, difficult to quantify and poorly characterised in current literature. This study aims to characterise trends in prescribing analgesia, non-analgesic palliative care medication and non-palliative medications, to cancer decedents, in their last year of life, and to assess any associations with demographic or clinical factors. Methods This descriptive study, analysed all 181,247 prescriptions issued to a study population of 2443 cancer decedents in Tayside, Scotland (2013–2015), in the last year of life, linking prescribing data to demographic, and cancer registry datasets using the unique patient-identifying Community Health Index (CHI) number. Anonymised linked data were analysed in Safe Haven using chi-squared test for trend, binary logistic regression and Poisson regression in SPSSv25. Results In their last year of life, three in four cancer decedents were prescribed strong opioids. Two-thirds of those prescribed opioids were also prescribed laxatives and/or anti-emetics. Only four in ten cancer decedents were prescribed all medications in the ‘Just in Case’ medication categories and only one in ten was prescribed breakthrough analgesia in the last year of life. The number of prescriptions for analgesia and palliative care drugs increased in the last 12 weeks of life. The number of prescriptions for non-palliative care medications, including anti-hypertensives, statins and bone protection, decreased over the last year, but was still substantial. Cancer decedents who were female, younger, or had lung cancer were more likely to be prescribed strong opioids; however, male cancer decedents had higher odds of being prescribed breakthrough analgesia. Cancer decedents who had late diagnoses had lower odds of being prescribed strong opioids. Conclusions A substantial proportion of cancer decedents were not prescribed strong opioids, breakthrough medication, or medication to alleviate common palliative care symptoms (including ‘Just in Case’ medication). Many patients continued to be prescribed non-palliative care medications in their last days and weeks of life. Age, gender, cancer type and timing of diagnosis affected patients’ odds of being prescribed analgesic and non-analgesic palliative care medication.

show abstract

Section: Introductionmentioning

confidence: 99%

Community prescribing trends and prevalence in the last year of life, for people who die from cancer

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Another observational study of 3347 colon cancer patients between 2000 and 2012 in Taiwan demonstrated that the number of visits increased steadily from 2000 to 2012 [ 17 ]. This increasing trend in ED visits was also observed in the current study.…”

Section: Discussionmentioning

confidence: 99%

Medical Utilization of Emergency Departments among Patients with Prostate Cancer: A Nationwide Population-Based Study in Taiwan

Liu

Hsu

Chen

et al. 2021

IJERPH

View full text Add to dashboard Cite

(1) Background: In Taiwan, prostate cancer is a major malignancy with an increasing incidence among men. This study explores the medical utilization of emergency departments among patients with prostate cancer in Taiwan. (2) Methods: This nationwide, population-based study was conducted via a cross-sectional method based on the Registry for Catastrophic Illness Patient Database from Taiwan’s National Health Insurance Research Database. Patients with newly diagnosed prostate cancer between 1997 and 2013 were enrolled in the study and divided into four treatment-related groups. The rate of emergency department presentation, disease categorization of emergency department visits, emergency department-related medical expenditures, and temporal trends were investigated. (3) Results: A total of 18,728 patients with prostate cancer were identified between 1997 and 2013, for whom 13,098 emergency department visits were recorded. The number of emergency department visits increased during the study period. The incidence rate for the medical utilization of emergency department visits was 822 per 1000 people during the study period. The incidence rates for patients with prostate cancer in the radical prostatectomy, radiotherapy, androgen deprivation therapy, and chemotherapy groups were 549, 1611, 1101, and 372, respectively. The average medical expenditure per emergency department visit was TWD 3779.8 ± 5116.2, and the expenditure was recorded for the chemotherapy group at TWD 4690.8 ± 7043.3. The most common disease diagnoses among patients with prostate cancer who presented to the emergency department were injury/poisoning (16.79%), genitourinary disorders (10.66%), and digestive disorders (10.48%). (4) Conclusions: This nationwide population-based study examined the emergency department visits of patients with prostate cancer in Taiwan, providing useful information for improving the quality of medical care.

show abstract

“…Among patients dying from cancer, the evidence was highly consistent across multiple publications in finding an association between gender (8 studies), age (5 studies), socioeconomic status (7 studies) and living arrangements (3 studies) and unscheduled care use among cancer decedents. Men were more likely to attend unscheduled care than women [6][7][8][9][10][11][12][13] . Older patients with cancer were more likely to use unscheduled care at the end of life than younger patients with cancer 6,7,9,13,14 .…”

Section: Demographymentioning

confidence: 97%

“…Cancer decedents who had lung cancer presented to unscheduled care more frequently than patients with other cancer types [7][8][9]12,14,16,20,21 . Pain was the single biggest clinical factor associated with use of unscheduled care, accounting for up to 83% of presentations 5,6,16,19,20,[22][23][24][25][26][27][28][29] . After pain, breathlessness 10,11,16,19,20,[22][23][24][25]27,29,30 , and gastrointestinal symptoms 10,16,19,20,[22][23][24][25][28][29][30] were consistently the most common reasons for visiting unscheduled care.…”

Section: Clinical and Patientmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with unscheduled care use by cancer decedents: a systematic review with narrative synthesis

Mills

Geneen

Buchanan

et al. 2020

BMJ Support Palliat Care

View full text Add to dashboard Cite

BackgroundPeople who die from cancer (cancer decedents) may experience unpleasant and distressing symptoms which cause them to present to unscheduled care. Unscheduled care is unplanned care delivered by general practitioner out-of-hours and emergency departments. Use of unscheduled care can disrupt treatment plans, leading to a disjointed patient care and suboptimal outcomes.ObjectivesThis systematic review aimed to identify factors associated with unscheduled care use by cancer decedents.MethodSystematic review with narrative synthesis of seven electronic databases (PubMed; Medline; Embase; Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials; Web of Science; Cumulative Index to Nursing and Allied Health Literature) from inception until 01 January 2020. All observational and experimental studies were included, irrespective of their research design.ResultsThe search yielded 238 publications included at full-text, of which 47 were included in the final review and synthesis. Unscheduled care use by cancer decedents was influenced by multiple factors, synthesised into themes: demography, clinical and patient, temporal, prescribing and systems. Cancer decedents who were older, men, had comorbidities, or lung cancer, were most likely to use unscheduled care. Unscheduled care presentations were commonly due to pain, breathlessness and gastrointestinal symptoms. Low continuity of care, and oncology-led care were associated with greater unscheduled care use. Access to palliative care, having an up-to-date palliative care plan, and carer education were associated with less unscheduled care use.ConclusionThe review identifies multiple factors associated with unscheduled care use by cancer decedents. Understanding these factors can inform future practice and policy developments, in order to appropriately target future interventions, optimise service delivery and improve the patient journey.PROSPERO registration numberCRD42016047231.

show abstract

An Analysis of Emergency Department Visits and the Survival Rate for Colorectal Cancer Patients: A Nationwide Population-based Study

Cited by 8 publications

References 18 publications

Community prescribing trends and prevalence in the last year of life, for people who die from cancer

Community prescribing trends and prevalence in the last year of life, for people who die from cancer

Medical Utilization of Emergency Departments among Patients with Prostate Cancer: A Nationwide Population-Based Study in Taiwan

Factors associated with unscheduled care use by cancer decedents: a systematic review with narrative synthesis

Contact Info

Product

Resources

About