On How Increasing Numbers of Newer Cancer Therapies Further Delay Referral to Hospice: The Increasing Palliative Care Imperative

Mintzer, David M.; Zagrabbe, Kathryn

doi:10.1177/1049909106297363

Cited by 29 publications

(16 citation statements)

References 9 publications

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“…This suggests that in addition to early clinical intervention by the PCT, the quality of collaboration and the structuring of discussion may be necessary for integrating PC into oncology. Moreover, such structured collaboration can easily be organised in the oncology setting and adjusted for the trajectory of illness and cancer therapy innovation, which is known to be a barrier in early PC intervention 23. “Early “seed” of the PC team is necessary but not sufficient.…”

Section: Discussionmentioning

confidence: 99%

Effect of integrated palliative care on the quality of end-of-life care: retrospective analysis of 521 cancer patients

Colombet

Montheil

Durand

et al. 2012

BMJ Support Palliat Care

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Section: Discussionmentioning

confidence: 99%

Effect of integrated palliative care on the quality of end-of-life care: retrospective analysis of 521 cancer patients

Colombet

Montheil

Durand

et al. 2012

BMJ Support Palliat Care

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“…Patients admitted to our APCU were more likely to receive ANT than were those admitted to hospices across the United States 15. First, our APCU is situated within a comprehensive cancer center that offers a full array of novel cancer therapies and clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Antineoplastic therapy use in patients with advanced cancer admitted to an acute palliative care unit at a comprehensive cancer center

Hui

Elsayem

et al. 2010

Cancer

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BACKGROUND:Cancer patients admitted to a palliative care unit generally have a poor prognosis. The role of antineoplastic therapy (ANT) in these patients remains controversial. In the current study, the authors examined the frequency and predictors associated with ANT use in hospitalized patients who required admission to an acute palliative care unit (APCU). METHODS: Included in the study were all 2604 patients admitted over a 5-year period to a 12-bed APCU located within a National Cancer Institute comprehensive cancer center, in which patients had access to both palliative care and ANT. Institutional databases were used to retrospectively retrieve data regarding patient demographics, cancer diagnosis, ANT use, length of hospital stay, and survival from time of admission. RESULTS: The median hospital stay was 11 days, and the median survival was 22 days. During hospitalization, 435 patients (17%) received ANT, including chemotherapy (N ¼ 297; 11%), hormonal agents (N ¼ 54; 2%), and targeted therapy (N ¼ 155; 6%). No significant change in the frequency of ANT use was detected over the 5-year period. Multivariate logistic regression analysis revealed that younger age, specific cancer diagnoses, and longer admissions were independently associated with ANT use. CONCLUSIONS: The use of ANT during hospitalization that included an APCU stay was limited to a small percentage of patients and did not increase over time. ANT use was associated with younger age, specific cancer diagnoses, and longer admissions. The APCU facilitates simultaneous care for patients receiving ANT.

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“…10 In a later study, the health care costs specifically for patients with cancer were 13% to 20% lower for those who had received hospice care than for those who had not. 18 The findings of several studies support that hypothesis. 12 In addition, Medicare costs were reduced further the longer an individual was enrolled in hospice.…”

Section: Ineffective Use Of Hospice Servicesmentioning

confidence: 77%

The Debate in Hospice Care

2008

JOP

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Improving end-of-life care has been an important issue in the oncology community as well as in the health care arena in general. The American Society of Clinical Oncology recently collaborated with the Education in Palliative and End-of-Life Care (EPEC) project to develop and disseminate EPEC-Oncology (EPEC-O), a comprehensive curriculum designed especially for oncology clinicians. In addition, earlier this year, the American College of Physicians issued a clinical practice guideline on evidence-based interventions to improve palliative care at the end of life. 1 The guideline notes the critical elements for end-of-life care as being support for families and caregivers; continuity of care; attention to wellbeing, including existential and spiritual concerns; and support for function and survival duration. The very elements of EPEC-O and the American College of Physicians guideline are at the core of the hospice movement that began more than 30 years ago. Current Clinical IssuesMAY 2008 • jop.ascopubs.org 153

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On How Increasing Numbers of Newer Cancer Therapies Further Delay Referral to Hospice: The Increasing Palliative Care Imperative

Cited by 29 publications

References 9 publications

Effect of integrated palliative care on the quality of end-of-life care: retrospective analysis of 521 cancer patients

Effect of integrated palliative care on the quality of end-of-life care: retrospective analysis of 521 cancer patients

Antineoplastic therapy use in patients with advanced cancer admitted to an acute palliative care unit at a comprehensive cancer center

The Debate in Hospice Care

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