Preferred Place of Death in Adult Cancer Patients: A Systematic Review and Meta-Analysis

Abstract

Background: Identifying the preferred place of death is a key indicator of the quality of death in cancer patients and one of the most important issues for health service policymakers. This study was done to determine the preferred place of death and the factors affecting it for adult patients with cancer.Methods: In this systematic review and meta-analysis study four online databases (PubMed, Scopus, web of science, ProQuest) were searched by relevant keywords. Quality assessment of papers was conducted using Newcastle-Ottawa (NOS) criterion. Odds ratios, relative risks, and 95% confidence intervals were determined for each of the factors extracted from the investigations.Results: A total of 14,920 participants of 27 studies were included into the meta-analysis. Based on the results, 55% of cancer patients with a confidence interval [95% CI (41–49)] preferred home, 17% of patients with a confidence interval [95% CI (−12%) 23)] preferred hospital and 10% of patients with confidence interval [95% CI (13–18)] preferred hospices as their favored place to die. Effective factors were also reported in the form of demographic characteristics, disease-related factors and psychosocial factors.Conclusions: This study showed that more than half of cancer patients chose home as their preferred place of death. Therefore, guided policies need to ensure that the death of the patients in the preferred place should be considered with priority.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020218680, identifier: CRD42020218680.

Levels and Determinants of Place-Of-Death Congruence in Palliative Patients: A Systematic Review

“…The results of the present review show that, although home remains one of the preferred places of death, previous studies indicate that hospitals are often one of the main places where death occurs (Nilsson et al, 2017 ). On this note, a recent systematic review and meta-analysis in cancer patients shows a high degree of variability in the preferred place of death where, while home remained the highest with 55% preference, other participants preferred hospital (17%) and hospice (10%) (Fereidouni et al, 2021 ). In the data obtained in the present review, home appears as the preferred place of death in all the studies that evaluate this, although the values for the hospital vary greatly between studies, exceeding 30% in several (Gerrard et al, 2011 ; Janssen et al, 2013 ).…”

“…In addition, specific diagnoses such as cancer or stroke were negatively associated with congruence in the studies evaluated. In the first case, one possible explanation is that cancer patients in advanced stages of the disease, despite greater knowledge of their prognosis, may still die in hospital due to the wider treatment options available (Fereidouni et al, 2021 ). Furthermore, this may also indicate an important shortcoming with respect to effective home care plans, since their effectiveness, a priori, should make it possible for many cancer patients to die in their preferred place (Cabañero-Martínez et al, 2020 ).…”

Place of death among Brazilian patients with cancer: preferences and associated factors

“…Understanding the preferred place of death (PPoD) for patients with advanced cancer is an important indicator of quality of death and one of the criteria for a ‘good death’ 1. Home represents the PPoD for most patients with cancer 2. However, this preference may not be shared by everyone, especially for patients suffering from severe and uncontrolled physical and psychological symptoms, unfavourable social or financial status, and lack of social and familiar support 3.…”

“…However, this preference may not be shared by everyone, especially for patients suffering from severe and uncontrolled physical and psychological symptoms, unfavourable social or financial status, and lack of social and familiar support 3. PPoD is unique to each person and can be influenced by specific determinants such as demographic characteristics, disease-related factors and psychological factors, along with social, economic and cultural contexts that vary across diverse cultures and countries 2…”

“…Regarding multiple PPoD aspects,1 2 the hospital death preference included active patients who were receiving standard oncological treatment, better functional status and symptoms absence. According to Vidal et al ,4 a large proportion of PC patients who preferred dying in the hospital encompassed individuals that had already tried home care due to severe distress, refractory symptoms or financial and social issues.…”