Quality of End-of-Life in Cancer Patients With Dementia: Using A Nationwide Inpatient Database

Hirooka, Kayo; Okumura, Yasuyuki; Matsumoto, Sachiko; Fukahori, Hiroki; Ogawa, Asao

doi:10.1016/j.jpainsymman.2022.03.016

Cited by 7 publications

(2 citation statements)

References 43 publications

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“…The findings of this study can be applied to the NDB. Several studies have assessed end-of-life care using the NDB in Japan [ 27 , 28 , 34 , 35 ]. Even though the accuracy of the method used in previous studies to identify the cause of death is important for the identification of patients with diseases of interest in end-of-life care, the method has not been validated.…”

Section: Discussionmentioning

confidence: 99%

Validation study on definition of cause of death in Japanese claims data

et al. 2023

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Identifying the cause of death is important for the study of end-of-life patients using claims data in Japan. However, the validity of how cause of death is identified using claims data remains unknown. Therefore, this study aimed to verify the validity of the method used to identify the cause of death based on Japanese claims data. Our study population included patients who died at two institutions between January 1, 2018 and December 31, 2019. Claims data consisted of medical data and Diagnosis Procedure Combination (DPC) data, and five definitions developed from disease classification in each dataset were compared with death certificates. Nine causes of death, including cancer, were included in the study. The definition with the highest positive predictive values (PPVs) and sensitivities in this study was the combination of “main disease” in both medical and DPC data. For cancer, these definitions had PPVs and sensitivities of > 90%. For heart disease, these definitions had PPVs of > 50% and sensitivities of > 70%. For cerebrovascular disease, these definitions had PPVs of > 80% and sensitivities of> 70%. For other causes of death, PPVs and sensitivities were < 50% for most definitions. Based on these results, we recommend definitions with a combination of “main disease” in both medical and DPC data for cancer and cerebrovascular disease. However, a clear argument cannot be made for other causes of death because of the small sample size. Therefore, the results of this study can be used with confidence for cancer and cerebrovascular disease but should be used with caution for other causes of death.

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Section: Discussionmentioning

confidence: 99%

Validation study on definition of cause of death in Japanese claims data

et al. 2023

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“…Two studies explored care quality and outcomes at EOL. Hirooka et al [38 ▪ ] used Japanese national inpatient medical records ( n = 16 758) to examine quality of EOL care for people with nonsmall cell lung cancer, with (26.9%) and without (73.1%) co-existing dementia, who died in hospital. They found lower aggressive intervention, in the form of incidence of mechanical ventilation and cardiopulmonary resuscitation use, in people with cancer and dementia.…”

Section: End Of Life Care Quality and Outcomesmentioning

confidence: 99%

End of life care for people with dementia and comorbid cancer: recent studies and research gaps

Surr,

Ashley

2024

Current Opinion in Psychiatry

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Purpose of review This narrative review examines recent research on end of life (EOL) care for people with dementia and comorbid cancer, highlighting the complexity and challenge of providing effective EOL care for this group and areas of interest for future research. Recent findings People with cancer and dementia and their family/supporters have more complex care and support needs at EOL that are less well met than those of older adults with cancer alone, including questionable use of aggressive EOL care interventions, poorer access to specialist palliative care teams and poor pain management. Those diagnosed with dementia at the same time as, or after their cancer diagnosis, are at greater risk of aggressive EOL care and EOL cancer treatment and care plans that are not able to meet their care needs as dementia progresses. Summary There is a lack of research on EOL care for people with cancer and dementia. There is little understanding of what good care for this population looks like and if and how EOL care can best meet the needs of people with cancer and dementia or their carers/supporters. More research is needed to inform improved care for this population.

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Ethische Aspekte des Managements behavioraler und psychologischer Symptome bei Demenz (BPSD)

Bruns,

Reuner

2024

Verhaltensstörungen Bei Demenzerkrankungen

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Quality of End-of-Life in Cancer Patients With Dementia: Using A Nationwide Inpatient Database

Cited by 7 publications

References 43 publications

Validation study on definition of cause of death in Japanese claims data

Validation study on definition of cause of death in Japanese claims data

End of life care for people with dementia and comorbid cancer: recent studies and research gaps

Ethische Aspekte des Managements behavioraler und psychologischer Symptome bei Demenz (BPSD)

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