Systemic Anti-Cancer Therapy Use in Palliative Care Outpatients With Advanced Cancer
Purpose: To evaluate factors associated with continuation of systemic anti-cancer therapy (SACT) after palliative care consultation, and SACT administration in the last 30 days of life, in outpatients with cancer referred to palliative care. Timing of referral was of particular interest. Methods: Pa...
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| Veröffentlicht in: | Journal of palliative care 2021-04, Vol.36 (2), p.78-86 |
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| container_title | Journal of palliative care |
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| creator | Wadhwa, Deepa Hausner, David Popovic, Gordana Pope, Ashley Swami, Nadia Maganti, Manjula Zimmermann, Camilla |
| description | Purpose:
To evaluate factors associated with continuation of systemic anti-cancer therapy (SACT) after palliative care consultation, and SACT administration in the last 30 days of life, in outpatients with cancer referred to palliative care. Timing of referral was of particular interest.
Methods:
Patient, disease, and treatment-related factors associated with SACT before and after palliative care, and in the last 30 days of life, were identified using 3-level multinomial logistic regression. Referral to palliative care was categorized by time from death as early (>12 months), intermediate (6-12 months), and late (≤6 months).
Results:
Of the 337 patients, 240 (71.2%) received SACT for advanced cancer; of these, 126 (52.5%) received SACT only prior to palliative care while 114 (47.5%) also received SACT afterward. Only 35/337 (10.4%) received SACT in the last 30 days of life. On multivariable analysis, factors associated with continuing SACT after palliative care consultation were a cancer diagnosis for |
| doi_str_mv | 10.1177/0825859720975949 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2500886937</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0825859720975949</sage_id><sourcerecordid>2500886937</sourcerecordid><originalsourceid>FETCH-LOGICAL-c365t-8fbde8d0000bea0eca37f46fc8ef7c32800be46f281139c86764d909bf902fd63</originalsourceid><addsrcrecordid>eNp1UM1LwzAUD6K4Ob17koDn6mvSNslxFL9gMMENjyVtX1zH1tUkHey_t6VTQfD0eO_39fgRch3CXRgKcQ-SxTJWgoESsYrUCRkznqggZoqfknEPBz0-IhfOrQFAAINzMuKcRaHgbEwWbwfncVsVdFr7Kkh1XaClixVa3Rzo0iGtavqqN5tK-2qPNNUW6bz1Tbdi7R19r_yKTst9LyzpoL8kZ0ZvHF4d54QsHx8W6XMwmz-9pNNZUPAk9oE0eYmy7N6CHDVgobkwUWIKiUYUnMn-3u1MhiFXhUxEEpUKVG4UMFMmfEJuB9_G7j5bdD5b71pbd5EZiwGkTBQXHQsGVmF3zlk0WWOrrbaHLISsrzH7W2MnuTkat_kWyx_Bd28dIRgITn_gb-q_hl8YL3lI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2500886937</pqid></control><display><type>article</type><title>Systemic Anti-Cancer Therapy Use in Palliative Care Outpatients With Advanced Cancer</title><source>SAGE Complete A-Z List</source><source>MEDLINE</source><creator>Wadhwa, Deepa ; Hausner, David ; Popovic, Gordana ; Pope, Ashley ; Swami, Nadia ; Maganti, Manjula ; Zimmermann, Camilla</creator><creatorcontrib>Wadhwa, Deepa ; Hausner, David ; Popovic, Gordana ; Pope, Ashley ; Swami, Nadia ; Maganti, Manjula ; Zimmermann, Camilla</creatorcontrib><description>Purpose:
To evaluate factors associated with continuation of systemic anti-cancer therapy (SACT) after palliative care consultation, and SACT administration in the last 30 days of life, in outpatients with cancer referred to palliative care. Timing of referral was of particular interest.
Methods:
Patient, disease, and treatment-related factors associated with SACT before and after palliative care, and in the last 30 days of life, were identified using 3-level multinomial logistic regression. Referral to palliative care was categorized by time from death as early (>12 months), intermediate (6-12 months), and late (≤6 months).
Results:
Of the 337 patients, 240 (71.2%) received SACT for advanced cancer; of these, 126 (52.5%) received SACT only prior to palliative care while 114 (47.5%) also received SACT afterward. Only 35/337 (10.4%) received SACT in the last 30 days of life. On multivariable analysis, factors associated with continuing SACT after palliative care consultation were a cancer diagnosis for <1 year (OR 3.09, p = 0.01), breast primary (OR 11.88, p = 0.0008), and early (OR 28.8, p < 0.001) or intermediate (OR 6.67, p < 0.001) referral timing. No factors were significantly associated with receiving SACT in the last 30 days versus earlier, but the median time from palliative care referral to death in those receiving SACT in the last 30 days versus stopping SACT earlier was 1.78 versus 4.27 months.
Conclusion:
Patients who received SACT following palliative care consultation were more likely to be referred early; however, patients receiving SACT in their last 30 days tended to be referred late.</description><identifier>ISSN: 0825-8597</identifier><identifier>EISSN: 2369-5293</identifier><identifier>DOI: 10.1177/0825859720975949</identifier><identifier>PMID: 33241732</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Cancer ; Cancer therapies ; Chemotherapy ; Humans ; Medical referrals ; Neoplasms - therapy ; Outpatients ; Palliative Care ; Patient care planning ; Referral and Consultation ; Retrospective Studies ; Time Factors</subject><ispartof>Journal of palliative care, 2021-04, Vol.36 (2), p.78-86</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-8fbde8d0000bea0eca37f46fc8ef7c32800be46f281139c86764d909bf902fd63</citedby><cites>FETCH-LOGICAL-c365t-8fbde8d0000bea0eca37f46fc8ef7c32800be46f281139c86764d909bf902fd63</cites><orcidid>0000-0003-4889-0244</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0825859720975949$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0825859720975949$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21800,27903,27904,43600,43601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33241732$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wadhwa, Deepa</creatorcontrib><creatorcontrib>Hausner, David</creatorcontrib><creatorcontrib>Popovic, Gordana</creatorcontrib><creatorcontrib>Pope, Ashley</creatorcontrib><creatorcontrib>Swami, Nadia</creatorcontrib><creatorcontrib>Maganti, Manjula</creatorcontrib><creatorcontrib>Zimmermann, Camilla</creatorcontrib><title>Systemic Anti-Cancer Therapy Use in Palliative Care Outpatients With Advanced Cancer</title><title>Journal of palliative care</title><addtitle>J Palliat Care</addtitle><description>Purpose:
To evaluate factors associated with continuation of systemic anti-cancer therapy (SACT) after palliative care consultation, and SACT administration in the last 30 days of life, in outpatients with cancer referred to palliative care. Timing of referral was of particular interest.
Methods:
Patient, disease, and treatment-related factors associated with SACT before and after palliative care, and in the last 30 days of life, were identified using 3-level multinomial logistic regression. Referral to palliative care was categorized by time from death as early (>12 months), intermediate (6-12 months), and late (≤6 months).
Results:
Of the 337 patients, 240 (71.2%) received SACT for advanced cancer; of these, 126 (52.5%) received SACT only prior to palliative care while 114 (47.5%) also received SACT afterward. Only 35/337 (10.4%) received SACT in the last 30 days of life. On multivariable analysis, factors associated with continuing SACT after palliative care consultation were a cancer diagnosis for <1 year (OR 3.09, p = 0.01), breast primary (OR 11.88, p = 0.0008), and early (OR 28.8, p < 0.001) or intermediate (OR 6.67, p < 0.001) referral timing. No factors were significantly associated with receiving SACT in the last 30 days versus earlier, but the median time from palliative care referral to death in those receiving SACT in the last 30 days versus stopping SACT earlier was 1.78 versus 4.27 months.
Conclusion:
Patients who received SACT following palliative care consultation were more likely to be referred early; however, patients receiving SACT in their last 30 days tended to be referred late.</description><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Humans</subject><subject>Medical referrals</subject><subject>Neoplasms - therapy</subject><subject>Outpatients</subject><subject>Palliative Care</subject><subject>Patient care planning</subject><subject>Referral and Consultation</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><issn>0825-8597</issn><issn>2369-5293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UM1LwzAUD6K4Ob17koDn6mvSNslxFL9gMMENjyVtX1zH1tUkHey_t6VTQfD0eO_39fgRch3CXRgKcQ-SxTJWgoESsYrUCRkznqggZoqfknEPBz0-IhfOrQFAAINzMuKcRaHgbEwWbwfncVsVdFr7Kkh1XaClixVa3Rzo0iGtavqqN5tK-2qPNNUW6bz1Tbdi7R19r_yKTst9LyzpoL8kZ0ZvHF4d54QsHx8W6XMwmz-9pNNZUPAk9oE0eYmy7N6CHDVgobkwUWIKiUYUnMn-3u1MhiFXhUxEEpUKVG4UMFMmfEJuB9_G7j5bdD5b71pbd5EZiwGkTBQXHQsGVmF3zlk0WWOrrbaHLISsrzH7W2MnuTkat_kWyx_Bd28dIRgITn_gb-q_hl8YL3lI</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Wadhwa, Deepa</creator><creator>Hausner, David</creator><creator>Popovic, Gordana</creator><creator>Pope, Ashley</creator><creator>Swami, Nadia</creator><creator>Maganti, Manjula</creator><creator>Zimmermann, Camilla</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><orcidid>https://orcid.org/0000-0003-4889-0244</orcidid></search><sort><creationdate>202104</creationdate><title>Systemic Anti-Cancer Therapy Use in Palliative Care Outpatients With Advanced Cancer</title><author>Wadhwa, Deepa ; Hausner, David ; Popovic, Gordana ; Pope, Ashley ; Swami, Nadia ; Maganti, Manjula ; Zimmermann, Camilla</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-8fbde8d0000bea0eca37f46fc8ef7c32800be46f281139c86764d909bf902fd63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Humans</topic><topic>Medical referrals</topic><topic>Neoplasms - therapy</topic><topic>Outpatients</topic><topic>Palliative Care</topic><topic>Patient care planning</topic><topic>Referral and Consultation</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wadhwa, Deepa</creatorcontrib><creatorcontrib>Hausner, David</creatorcontrib><creatorcontrib>Popovic, Gordana</creatorcontrib><creatorcontrib>Pope, Ashley</creatorcontrib><creatorcontrib>Swami, Nadia</creatorcontrib><creatorcontrib>Maganti, Manjula</creatorcontrib><creatorcontrib>Zimmermann, Camilla</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Journal of palliative care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wadhwa, Deepa</au><au>Hausner, David</au><au>Popovic, Gordana</au><au>Pope, Ashley</au><au>Swami, Nadia</au><au>Maganti, Manjula</au><au>Zimmermann, Camilla</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systemic Anti-Cancer Therapy Use in Palliative Care Outpatients With Advanced Cancer</atitle><jtitle>Journal of palliative care</jtitle><addtitle>J Palliat Care</addtitle><date>2021-04</date><risdate>2021</risdate><volume>36</volume><issue>2</issue><spage>78</spage><epage>86</epage><pages>78-86</pages><issn>0825-8597</issn><eissn>2369-5293</eissn><abstract>Purpose:
To evaluate factors associated with continuation of systemic anti-cancer therapy (SACT) after palliative care consultation, and SACT administration in the last 30 days of life, in outpatients with cancer referred to palliative care. Timing of referral was of particular interest.
Methods:
Patient, disease, and treatment-related factors associated with SACT before and after palliative care, and in the last 30 days of life, were identified using 3-level multinomial logistic regression. Referral to palliative care was categorized by time from death as early (>12 months), intermediate (6-12 months), and late (≤6 months).
Results:
Of the 337 patients, 240 (71.2%) received SACT for advanced cancer; of these, 126 (52.5%) received SACT only prior to palliative care while 114 (47.5%) also received SACT afterward. Only 35/337 (10.4%) received SACT in the last 30 days of life. On multivariable analysis, factors associated with continuing SACT after palliative care consultation were a cancer diagnosis for <1 year (OR 3.09, p = 0.01), breast primary (OR 11.88, p = 0.0008), and early (OR 28.8, p < 0.001) or intermediate (OR 6.67, p < 0.001) referral timing. No factors were significantly associated with receiving SACT in the last 30 days versus earlier, but the median time from palliative care referral to death in those receiving SACT in the last 30 days versus stopping SACT earlier was 1.78 versus 4.27 months.
Conclusion:
Patients who received SACT following palliative care consultation were more likely to be referred early; however, patients receiving SACT in their last 30 days tended to be referred late.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>33241732</pmid><doi>10.1177/0825859720975949</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4889-0244</orcidid></addata></record> |
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| ispartof | Journal of palliative care, 2021-04, Vol.36 (2), p.78-86 |
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| source | SAGE Complete A-Z List; MEDLINE |
| subjects | Cancer Cancer therapies Chemotherapy Humans Medical referrals Neoplasms - therapy Outpatients Palliative Care Patient care planning Referral and Consultation Retrospective Studies Time Factors |
| title | Systemic Anti-Cancer Therapy Use in Palliative Care Outpatients With Advanced Cancer |
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