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Intensity of Cancer Care Near the End of Life at a Tertiary Care Cancer Center in Jordan
Journal article   Open access   Peer reviewed

Intensity of Cancer Care Near the End of Life at a Tertiary Care Cancer Center in Jordan

Hikmat Abdel-Razeq, Omar Shamieh, Mahmoud Abu-Nasser, Moath Nassar, Yazan Samhouri, Bashar Abuqayas, Joud Asfour, Joud Jarrah, Zaid Abdelrahman, Zaid Ameen, …
Journal of pain and symptom management, Vol.57(6), pp.1106-1113
06/2019
DOI: 10.1016/j.jpainsymman.2019.02.016
PMID: 30802634
url
https://doi.org/10.1016/j.jpainsymman.2019.02.016View
Published (Version of record) Open Access

Abstract

Chemotherapy use in the last month of life is an indicator of poor quality of end-of-life care. We assessed the frequency of chemotherapy use at the end of life at our comprehensive cancer center in Jordan and identified the factors associated with chemotherapy use. We conducted a retrospective chart review to examine the use of chemotherapy in the last 30 days and 14 days of life in consecutive adult patients with cancer seen at King Hussein Cancer Center (KHCC) who died between January 1, 2010, and December 31, 2012. We collected data on patient and disease characteristics, palliative care referral, and end-of-life care outcome indicators. Among the 1714 decedents, 310 (18.1%) had chemotherapy use in the last 30 days and 142 (8.3%) in the last 14 days of life. Over half (910; 53.1%) had a palliative care referral. Chemotherapy use in the last 30 and 14 days of life were associated with younger age (odds ratio [OR] 0.99/yr, P = 0.01, and OR 0.99/yr, P = 0.01, respectively) and hematological malignances (OR 1.98, P < 0.001, and OR 2.85, P < 0.001, respectively). Palliative care referral was significantly associated with decreased use of chemotherapy in the last 30 (OR 0.30, P < 0.001) and 14 (OR 0.15, P < 0.001) days of life. A sizable minority of patients with cancer at KHCC received chemotherapy at the end of life. Younger patients and those with hematological malignancies were more likely to receive chemotherapy, whereas those referred to palliative care were significantly less likely to receive chemotherapy at the end of life.
 Palliative Care Drug therapy neoplasms quality of health care terminal care

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