Study Finds Opportunity for End-of-Life Discussions
Madison, Wisconsin - A study at the University of Wisconsin Carbone Cancer Center says most patients with advanced cancer who have unplanned hospitalizations die in less than six months, yet they rarely are sent home with palliative and end-of-life care services.
“The findings suggest that there is an important opportunity for advanced-care planning conversations with hospitalized cancer patients in late stages of the disease, while they are seeking management of symptoms like pain and nausea,” said study co-author Dr. Toby Campbell, director of palliative care at the UW Carbone Cancer Center and UW Hospital and Clinics. The study was led by oncology fellow Dr. Gabrielle Rocque.
The findings, published in the December issue of the Journal of Oncology Practice, compared 2000 and 2010 data from admissions, interventions and survival rates of cancer patients with unplanned hospitalizations at the academic medical center.
The survey included 191 unplanned hospital admissions of 151 patients in 2000 and 149 admissions of 119 patients in 2010. Survival was less than six months and did not improve between 2000 and 2010. But only 23 percent received palliative care or hospice in 2000 and 24 percent in 2010.
“Based on these findings, an unscheduled hospitalization for advanced-cancer patients is a strong predictor of survival of six months or less,” said Campbell. “Hospital admission represents an opportunity to talk with the patient about their physical and emotional symptoms, their hopes for the future, and their end-of-life care options.”
After the survey results were analyzed, the UW Carbone Cancer Center began a clinical trial in which all advanced-cancer patients with unplanned hospitalizations automatically receive a palliative-care consultation.
“Integrating palliative care into oncology services is a quality care initiative that focuses on the patient and empowers them to make the best choices for themselves and their families,” said Campbell.
Date Published: 12/18/2012