Talita Caroline de Oliveira Valentino1,2, Bianca Sakamoto Ribeiro Paiva1,2, Marco Antonio de Oliveira2, David Hui3, Carlos Eduardo Paiva4,5,6,7. 1. Oncology Post-Graduate Program (Stricto Sensu), Barretos Cancer Hospital, Barretos, São Paulo, Brazil. 2. Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, São Paulo, Brazil. 3. Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Oncology Post-Graduate Program (Stricto Sensu), Barretos Cancer Hospital, Barretos, São Paulo, Brazil. caredupai@gmail.com. 5. Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, São Paulo, Brazil. caredupai@gmail.com. 6. Department of Clinical Oncology-Breast and Gynecology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. caredupai@gmail.com. 7. Institute of Education and Research-Post-Graduation, Street Antenor Duarte Villela, 1331, Barretos, São Paulo, CEP 14784-400, Brazil. caredupai@gmail.com.
Abstract
PURPOSE: The purpose of the study is to estimate the proportion of patients who had access to palliative care (PC) and to identify the timing and factors associated with this access. METHODS: A retrospective longitudinal study that included patients who died of advanced cancer between the years of 2010 and 2014 was conducted. The proportion of patients who received PC consultations was compared during those years. Sociodemographic and clinical factors, the timing between first PC consultation and death (early, ≥ 3 months; late, < 3 months), and first PC consultation were assessed. RESULTS: Of the 1284 studied patients, 988 (76.9%) were referred to PC and 839 (65.3%) had a PC consultation. The proportion of patients who received late PC consultation increased between the years 2010 and 2014 (44.2 vs. 60.4%, p = 0.001). Multivariate analysis revealed that younger age (odds ratio (OR) = 0.98, p = 0.016) and gynecologic cancer (OR = 2.17, p = 0.011) were associated with a PC consultation. Upper gastrointestinal tract (GIT) cancer (OR = 2.42, p = 0.001) and hematologic malignancies (OR = 0.37, p = 0.001) were associated with late PC consultations. The median time interval between the first PC consultation and death was 2.66 months: timing differed significantly among cancer subtypes (p = 0.002). CONCLUSION: Most patients received PC consultation before death, and the number of patients with late consultation increased throughout the study. Patients with late referrals could have received PC earlier. The current findings suggest the need to standardize the referral criteria to optimize access to PC.
PURPOSE: The purpose of the study is to estimate the proportion of patients who had access to palliative care (PC) and to identify the timing and factors associated with this access. METHODS: A retrospective longitudinal study that included patients who died of advanced cancer between the years of 2010 and 2014 was conducted. The proportion of patients who received PC consultations was compared during those years. Sociodemographic and clinical factors, the timing between first PC consultation and death (early, ≥ 3 months; late, < 3 months), and first PC consultation were assessed. RESULTS: Of the 1284 studied patients, 988 (76.9%) were referred to PC and 839 (65.3%) had a PC consultation. The proportion of patients who received late PC consultation increased between the years 2010 and 2014 (44.2 vs. 60.4%, p = 0.001). Multivariate analysis revealed that younger age (odds ratio (OR) = 0.98, p = 0.016) and gynecologic cancer (OR = 2.17, p = 0.011) were associated with a PC consultation. Upper gastrointestinal tract (GIT) cancer (OR = 2.42, p = 0.001) and hematologic malignancies (OR = 0.37, p = 0.001) were associated with late PC consultations. The median time interval between the first PC consultation and death was 2.66 months: timing differed significantly among cancer subtypes (p = 0.002). CONCLUSION: Most patients received PC consultation before death, and the number of patients with late consultation increased throughout the study. Patients with late referrals could have received PC earlier. The current findings suggest the need to standardize the referral criteria to optimize access to PC.
Entities:
Keywords:
Advanced cancer; Health services; Palliative care; Quality of health care; Referral and consultation
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