Impact of palliative care on quality of end-of-life care among Brazilian patients with advanced cancers

AbstractContextMany patients with advanced cancer experience aggressive care during the end-of-life. Several studies have evaluated the benefits of palliative care (PC) on the reduction of aggressive measures; however, limited data are available about their benefit in Brazilian patients. ObjectivesT...

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Bibliographic Details
Published in:Journal of pain and symptom management 2020-01, Vol.59 (1), p.39-48
Main Authors: de Oliveira Valentino, Talita Caroline, Ms, RN, Paiva, Carlos Eduardo, PhD, MD, Hui, David, MD, MSc, de Oliveira, Marco Antonio, Ribeiro Paiva, Bianca Sakamoto, PhD, RN
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Brazil
Cancer
Chemotherapy
Emergency services
End of life decisions
Female
Hospice care
Hospitalization
Humans
Intensive care
Longitudinal Studies
Male
Medical records
Middle Aged
Neoplasms
Neoplasms - therapy
Pain Medicine
Palliative Care
Patients
Place of death
Quality of care
Quality of Health Care
Retrospective Studies
Terminal Care
Terminal illnesses
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Summary:AbstractContextMany patients with advanced cancer experience aggressive care during the end-of-life. Several studies have evaluated the benefits of palliative care (PC) on the reduction of aggressive measures; however, limited data are available about their benefit in Brazilian patients. ObjectivesTo evaluate the impact of palliative care on the reduction of aggressive measures at the end-of-life. MethodsLongitudinal study that analyzed retrospectively medical records of patients who died of advanced cancer from 2010 to 2014. Data were obtained on PC referral and five quality of end-of-life care indicators; i.e., emergency department visits, hospital admission, intensive care unit admission, use of systemic antineoplastic therapy within the last 30 days of life and place of death in hospital as well as the use of a composite score for aggressiveness of care. ResultsOut of the 1,284 patients, 832 (65%) received some aggressive measures in end-of-life care. Over the years, there was a reduction in the aggressiveness of care (score = 0: 33.2% vs. 47.1%, p
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2019.08.021