Early End-of-Life Talks Can Reduce Aggressive Cancer Care

Discussing EOL plans prior to last 30 days of life linked to less aggressive, more hospice care

WEDNESDAY, Nov. 14 (HealthDay News) -- For stage IV cancer patients, end-of-life (EOL) discussions that are conducted with physicians before the last 30 days of life correlate with less aggressive care close to death and greater use of hospice care, according to a study published online Nov. 13 in the Journal of Clinical Oncology.

In order to assess the correlation between EOL characteristics and the aggressiveness of care that patients receive near death, Jennifer W. Mack, M.D., M.P.H., of the Dana-Farber Cancer Institute in Boston, and colleagues conducted a prospective cohort study involving 1,231 patients with stage IV lung or colorectal cancer who survived at least one month but died during a 15-month study period.

The researchers found that nearly half of patients received one or more markers of aggressive EOL care, including 16 percent who received chemotherapy within the last 14 days of life; 9 percent who received care in the intensive care unit in the last 30 days of life; and 40 percent who received acute hospital-based care in the last 30 days of life. The likelihood of receiving aggressive measures of care (chemotherapy, acute care, any aggressive care) at EOL was significantly lower for those patients who had EOL discussions with their physicians before the last 30 days of life. These patients also had a significantly increased likelihood of receiving hospice care and initiating hospice care earlier.

"Given the many arguments for less aggressive EOL care, earlier discussions have the potential to change the way EOL care is delivered for patients with advanced cancer and help to assure that care is consistent with patients' preferences," the authors write.

Abstract
Full Text

Copyright © 2012 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Debunking Three Rape Myths
Journal of Forensic Nursing, October/December 2014
Expires: 12/31/2016 CE:2.5 $24.95


Drug updates and approvals: 2014 in review
The Nurse Practitioner, 13December 2014
Expires: 12/31/2016 CE:3 $27.95


Can Food Processing Enhance Cancer Protection?
Nutrition Today, September/October 2014
Expires: 10/31/2016 CE:2 $21.95


More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events