Hospice Utilization and End-of-Life Care in Metastatic Breast Cancer Patients at a Comprehensive Cancer Center
Hospice Utilization and End-of-Life Care in Metastatic Breast Cancer Patients at a Comprehensive Cancer Center
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DOI：
10.1089/jpm.2014.0238
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发表时间：
2015-01-01
影响因子：
2.8
通讯作者：
Kerr, Christopher W.
中科院分区：
文献类型：
--
作者：
O'Connor, Tracey L.;Ngamphaiboon, Nuttapong;Kerr, Christopher W.
背景资料：转移性乳腺癌患者有多种治疗选择，并且可能存在晚期或缺乏临终关怀转诊的风险，这使得症状和生活质量难以实现有意义的改善。目的：我们的目的是调查临终关怀的利用情况，病人入院时的状况，1999年至2010年在美国国家癌症研究所（NCI）接受转移性乳腺癌治疗的患者的护理质量-方法：我们进行了一项回顾性数据库审查，确定了182例因乳腺癌死亡的患者，他们有资格通过当地的非营利临终关怀机构获得服务。转移性乳腺癌患者与临终关怀数据库相匹配，以获得临终关怀利用和质量措施的信息。最后一次化疗的日期，药物使用，文件的预先指示和姑息治疗的讨论，并通过图表abstraction.Results收集的死亡地点：三分之一（33%）的转移性乳腺癌患者在癌症研究所治疗在研究期间死亡没有临终关怀转诊。在没有临终关怀转诊的死亡患者中，只有7%的患者有肿瘤学小组关于姑息治疗作为一种选择的讨论记录（p
Background: Metastatic breast cancer patients have many options for therapy and may be at risk for late or absent hospice referrals, which make meaningful improvements in symptoms and quality of life difficult to achieve.Objective: We aimed to examine hospice utilization, status of patients on admission, and quality of care of patients treated for metastatic breast cancer from 1999 to 2010 at a National Cancer Institute (NCI)-designated comprehensive cancer center located in Western New York.Methods: We conducted a retrospective database review that identified 182 patients with deaths resulting from breast cancer who were eligible for services through a local not-for-profit hospice. Patients with metastatic breast cancer were matched to the hospice database for information on hospice utilization and quality measures. Date of last chemotherapy, medication use, documentation of advance directive and palliative care discussions, and place of death were collected through chart abstraction.Results: One-third (33%) of metastatic breast cancer patients treated at the cancer institute during the study period died without a hospice referral. Only 7% of patients who died without a hospice referral had a documented discussion of palliative care as an option by the oncology team (p