Difference did not persist after exclusion of people who died suddenly
By Elana Gotkine HealthDay Reporter
MONDAY, April 29, 2024 (HealthDay News) — People with opioid use disorder (OUD) are less likely to receive palliative care during the last 90 days before death, according to a study published online April 29 in CMAJ, the journal of the Canadian Medical Association.
Jenny Lau, M.D., from the University Health Network in Toronto, and colleagues conducted a cohort study using health administrative databases to identify people who died between July 1, 2015, and Dec. 31, 2021, to compare palliative care provision during the last 90 days before death for decedents with and without OUD. Overall, 1.6 percent of 679,840 decedents had OUD.
The researchers found that people with OUD died at a younger age and were more likely to live in neighborhoods with high marginalization indices compared with people without OUD. People with OUD were less likely to receive palliative care at the end of their lives (adjusted relative risk, 0.84; 95 percent confidence interval, 0.82 to 0.76); after exclusion of those who died suddenly, this association did not persist (adjusted relative risk, 0.99; 95 percent confidence interval, 0.96 to 1.01). Regardless of cause of death, people with OUD were less likely to receive palliative care in clinics and their homes.
“People with OUD were less likely to receive palliative care despite accessing palliative care earlier, which may reflect their end-of-life illness trajectories and underlying structural vulnerability that may prompt them to receive palliative care primarily in acute care,” the authors write.
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