Increase seen in number of acute care visits, hospice use, palliative care, advanced care planning from six months before to month of death
By Elana Gotkine HealthDay Reporter
FRIDAY, Feb. 28, 2025 (HealthDay News) — Many patients with advanced cancer receive potentially aggressive care in the last month of life at the expense of supportive care, according to a study published online Feb. 21 in JAMA Health Forum.
Youngmin Kwon, Ph.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues examined contemporary patterns of end-of-life care among patients with advanced cancer in a retrospective cohort study to determine whether efforts to improve end-of-life care among these patients in the last decade have had an impact. The study included 33,744 fee-for-service Medicare decedents aged 66 years or older who were originally diagnosed with distant-stage breast, prostate, pancreatic, or lung cancers and died between 2014 and 2019.
The researchers observed an increase in the mean number of acute care visits from six months before death to the month of death (from 14.0 to 46.2 per 100 person-months), as well as increases in hospice use (from 6.6 to 73.5 per 100 person-months), palliative care (from 2.6 to 26.1 per 100 person-months), and advanced care planning (from 1.7 to 12.8 per 100 person-months). Any indicator of potentially aggressive care was experienced by 45.0 percent of decedents in the last 30 days of life.
“We found that many patients continue to receive potentially aggressive interventions at end of life at the expense of supportive care services,” the authors write. “To make meaningful improvements in the quality of end-of-life care, a multifaceted approach that addresses patient, physician, and system-level factors associated with persistent patterns of potentially aggressive care will be required.”
One author disclosed ties to Pfizer.
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