• J Pain Symptom Manage · Jun 2019

    Intensity of Cancer Care Near the End-of-Life at a Tertiary Care Cancer Center in Jordan.

    • Hikmat Abdel-Razeq, Omar Shamieh, Mahmoud Abu-Nasser, Moath Nassar, Yazan Samhouri, Bashar Abu-Qayas, Joud Asfour, Joud Jarrah, Zaid Abdelrahman, Zaid Ameen, AbdelRahman Al-Hawamdeh, Mohammad Alomari, Amal Al-Tabba', Dalia Al-Rimawi, and David Hui.
    • King Hussein Cancer Center, Amman, Jordan.
    • J Pain Symptom Manage. 2019 Jun 1; 57 (6): 110611131106-1113.

    ContextChemotherapy use in the last month of life is an indicator of poor quality of end-of-life care.ObjectivesWe assessed the frequency of chemotherapy use at the end of life at our comprehensive cancer center in Jordan and identified the factors associated with chemotherapy use.MethodsWe conducted a retrospective chart review to examine the use of chemotherapy in the last 30 days and 14 days of life in consecutive adult patients with cancer seen at King Hussein Cancer Center (KHCC) who died between January 1, 2010, and December 31, 2012. We collected data on patient and disease characteristics, palliative care referral, and end-of-life care outcome indicators.ResultsAmong the 1714 decedents, 310 (18.1%) had chemotherapy use in the last 30 days and 142 (8.3%) in the last 14 days of life. Over half (910; 53.1%) had a palliative care referral. Chemotherapy use in the last 30 and 14 days of life were associated with younger age (odds ratio [OR] 0.99/yr, P = 0.01, and OR 0.99/yr, P = 0.01, respectively) and hematological malignances (OR 1.98, P < 0.001, and OR 2.85, P < 0.001, respectively). Palliative care referral was significantly associated with decreased use of chemotherapy in the last 30 (OR 0.30, P < 0.001) and 14 (OR 0.15, P < 0.001) days of life.ConclusionsA sizable minority of patients with cancer at KHCC received chemotherapy at the end of life. Younger patients and those with hematological malignancies were more likely to receive chemotherapy, whereas those referred to palliative care were significantly less likely to receive chemotherapy at the end of life.Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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