The Impact of Palliative Care Consultation on Aggressive Medical Interventions in End-of-life Among Patients with Metastatic Breast Cancer: Insights from the U.S. National Patient Sample.

Autor:	Zhang Z; Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, St. Louis, MO, USA., Lovell A; School of Medicine, Saint Louis University, St. Louis, MO, USA., Subramaniam DS; Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, St. Louis, MO, USA.; Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA., Hinyard L; Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, St. Louis, MO, USA.; Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA.
Jazyk:	angličtina
Zdroj:	Journal of palliative care [J Palliat Care] 2025 Jan; Vol. 40 (1), pp. 8-17. Date of Electronic Publication: 2024 May 15.
DOI:	10.1177/08258597241253933
Abstrakt:	Background: Advancement in treatment has led to prolonged survival and a rising number of women living with metastatic breast cancer (MBC) in the United States. Due to its high symptom burden, it is recommended that palliative care be integrated into the standard care to help improve quality of life. However, little is known about the use of palliative care among MBC patients in the nation. Objectives: To determine utilization of palliative care consult (PCC) after metastasis and the influence of PCC on healthcare utilization in the end of life among women living with MBC in the US. Methods: This retrospective cohort study examined a national electronic health record database to quantify the PCC use after metastasis diagnosis until death and the associations of PCC with Emergency Department (ED), Intensive Care Unit (ICU), and chemotherapies in the end-of-life women (age ≥ 18 years) living with MBC. Results: From a cohort of 2615 deceased MBC patients, 37% received PCC in the last 6 months of life. Patients who had received PCC in the end-of-life were more likely to be hospitalized, admitted to ED and ICU, and receive chemotherapies in the last 60 days before death. However, patients who had received end-of-life PCC had less hospital and ED visits and received less chemotherapies after PCC initiated. Conclusion: While PCC can reduce end-of-life aggressive interventions, it was underutilized among patients with MBC in the end-of-life. A myriad of clinical and patient factors may still challenge timely consultation. We urge for future endeavors in developing strategies to remove barriers in the implementation, especially earlier in the disease course, to assure timely PC treatments and reduce discomfort amid aggressive interventions for MBC. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu