| Abstrakt: |
Background: Given the paucity of data on the end of life (EOL) of prostate-cancer (PC) patients, we investigated medication prescription patterns and hospitalizations during their final year of life. Methods: The data base of the Österreichische Gesundheitskasse Vienna (ÖGK-W) was used to identify all men who died with the diagnosis PC between 1.1.2015 and 31.12.2021 and who were under androgen deprivation and/or new hormonal therapies. Patient age, prescription patterns and hospitalizations during the last year of life were recorded, odds ratios for age groups were analyzed. Results: A total of 1.109 patients were included. ADT was given in 86.7% (n= 962) and NHT in 62.8% (n= 696). Overall, prescription of analgesics increased from 41% (n= 455) during the first to 65.1% (n= 722) in the last quarter of the final year of life. Prescription of NSAIDs was almost consistent (18–20%) whereas the number of patients receiving other non-opioids (paracetamol, metamizole) more than doubled (18 to 39%). Older men had lower prescription rates for NSAID (OR: 0.47, 95% CI: 0.35–0.64), non-opioids (OR: 0.43, 95% CI: 0.32–0.57), opioids (OR: 0.45, 95% CI: 0.34–0.6) and adjuvant analgesics (OR: 0.42, 95% CI: 0.28–0.65). Approximately 2/3 of patients (n= 733) died in the hospital with a median of four hospitalizations in the final year of life. The overall cumulative length of admission was less than 50d in 61.9%, 51–100d in 30.6% and >100d in 7.6%. Younger patients (<70 yrs) were more likely to die in the hospital (OR: 1.66, 95% CI: 1.15–2.39), had a higher median rate of hospitalizations (n= 6) and longer cumulative duration of admissions. Conclusions: Resource use increased during the last year life of PC patients with highest rates in younger men. Hospitalization rates were high and 2/3 died in the hospital, both showed clear age dependency with higher rates, duration and death in the hospital for younger men. |
Full text from SpringerLink