Lung cancer and end-of-life care: a systematic review and thematic synthesis of aggressive inpatient care
| Autor: | Frédéric Rivière, Morgane Didier, Jacques Margery, Olivier Bylicki, Christos Chouaid, F. Grassin |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Lung Neoplasms Palliative care MEDLINE Medicine (miscellaneous) Review healthcare costs 03 medical and health sciences 0302 clinical medicine Health care Humans Medicine aggressive care 030212 general & internal medicine Intensive care medicine end-of-life care Inpatients Terminal Care Inpatient care Oncology (nursing) business.industry Palliative Care General Medicine Emergency department Chemotherapy regimen Clinical trial lung cancer Medical–Surgical Nursing 030220 oncology & carcinogenesis business End-of-life care |
| Zdroj: | BMJ Supportive & Palliative Care |
| ISSN: | 2045-4368 2045-435X |
| DOI: | 10.1136/bmjspcare-2019-001770 |
| Popis: | ObjectivesDespite recent advances in thoracic oncology, most patients with metastatic lung cancer die within months of diagnosis. Aggressiveness of their end-of-life (EOL) care has been the subject of numerous studies. This study was undertaken to evaluate the literature on aggressive inpatient EOL care for lung cancer and analyse the evolution of its aggressiveness over time.MethodsA systematic international literature search restricted to English-language publications used terms associated with aggressiveness of care, EOL and their synonyms. Two independent researchers screened for eligibility and extracted all data and another a random 10% sample of the abstracts. Electronic Medline and Embase databases were searched (2000–20 September 2018). EOL-care aggressiveness was defined as follows: 1) chemotherapy administered during the last 14 days of life (DOL) or new chemotherapy regimen during the last 30 DOL; 2) >2 emergency department visits; 3) >1 hospitalisation during the last 30 DOL; 4) ICU admission during the last 30 DOL and 5) palliative care started ResultsAmong the 150 articles identified, 42 were retained for review: 1 clinical trial, 3 observational cohorts, 21 retrospective analyses and 17 administrative data-based studies. The percentage of patients subjected to aggressive therapy seems to have increased over time. Early management by palliative care teams seems to limit aggressive care.ConclusionsOur analysis indicated very frequent aggressive EOL care for patients with lung cancer, regardless of the definition used. The extent of that aggressiveness and its impact on healthcare costs warrant further studies. |
| Databáze: | OpenAIRE |
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