Study Finds Trends and Disparities in EOL Care for Patients With Hematologic Malignancies
Studies suggest that patients with hematologic malignancies receive more aggressive end-of-life (EOL) care than those with solid tumors. In addition, racial and ethnic minorities are reported to have lower rates of hospice care, advanced directive (AD) use, and palliative care use. Researchers assessed differences in hospital use patterns and documentation of advanced care planning between patients with solid tumors and hematologic malignancies. And in a subgroup analysis, they examined differences in outcomes associated with racial and ethnic minority status in patients with hematologic malignancies. Kedar Kirtane, MD, at the Fred Hutchinson Cancer Research Center at the University of Washington in Seattle, discussed the findings at the ASH Annual Meeting.
What Oncology Nurses Need to Know About Cultural Differences During End-of-Life Care
Beyond the emotional complexities of end-of-life care, a multitude of cultural nuances and differences can affect the care that oncology nurses need to provide to their patients and family members. As the face of the healthcare team, oncology nurses are often called on to navigate this delicate area within the cancer continuum.
The Case of the Comfort Care Concerns
Phil is a 63-year-old man who is admitted to the inpatient oncology unit for severe pain resulting from metastatic small cell lung cancer. His wife and two daughters are at his bedside. Earlier in the day, the medical oncologist discussed additional treatment options or hospice care. Phil decided on comfort care with the hope of getting his pain managed and going home on hospice.
Ethnic Minority Patients May Receive Inferior End-of-Life Care
According to the results of a study published in the Journal of Clinical Oncology, African American and Hispanic patients with ovarian cancer who lived in Texas were more likely to receive invasive or toxic treatment and be admitted to intensive care in their final month of life than their Caucasian counterparts.
Chemotherapy Use Near the End of Life Is More Common in United States
National guidelines suggest that the use of chemotherapy near end of life (EOL) is aggressive and is associated with poorer patient quality of life. In addition, Medicare payments for outpatient chemotherapy have decreased since around 2005–2006. In a recent study presented at the 2017 ASCO Annual Meeting, researchers evaluated the impact of U.S. payment reform and guidelines on chemotherapy use at EOL, comparing chemotherapy use at EOL in the United States and other countries.