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CC BY-NC-ND 4.0 · South Asian J Cancer 2018; 07(03): 210-213
DOI: 10.4103/sajc.sajc_257_17
ORIGINAL ARTICLE: Palliative Care

Palliative care and end-of-life measure outcomes: Experience of a tertiary care institute from South India

Autor*innen

  • Praveen Adusumilli

    Department of Medical Oncology, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Andhra Pradesh

  • Lingaraj Nayak

    Department of Medical Oncology, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Andhra Pradesh

  • Vidya Viswanath

    Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Andhra Pradesh

  • Leela Digumarti

    Department of Gynaec Oncology, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Andhra Pradesh

  • Raghunadha Rao Digumarti

    Department of Medical Oncology, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Andhra Pradesh

Source of Support: Nill.
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Abstract

Introduction: Desisting from disease directed treatment in the past weeks of life is a quality criterion in oncology service. Patients with advanced cancer have unrealistic expectations from chemotherapy and hold on to it as a great source of hope. Many oncologists continue futile and unnecessary treatments, instead of conveying to the patients the lack of benefit, resulting in delayed referral for palliative care (PC). Materials and Methods: This is a retrospective analysis of case records from June 2014 to December 2015. The primary objective was to study, how far back in time terminally ill cancer patients received definitive cancer directed therapy (DCDT). Apart from patient demographics, the diagnosis, stage, and details of DCDT, and death were captured. PC referral data were recorded. DCDT to death was taken as treatment-free interval (TFI). Analysis was performed using IBM SPSS Statistics for Windows, Version 20. Results: A total of 292 case records were evaluated. Seventy-three had inadequate treatment details. Hence, 219 records were analyzed. PC referral was done in 78.5% of patients. Only best supportive care (BSC) without any DCDT was given in 27 patients. The most common reason for BSC was a poor performance status in 92.5%. The median time from PC referral till death was 43.5 days (range: 1–518 days). Chemotherapy was the most common DCDT in 52.9% of patients. The median time from DCDT and death was 49 days (range: 0–359 days). Cervical and ovarian cancers patients had the longest TFI ; shortest in unknown primary. Most patients died at home (70.4%). Patients receiving PC preferred home or hospice as place of death. Of the 80 patients given hospice care, 39 (36.5%) died in the hospice. Conclusion: While DCDT needs to be started at the right time, it should also be discontinued when futile. Early involvement of the PC team, even while patients are on DCDT makes the transition smoother and more meaningful.

Key words

End-of-Life measures - palliative care - South India - tertiary institute


Publikationsverlauf

Artikel online veröffentlicht:
22. Dezember 2020

© 2018. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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