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Quality of end-of-life care in multiple myeloma: A 13-year analysis of a population-based cohort in Ontario, Canada.
Mohyuddin, Ghulam Rehman; Sinnarajah, Aynharan; Gayowsky, Anastasia; Chan, Kelvin K W; Seow, Hsien; Mian, Hira.
Afiliação
  • Mohyuddin GR; Department of Hematology, Huntsman Cancer Institute, Salt Lake City, Utah, USA.
  • Sinnarajah A; Department of Medicine, Queen's University, Kingston, Ontario, Canada.
  • Gayowsky A; ICES McMaster, McMaster University, Hamilton, Ontario, Canada.
  • Chan KKW; Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
  • Seow H; Canadian Centre for Applied Research in Cancer Control, Vancouver, British Columbia, Canada.
  • Mian H; Department of Oncology, McMaster University, Hamilton, Ontario, Canada.
Br J Haematol ; 199(5): 688-695, 2022 12.
Article em En | MEDLINE | ID: mdl-35949180
ABSTRACT
Optimizing end-of-life (EOL) care for multiple myeloma (MM) represents an unmet need. An administrative cohort in Ontario, Canada was analysed between 2006 and 2018. Aggressive care was defined as two or more emergency-department visits in the last 30 days before death, or at least two new hospitalizations within 30 days of death, or an intensive care unit (ICU) admission within the last 30 days of life. Supportive care was defined as a physician house-call in the last two weeks before death, or a palliative nursing or personal support visit at home in the last 30 days before death. Among 5095 patients, 23.2% of patients received chemotherapy at EOL and 55.6% of patients died as inpatient. A minority received aggressive care at EOL [28.3% autologous stem cell transplant (ASCT), 20.4% non-ASCT], and a majority received supportive care at EOL (65.4% ASCT, 61.5% non-ASCT). Supportive care was less likely to be received by those aged over 80 years and in lower-income neighbourhoods. Supportive care at EOL increased from 56.0% in 2006 to 70.3% in 2018. Despite improvements, many patients with MM experience aggressive care at EOL. Even in a publicly funded health care system, disparities based on age, income and community size are present.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Assistência Terminal / Mieloma Múltiplo / Neoplasias Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Aged80 / Humans País/Região como assunto: America do norte Idioma: En Revista: Br J Haematol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Assistência Terminal / Mieloma Múltiplo / Neoplasias Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Aged80 / Humans País/Região como assunto: America do norte Idioma: En Revista: Br J Haematol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos