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Ajibawo T, Okunowo O. Prevalence and Factors Associated With Palliative Care Utilization Among Hospitalized Patients With Gallbladder Cancer- A National Inpatient Sample Analysis. Am J Hosp Palliat Care 2024:10499091241262968. [PMID: 38881223 DOI: 10.1177/10499091241262968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Abstract
OBJECTIVES Various factors have been associated with palliative utilization in different cancers. However, literature is still lacking on the prevalence and factors associated with palliative care use in gallbladder cancer (GBC). This study aims to determine the prevalence of palliative care utilization and examine the factors associated with palliative care utilization among patients with GBC. METHODS We conducted a retrospective analysis using the National Inpatient Sample between 2016 and 2018. Descriptive statistics were used to characterize the study population. We explored factors associated with palliative care utilization among hospitalized GBC patients using logistic regression. RESULTS Of the 20280 GBC hospitalizations, 18.0 % utilized palliative care. Multivariable analysis revealed that treatment at urban teaching hospitals, or treatment at urban nonteaching hospitals, Medicare insurance, other insurance coverage, transfer to a facility/discharge with home health, and death during hospital stay were associated with higher utilization of palliative care. In contrast, non-elective admissions were associated with decreased odds of palliative care utilization. CONCLUSION Palliative care use among GBC patients is still low at 18.0%. Palliative care use was associated with insurance disparities, discharge disposition, hospital location, and type of admission. Therefore, concerted efforts to address these disparities in palliative care utilization are needed to improve the quality of care for this population.
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Affiliation(s)
| | - Oluwatimilehin Okunowo
- Department of Computational and Quantitative Medicine, Division of Biostatistics, Beckman Research Institute of City of Hope, Duarte, CA, USA
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Freeman JQ, Omoleye OJ, Zhao F, Huo D. Palliative Care Use Trends, Racial/Ethnic Disparities, and Overall Survival Differences Among Patients With Metastatic Breast Cancer. J Palliat Med 2024; 27:763-775. [PMID: 38301120 DOI: 10.1089/jpm.2023.0547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
Background: Palliative care improves cancer patients' quality of life. Limited research has investigated racial/ethnic disparities in palliative care utilization and its associated survival among metastatic breast cancer (MBC) patients. Objectives: To examine racial/ethnic palliative care use disparities and assess racial/ethnic overall survival differences in MBC patients stratified by palliative care use. Design: A retrospective study of MBC patients from the 2004-2020 National Cancer Database. Measurements: Palliative care was defined as noncurative cancer treatment, including surgery, radiotherapy, systemic therapy, and/or pain management; utilization was coded "yes/no." Racial/ethnic groups included Asian, American Indian or Alaska Native (AIAN), Black, Hawaiian or Other Pacific Islander (HPI), Hispanic, and White. Logistic regression was performed to assess palliative care use disparities. Overall survival was modeled using Cox regression. Results: Of 148,931 patients, the mean age was 62 years; 99% were female; 73% identified as White, 17% as Black, 6% as Hispanic, 3% as Asian, 0.3% as AIAN, and 0.3% as HPI; 42% and 39% had Medicare and private insurance, respectively. Overall, 21% used palliative care, with an increasing utilization rate from 2004 to 2020 (3.6% increase per year, p-trend <0.001). Black (adjusted odds ratio [aOR] = 0.89; 95% confidence interval [CI]: 0.84 to 0.94), Asian (aOR = 0.76; 95% CI: 0.68 to 0.86), and Hispanic (aOR = 0.68; 95% CI: 0.62 to 0.74) patients had a lower likelihood of palliative care utilization than White patients. Among palliative care users, compared with White patients, Black (adjusted hazard ratio [aHR] = 1.14, 95% CI: 1.07 to 1.21) patients had a greater mortality risk, while Asian (aHR = 0.83, 95% CI: 0.71 to 0.97) and Hispanic (aHR = 0.77, 95% CI: 0.69 to 0.87) patients had a lower mortality risk. Conclusions: Palliative care utilization among MBC patients significantly increased but remained suboptimal. Racial/ethnic minority patients were less likely to use palliative care, and Black patients had worse survival, than White patients, suggesting the need for improving palliative care access and ameliorating disparities in MBC patients.
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Affiliation(s)
- Jincong Q Freeman
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA
- Center for Health and the Social Sciences, The University of Chicago, Chicago, Illinois, USA
- Cancer Prevention and Control Research Program, UChicago Medicine Comprehensive Cancer Center, Chicago, Illinois, USA
| | - Olasubomi J Omoleye
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Fangyuan Zhao
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA
| | - Dezheng Huo
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA
- Cancer Prevention and Control Research Program, UChicago Medicine Comprehensive Cancer Center, Chicago, Illinois, USA
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois, USA
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Fetene D, Taylor L, Ferrell B, Deribe B, Abdella J, Aynalem A. Factors affecting need and utilization of palliative care services among Ethiopian women in an oncology department: A hospital-based cross-sectional study. Palliat Care Soc Pract 2024; 18:26323524241253625. [PMID: 38800039 PMCID: PMC11127578 DOI: 10.1177/26323524241253625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 04/21/2024] [Indexed: 05/29/2024] Open
Abstract
Background Palliative care, which aims to alleviate physical and emotional distress from cancer, is underutilized in many African healthcare systems. Therefore, there is a lack of data on the need and utilization of palliative care services among women with breast cancer in Ethiopia. Objectives The goal of this study was to identify the level of need and utilization of palliative care services and identify associated factors among women in an oncology department of Hawassa comprehensive and specialized hospitals. Design Hospital-based cross-sectional study. Methods A total of 121 women age ⩾18 years old with breast cancer participated from 1 August to 30 October 2021. A hospital-based consecutive sampling technique was used. Data regarding the need and utilization of palliative care services were collected via questionnaire and interview, entered using EpiData 4.6.0.6, and analyzed by SPSS version 25. Variables with p < 0.25 were considered for multivariate analysis, and those with p < 0.05 indicate an association with palliative care utilization. Result Seventy-two (59.5%) had worse utilization of palliative care services, with higher odds in rural areas (adjusted odds ratio = 11.82). Conclusion The study findings indicated that more than half of the study participants had worse utilization of palliative care services, with rural living being a contributing factor.
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Affiliation(s)
- Deriba Fetene
- Department of Nursing, School of Health Sciences, College of Medicine and Health Sciences, Madda Walabu University, Bale Robe, Oromia 247, Ethiopia
| | - Lesley Taylor
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
| | - Betty Ferrell
- Division of Nursing Research and Education, City of Hope Medical Center, Duarte, CA, USA
| | - Bedilu Deribe
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Jabir Abdella
- School of Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Amdehiwot Aynalem
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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de Ligt KM, de Rooij BH, Koppert LB, van de Poll-Franse LV, Velikova G, Cardoso F. Patient-Reported Outcome Measures to Improve the Care Continuum for Patients With Metastatic Breast Cancer: Opportunities and Implications for Nursing Practice. Semin Oncol Nurs 2023; 39:151510. [PMID: 37833113 DOI: 10.1016/j.soncn.2023.151510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVES Albeit treatable, metastatic breast cancer (MBC) remains incurable. To achieve remaining life years lived well, extended survival should be balanced with optimal health-related quality of life (HRQoL) and timely initiated supportive, palliative, and end-of-life care. The Advanced Breast Cancer (ABC) Global Alliance identified 10 urgent and actionable goals for the decade between 2015 and 2025 to achieve substantial improvement in the lives of patients living with ABC, including MBC. Enhancements are needed for HRQoL, research, quality of care, and survival. We explore the potential of patient-reported outcome measures (PROMs) in addressing these gaps and aim to describe opportunities and current initiatives for improving the MBC care continuum through PROMs. DATA SOURCES Narrative description of recent literature on MBC and PROMs. CONCLUSION We believe PROMs can make valuable contributions to seven of the 10 goals described: 1) enhancing the understanding of MBC through high-quality data collection, 2) improving HRQoL and raising consideration of survival versus HRQoL, 2) prolonging survival, 4) increasing referral to nonclinical support services, 5) supporting patient-healthcare provider communication, 6) encouraging improvements in healthcare access, and 7) supporting meeting patients' informational needs. IMPLICATIONS FOR NURSING PRACTICE Maximizing the benefits of PROMs requires effective implementation. Because nurses and nurse practitioners are at the forefront of care, they can offer a comprehensive understanding of patients' needs and play a crucial role in facilitating the integration of PROMs into routine care for MBC patients and ultimately optimizing patients' outcomes and life years and months left.
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Affiliation(s)
- Kelly M de Ligt
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - Belle H de Rooij
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht; Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Linetta B Koppert
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Lonneke V van de Poll-Franse
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam; Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht; and Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Galina Velikova
- Leeds Institute of Medical Research at St James's and Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, United Kingdom
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
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Newport KB, Webb JA. Innovations and Opportunities for the Integration of Palliative Care in Cancer Care. Curr Probl Cancer 2023; 47:101016. [PMID: 37806918 DOI: 10.1016/j.currproblcancer.2023.101016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 10/10/2023]
Affiliation(s)
- Kristina B Newport
- Section of Palliative Care, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Jason A Webb
- Section of Palliative Care, Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland, Oregon; Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon.
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Vâlcu EG, Firescu D, Nechita A, Ciubară A, Constantin GB, Rahnea-Nita G, Rebegea LF. Considerations Regarding Online Group Psychotherapy Sessions for Breast Cancer Patients in Active Phase of Oncological Treatment. Healthcare (Basel) 2023; 11:2311. [PMID: 37628508 PMCID: PMC10454484 DOI: 10.3390/healthcare11162311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION The aim of this study is to evaluate the results of online group meetings for breast cancer patients in the active phase of treatment. The group therapy sessions took place weekly, synchronously, online, on Zoom, with a total of 12 meetings lasting about 2.5 h per session, between December 2021 and February 2022. We analyzed the topics of discussion chosen by the participants, the structure of the group, the results obtained at the main scales of evaluation/monitoring of quality of life and the motivation of patients to participate in the therapeutic group. All patients were in the active phase of treatment (chemotherapy, radiotherapy, hormone therapy, etc.). The main goal of the group therapy was to reduce the stress related to the disease. MATERIAL AND METHODS Systematic observations included ABS psychological tests, EQ-5D-5L, HADS-Hospital Anxiety and Depression Scale, and the Recurrence Fear Questionnaire; the questionnaires were administered at the beginning and at the end of the therapeutic intervention; the participation in the therapy and in the research of the patients began after signing the informed consent document; the intervention was evaluated at the end using a feedback questionnaire. The group was closed, and the participants signed an informed consent document and agreed to have the sessions recorded. RESULTS Comparing the initial with the final results of the psychological tests administered, there was an improvement in the quality of life of the participants in all areas, with a clinically significant decrease in the areas of pain and depression, along with an increase in perception of well-being, a decrease in FoP scores and an increase in the level of rationality about the disease. CONCLUSIONS Group therapy for cancer patients was useful in improving the quality of life; the closed group, even online, provided a safe environment in which they could share feelings. A close correlation was noted between the scores obtained on the FoP-Q and HADS scales. It is evident that there is a strong relationship between FoP and depression. Results on these scales correlated well with results on the EQ-5D-5L quality of life questionnaire.
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Affiliation(s)
- Elena Gabriela Vâlcu
- School of Advanced Doctoral Studies, “Dunarea de Jos” University, 800008 Galati, Romania; (E.G.V.); (D.F.); (A.N.); (A.C.); (L.-F.R.)
| | - Dorel Firescu
- School of Advanced Doctoral Studies, “Dunarea de Jos” University, 800008 Galati, Romania; (E.G.V.); (D.F.); (A.N.); (A.C.); (L.-F.R.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania
| | - Aurel Nechita
- School of Advanced Doctoral Studies, “Dunarea de Jos” University, 800008 Galati, Romania; (E.G.V.); (D.F.); (A.N.); (A.C.); (L.-F.R.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania
- Department of Pediatrics, “Sf. Ioan” Clinical Hospital for Children, 800487 Galati, Romania
| | - Anamaria Ciubară
- School of Advanced Doctoral Studies, “Dunarea de Jos” University, 800008 Galati, Romania; (E.G.V.); (D.F.); (A.N.); (A.C.); (L.-F.R.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania
| | | | - Gabriela Rahnea-Nita
- Clinical Department, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- “Sf. Luca” Chronic Diseases Hospital, 041915 Bucharest, Romania
| | - Laura-Florentina Rebegea
- School of Advanced Doctoral Studies, “Dunarea de Jos” University, 800008 Galati, Romania; (E.G.V.); (D.F.); (A.N.); (A.C.); (L.-F.R.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania
- Department of Oncology, “Sf. Andrei” County Emergency Clinical Hospital, 800179 Galati, Romania
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