Meaningful changes in end-of-life care among patients with myeloma

Haematologica
Oreofe O OdejideGregory A Abel

Abstract

Patients with advanced myeloma experience a high symptom burden particularly near the end of life, making timely hospice use crucial. Little is known about the quality and determinants of end-of-life care for this population, including whether potential increases in hospice use are also accompanied by "late" enrollment (≤ 3 days before death). Using the Surveillance, Epidemiology, and End-Results-Medicare database, we identified patients ≥ 65 years diagnosed with myeloma between 2000 and 2013 who died by December 31, 2013. We assessed prevalence and trends in hospice use, including late enrollment. We also examined six established measures of potentially aggressive medical care at the end of life. Independent predictors of late hospice enrollment and aggressive end-of-life care were assessed using multivariable logistic regression analyses. Of 12,686 myeloma decedents, 48.2% enrolled in hospice. Among the 6111 who enrolled, 17.2% spent ≤ 3 days there. There was a significant trend in increasing hospice use, from 28.5% in 2000 to 56.5% by 2013 (Ptrend <0.001), no significant rise in late enrollment (12.2% in 2000 to 16.3% in 2013, Ptrend =0.19), and a slight decrease in aggressive end-of-life care (59.2% in 2000 to 56.7% in 2013...Continue Reading

Citations

Feb 6, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Areej El-JawahriThomas W LeBlanc
Nov 1, 2018·Current Opinion in Supportive and Palliative Care·Thomas W LeBlanc, Areej El-Jawahri
Sep 16, 2020·International Journal of Environmental Research and Public Health·Jing LiaoPing Ni
Jul 24, 2018·Current Opinion in Supportive and Palliative Care·Dena Schulman-GreenRuth McCorkle
Apr 2, 2021·BMC Cancer·Saqib AbbasiGhulam Rehman Mohyuddin
Apr 18, 2021·Current Hematologic Malignancy Reports·Thomas M Kuczmarski, Oreofe O Odejide

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