Symptom Management and Support in Dying Patients with Cancer and Coronavirus Disease-19—A Register-Based Study
(2023) In Journal of Palliative Care 38(3). p.261-267- Abstract
Objective: Little is known to what extent access to specialist palliative care (SPC) for cancer patients dying with coronavirus disease-2019 (COVID-19) affects the occurrence of breakthrough symptoms, symptom relief, and overall care, compared to hospital deaths. Our aim was to include patients with both COVID-19 and cancer and compare those dying in hospitals with those dying in SPC with reference to the quality of end-of-life care. Methods: Patients with both cancer and COVID-19 who died in hospitals (n = 430) and within SPC (n = 384) were identified from the Swedish Register of Palliative Care. The hospital and SPC groups were compared regarding the quality of end-of-life care, including the occurrence of 6 breakthrough symptoms... (More)
Objective: Little is known to what extent access to specialist palliative care (SPC) for cancer patients dying with coronavirus disease-2019 (COVID-19) affects the occurrence of breakthrough symptoms, symptom relief, and overall care, compared to hospital deaths. Our aim was to include patients with both COVID-19 and cancer and compare those dying in hospitals with those dying in SPC with reference to the quality of end-of-life care. Methods: Patients with both cancer and COVID-19 who died in hospitals (n = 430) and within SPC (n = 384) were identified from the Swedish Register of Palliative Care. The hospital and SPC groups were compared regarding the quality of end-of-life care, including the occurrence of 6 breakthrough symptoms during the last week in life, symptom relief, end-of-life care decisions, information, support, and human presence at death. Results: Breakthrough of breathlessness was more common in the hospital patients compared to the SPC patients (61% and 39%, respectively; p <.001), while pain was less common (65% and 78%, respectively; p <.001). Breakthrough of nausea, anxiety, respiratory secretions, or confusion did not differ. All 6 symptoms, except for confusion, were more often completely relieved in SPC (p =.014 to p <.001 in different comparisons). In SPC, a documented decision about the goal being end-of-life care and information about this were more common than in hospitals (p <.001). Also, to have family members present at the time of death and for family members to be offered a follow-up talk afterward was more common in SPC (p <.001). Conclusion: More systematic palliative care routines may be an important factor for better symptom control and higher quality of end-of-life care in hospitals.
(Less)
- author
- Hedman, Christel LU ; Strang, Peter ; Lundström, Staffan and Martinsson, Lisa
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cancer, COVID-19, end-of-life care, hospital care, palliative care, symptoms
- in
- Journal of Palliative Care
- volume
- 38
- issue
- 3
- pages
- 261 - 267
- publisher
- Centre for Bioethics
- external identifiers
-
- pmid:36793233
- scopus:85148422498
- ISSN
- 0825-8597
- DOI
- 10.1177/08258597231157622
- language
- English
- LU publication?
- yes
- id
- 237b21a5-5aa1-4c8b-ab19-a1d867216107
- date added to LUP
- 2023-03-07 15:03:23
- date last changed
- 2024-09-19 08:48:47
@article{237b21a5-5aa1-4c8b-ab19-a1d867216107, abstract = {{<p>Objective: Little is known to what extent access to specialist palliative care (SPC) for cancer patients dying with coronavirus disease-2019 (COVID-19) affects the occurrence of breakthrough symptoms, symptom relief, and overall care, compared to hospital deaths. Our aim was to include patients with both COVID-19 and cancer and compare those dying in hospitals with those dying in SPC with reference to the quality of end-of-life care. Methods: Patients with both cancer and COVID-19 who died in hospitals (n = 430) and within SPC (n = 384) were identified from the Swedish Register of Palliative Care. The hospital and SPC groups were compared regarding the quality of end-of-life care, including the occurrence of 6 breakthrough symptoms during the last week in life, symptom relief, end-of-life care decisions, information, support, and human presence at death. Results: Breakthrough of breathlessness was more common in the hospital patients compared to the SPC patients (61% and 39%, respectively; p <.001), while pain was less common (65% and 78%, respectively; p <.001). Breakthrough of nausea, anxiety, respiratory secretions, or confusion did not differ. All 6 symptoms, except for confusion, were more often completely relieved in SPC (p =.014 to p <.001 in different comparisons). In SPC, a documented decision about the goal being end-of-life care and information about this were more common than in hospitals (p <.001). Also, to have family members present at the time of death and for family members to be offered a follow-up talk afterward was more common in SPC (p <.001). Conclusion: More systematic palliative care routines may be an important factor for better symptom control and higher quality of end-of-life care in hospitals.</p>}}, author = {{Hedman, Christel and Strang, Peter and Lundström, Staffan and Martinsson, Lisa}}, issn = {{0825-8597}}, keywords = {{cancer; COVID-19; end-of-life care; hospital care; palliative care; symptoms}}, language = {{eng}}, number = {{3}}, pages = {{261--267}}, publisher = {{Centre for Bioethics}}, series = {{Journal of Palliative Care}}, title = {{Symptom Management and Support in Dying Patients with Cancer and Coronavirus Disease-19—A Register-Based Study}}, url = {{http://dx.doi.org/10.1177/08258597231157622}}, doi = {{10.1177/08258597231157622}}, volume = {{38}}, year = {{2023}}, }