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Symptom Management and Support in Dying Patients with Cancer and Coronavirus Disease-19—A Register-Based Study

Hedman, Christel LU ; Strang, Peter ; Lundström, Staffan and Martinsson, Lisa (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.

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author
; ; and
organization
publishing date
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
SAGE Publications
external identifiers
  • scopus:85148422498
  • pmid:36793233
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
2025-12-13 03:31:08
@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 &lt;.001), while pain was less common (65% and 78%, respectively; p &lt;.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 &lt;.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 &lt;.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 &lt;.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    = {{SAGE Publications}},
  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}},
}