Patients with prostate cancer used many healthcare resources during the final year of life, remodeling services may improve the quality of care. These findings were published in the Journal of Palliative Care.
Records from 77 patients with prostate cancer who died during a 2-year period from a single district in London were assessed for use of palliative care.
Patients were median age 76 years (range, 56 to 92) at cancer diagnosis, 83 years (range, 57 to 98) at death, and died 5 years (range, 0 to 25) following their diagnosis. Patients died at the hospital (50.6%), home (26.0%), or hospice (23.4%).
During the final year, 78.0% had more than 1 outpatient appointment (mean, 6.1/patient) for a total of 473 attended appointments; the majority of which (77.8%) occurred during the final 6 months of life (P <.001).
Urology (70.0%) and oncology (17.5%) consultations were attended by physicians (61.3%) or nurses (38.7%). Nurse-led consultations doubled during the final 6 months of life (117 vs 66).
Nearly half (46.8%) of patients were admitted to the hospital, totaling 247 days of inpatient care. The majority (81.8%) were admitted to the emergency department due to feeling unwell (30.2%), falls (9.9%), urosepsis (8.7%), and chest sepsis (8.7%), totaling 1816 emergency inpatient days.
This study may have been limited by not including the timing of palliative care referral, as earlier referrals may help reduce end-of-life hospitalizations.
The study authors concluded that increased use of healthcare services during the final year of life among patients with prostate cancer indicated a need for better communication between urology, oncology, and palliative care. A reorganization may help to reduce cost and increase care quality.
Tien T, Gkougkousis E, Allchorne P, Green JSA. The use of healthcare services by prostate cancer patients in the last 12 months of life: how do we improve the quality of care during this period?J Palliat Care. Published November 26, 2020. doi:10.1177/0825859720975944