Latino patients with advanced cancer who discussed their end-of-life (EOL) care with their clinicians were more likely to complete a do-not-resuscitate (DNR) order compared with Latino patients who had not had such a discussion, and equally as likely to complete a DNR order as non-Latino white patients, according to a report published in the journal Cancer.1
DNR orders are part of an advanced care plan that is associated with better quality of life at the end of life; however, Latino patients with advanced cancer are less likely to sign DNR orders compared with their non-Latino white counterparts.
Researchers sought to examine the association between EOL discussions and DNR order completion in Latino and non-Latino white patients with advanced cancer.
The researchers recruited 61 Latino patients with cancer and 56 non-Latino white patients with cancer as part of the Coping with Cancer study, a prospective cohort study designed to examine social and psychological influences on EOL care among patients with advanced cancer.
For the study, structured interviews were conducted to identify which patients had EOL discussions with their clinicians and whether DNR orders were completed.
A significantly greater association was seen between EOL discussions and DNR order completion among Latino patients compared with non-Latino white patients, adjusting for potential confounds (interaction adjusted odds ratio, 6.64; P=.041).
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Latino patients who discussed EOL care with their clinicians were more than 10 times more likely (adjusted odds ratio, 10.91; P=.001) to complete a DNR order than were Latino patients who had not had an EOL discussion. In addition, they were equally as likely to complete a DNR order compared with non-Latino white patients.
“Differences in the impact of EOL discussions on DNR order completion may explain Latino/non-Latino ethnic disparities in DNR order completion in EOL care, and point to a means to eliminate those disparities,” conclude the researchers.
1. Shen MJ, Prigerson HG, Paulk E, et al. Impact of end-of-life discussions on the reduction of Latino/non-Latino disparities in do-not-resuscitate order completion [published online ahead of print March 15, 2016). Cancer. doi:10.1002/cncr.29973.