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Palliative care is related to less aggressive end-of-life treatment in haematology-oncology: a retrospective cohort study
  1. Davide Facchinelli1,
  2. Corinna Greco1,
  3. Manuela Rigno2,
  4. Daniela Menon1,
  5. Pietro Manno3,
  6. Leonardo Potenza4,
  7. Claudio Cartoni5,
  8. Marcello Riva1,
  9. Laura Dalla Verde3,
  10. Anna Varalta3 and
  11. Alberto Tosetto1
  1. 1Hematology Department, Ospedale San Bortolo di Vicenza, Vicenza, Italy
  2. 2Transfusion Medicine, Ospedale San Bortolo di Vicenza, Vicenza, Italy
  3. 3Palliative Care Unit, Ospedale San Bortolo di Vicenza, Vicenza, Italy
  4. 4Hematology Department, Policlinico di Modena, Modena, Italy
  5. 5Hematology Department, Umberto I Policlinico di Roma, Roma, Italy
  1. Correspondence to Dr Davide Facchinelli; davide.facchinelli{at}aulss8.veneto.it

Abstract

Objectives Patients with haematological malignancies (HM) experience high-intensity medical care near the end of life (EOL), have low rates of hospice and palliative care (PC) use and are more likely to die in the hospital. We compared the quality indicators for EOL care in patients followed by a haematologist with or without PC.

Methods This observational, retrospective study evaluated a cohort of 196 consecutive patients with HM. We used a mean composite score for the aggressiveness of EOL. The quality indicators evaluated were chemotherapy, place of death, transfusions and hospital use in the last month of life.

Results Eighty patients were offered PC and 116 were not. The composite score for aggressive EOL care was significantly higher for patients not followed by PC (2.2 vs 0.5; p<0.0001). None of the PC group patients was intubated or admitted to intensive care; 91.2% of the patients followed by PC died at home or in hospice, while 81.9% of the other patients died in the hospital.

Conclusion Many patients who died of HM received intensive treatment near EOL. Our data support the value of integrating PC into the HM routine practice and can be the basis for new studies.

  • Supportive care
  • Quality of life

https://doi.org/10.1136/spcare-2024-005089

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    Footnotes

    • Contributors DF is the guarantor. DF, LP and CC contributed to the design of the study. DF, CG, LP, CC, MD, PM, RMan, RMar, TA, LDV and VA contributed to the acquisition of data and to the analysis and interpretation. DF, TA and CG contributed to the writing of the paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.