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Attend this session at the
2017 ASCO Annual Meeting!


Session: Patient and Survivor Care

Type: Poster Session

Time: Saturday June 3, 1:15 PM to 4:45 PM

Location: Hall A


Session: Patient and Survivor Care

Type: Poster Discussion Session

Time: Saturday June 3, 4:45 PM to 6:00 PM

Location: S404

Agreement about end-of-life (EOL) care among advanced cancer patients and their caregivers: Associations with care received.

Sub-category:
End-of-Life Care

Category:
Patient and Survivor Care

Meeting:
2017 ASCO Annual Meeting

Abstract No:
10021

Poster Board Number:
Poster Discussion Session (Board #10)

Citation:
J Clin Oncol 35, 2017 (suppl; abstr 10021)

Author(s): Charles Stewart Kamen, Paul Duberstein, Holly Gwen Prigerson, Supriya Gupta Mohile, Matthew Asare, Michelle Christine Janelsins, Karen Michelle Mustian, Luke Joseph Peppone, Ronald M. Epstein; University of Rochester Medical Center, Rochester, NY; Weill Cornell Medical College, New York, NY; University of Rochester, Rochester, NY

Abstract Disclosures

Abstract:

Background: Patients with advanced cancer and their caregivers often have different preferences regarding patients’ EOL care. Disagreement in a patient-caregiver dyad can increase stress and result in suboptimal care. Understanding factors that promote agreement, as well as the effect of agreement on care received at EOL, can inform interventions to improve communication and EOL decision-making for patients and caregivers. Methods: 205 patients (Stage III or IV cancer plus limited prognosis) and their caregivers were recruited to a randomized controlled trial of a communication intervention for patients, caregivers, and providers (Cancer Communication Study, PI: Epstein). Before intervention, patients completed the Preferences for Life-Extending Treatment questionnaire, which asked their preference regarding experimental treatment, life support, and palliative care; caregivers were asked about patients’ preferences. Binomial logistic regressions analyses modeled agreement in preferences as a function of patient and caregiver demographic characteristics and EOL care received as a function of patient-caregiver agreement. Results: The majority of patient-caregiver dyads agreed about experimental treatment (60.3%), life support (63.4%), and palliative care (70.7%). Dyads were more likely to agree about palliative care when patients were female (OR = 1.94, p = .03) and non-Hispanic white (OR = 2.10, p = .07) and when caregivers were college educated (OR = 2.04, p = .03). Of the 82 patients who died during study follow-up, 57 (69.5%) received EOL care congruent with their preferences. In 19 of the 38 (50%) cases where patient-caregiver dyads disagreed, caregivers’ preferences predicted EOL care received. Dyadic agreement about life support was associated with increased odds of patients receiving/not receiving life support congruent with their preference (OR = 3.02, p = .02). Conclusions: Facilitating agreement between patients and caregivers could improve receipt of patient-centered care. A communication intervention designed to increase dyadic agreement by helping patients and caregivers discuss challenging EOL decisions might improve EOL care delivery. Clinical trial information: NCT01485627

 
Other Abstracts in this Sub-Category:

 

1. Lorazepam as an adjuvant to haloperidol for agitated delirium at the end of life: A double-blind randomized controlled trial.

Meeting: 2017 ASCO Annual Meeting Abstract No: 10003 First Author: David Hui
Category: Patient and Survivor Care - End-of-Life Care

 

2. The PULSES project: Teaching the vital elements of code status discussions to oncology residents.

Meeting: 2017 ASCO Annual Meeting Abstract No: 10024 First Author: Oren Hannun Levine
Category: Patient and Survivor Care - End-of-Life Care

 

3. Predictive value of the patient reported outcome “living with cancer” instrument on overall survival in advanced cancer patients: A tool for guiding timing of palliative care consultations.

Meeting: 2017 ASCO Annual Meeting Abstract No: 10025 First Author: Stuart L. Goldberg
Category: Patient and Survivor Care - End-of-Life Care

 

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