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Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2017 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

The stability of treatment preferences of advanced cancer patients over time.

Sub-category:
End-of-Life Care

Category:
Patient and Survivor Care

Meeting:
2017 ASCO Annual Meeting

Abstract No:
e21501

Citation:
J Clin Oncol 35, 2017 (suppl; abstr e21501)

Author(s): Lea Jasmina Jabbarian, Renee Maciejewski, Paul K Maciejewski, Holly Gwen Prigerson; Erasmus MC, Rotterdam, Netherlands; Weill Cornell Medical College, New York, NY

Abstract Disclosures

Abstract:

Background: The stability of patient treatment preferences has important implications for the optimal timing of advance care planning. Nevertheless, longitudinal data on cancer patients in real-life settings have not examined stability of treatment preferences over time. This study examines the stability of treatment preferences of advanced cancer patients over time and the potential influence of changes in physical functioning. Methods: The patient sample (N = 104) was drawn from a multi-institutional, longitudinal cohort study of patients recruited between 2010 and 2015. Patients with metastatic solid tumor cancer that had progressed on prior chemotherapy regimens were interviewed after an initial clinic meeting in which their most recent scan results were discussed (baseline) and, subsequently, completed monthly follow-ups. Patients reported their treatment preferences (i.e., comfort versus life-extending care) and physical functioning at each assessment. Results: The treatment preferences of the majority of patients (80.8%) remained stable within the first month of follow-up. Patient characteristics, such as age or type of cancer, were not significantly associated with treatment preference stability. The proportion of patients whose preferences changed in favor of comfort care (10.6%) was only slightly higher than the proportion of patients whose preferences changed in favor of life-extending care (8.7%). The same pattern held for the two- and three-month follow-up assessments. Improvement in physical functioning was significantly associated with change in treatment preferences. However, the vast majority of patients (72.2%) had stable or declining physical functioning. Conclusions: Most advanced cancer patients have stable treatment preferences regarding comfort versus life-extending care in the months leading up to their death. Thus, advance care planning earlier in the course of illness may not be premature for the vast majority of patients. As physical functioning changes, treatment preferences should be re-evaluated.

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

Meeting: 2017 ASCO Annual Meeting Abstract No: 10021 First Author: Charles Stewart Kamen
Category: Patient and Survivor Care - End-of-Life Care

 

3. 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

 

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