The following is a summary of the “Effect of Specialized Palliative Care on End-of-Life Care Intensity in AYAs with Cancer,” published in the November 2022 issue of Pain and Symptom Management by Jewitt, et al.
High intensity (HI) care is often used for terminally ill adolescents and young adults (AYAs; 15–39 years old) (EOL). The risk of receiving high-intensity end-of-life care (HI-EOL) is reduced when palliative care (PC) is involved with this population. It is unclear whether this correlation holds true for both specialized and general-purpose computers. The goals of this study were twofold: to ascertain whether or not SPC influenced the level of end-of-life care that AYAs with cancer received, and to identify which populations were most at risk for diminished access to SPC.
Using registry and population-based data, researchers identified a cohort of young adults (AYAs) who died from cancer in Ontario, Canada, between 2000 and 2017.
All of the following: more than 1 emergency department visit, more than 1 hospitalization, or any ICU admission within 30 days of death constituted the primary composite measure of HI-EOL care. Involvement in SPC and GPC was determined by using billing codes from physicians. SPC was awarded to 2,140 (or 30%) of the 7,122 AYA deaths, and GPC was awarded to 943 (13%).
Young adults who passed away at a younger age, those diagnosed with hematologic malignancies, males, and those living in rural areas were less likely to receive SPC.
The odds of receiving HI-EOL care increased by 1.5 times among those who did not have PC involvement (P<0.0001). Involvement in an SPC was linked to a lower risk of HI-EOL care (OR SPC vs. GPC 0.8; P = 0.007) and a lower risk of ICU admission (OR 0.7; P = 0.006). The likelihood that a young adult with cancer would receive HI-EOL care was lowest among those with a social support system. However, getting your hands on SPC is still difficult.