Chemotherapy and healthcare utilisation near the end of life in patients with cancer
Corresponding Author
K.J.G. Schulkes MD
PhD, Resident Pulmonology
Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Department of Pulmonology, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Correspondence
Karlijn J.G. Schulkes, Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
Email: [email protected]
Search for more papers by this authorI.C. van Walree MD
Resident Geriatric Medicine
Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorL.J.R. van Elden MD, PhD
Pulmonologist
Department of Pulmonology, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorF. van den Bos MD
Geriatrician
Department of Internal Medicine, Haga Hospital, The Hague, The Netherlands
Search for more papers by this authorL. van Huis-Tanja MD, PhD
Medical Oncologist
Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorJ.-W.J. Lammers MD, PhD
Pulmonologist
Department of Pulmonology, UMC Utrecht, Utrecht, The Netherlands
Search for more papers by this authorD. ten Bokkel Huinink MD
Medical Oncologist
Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorM.E. Hamaker MD, PhD
Geriatrician
Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorCorresponding Author
K.J.G. Schulkes MD
PhD, Resident Pulmonology
Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Department of Pulmonology, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Correspondence
Karlijn J.G. Schulkes, Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
Email: [email protected]
Search for more papers by this authorI.C. van Walree MD
Resident Geriatric Medicine
Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorL.J.R. van Elden MD, PhD
Pulmonologist
Department of Pulmonology, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorF. van den Bos MD
Geriatrician
Department of Internal Medicine, Haga Hospital, The Hague, The Netherlands
Search for more papers by this authorL. van Huis-Tanja MD, PhD
Medical Oncologist
Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorJ.-W.J. Lammers MD, PhD
Pulmonologist
Department of Pulmonology, UMC Utrecht, Utrecht, The Netherlands
Search for more papers by this authorD. ten Bokkel Huinink MD
Medical Oncologist
Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorM.E. Hamaker MD, PhD
Geriatrician
Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
Search for more papers by this authorAbstract
The quality of medical care delivered to patients with cancer near the end of life is a significant issue. Previous studies have defined several areas suggestive of aggressive cancer treatment as potentially representing poor quality care. The primary objective of current analysis was to examine chemotherapy and healthcare utilisation in the last 3 months of life among patients with cancer that received palliative chemotherapy. Patients were selected from the hospital administration database of the Diakonessenhuis Utrecht, the Netherlands. Data were extracted from the medical files. A total of 604 patients were included for analysis (median age: 64 years). For 300 patients (50%) chemotherapy was given in the last 3 months (CT+). For 76% (n = 229) of CT+ patients unplanned hospital admissions were made in these last 3 months, compared to 44% (n = 133) of CT− patients (p < .001). Visits to the emergency room in last 3 months were made by 67% (n = 202) of CT+ patients compared to 43% (n = 132) of CT− patients (p < .001). Healthcare consumption was significantly higher in patients who received chemotherapy in the last 3 months of life. Being able to inform our patients about these aspects of treatment can help to optimise both the quality of life and the quality of dying in patients with cancer.
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