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Article

Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study

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School of Nursing, Queen’s University, Kingston, ON K7L 3N6, Canada
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ICES Queen’s, Queen’s University, Kingston, ON K7L 3L4, Canada
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School of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada
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Division of Cancer Care and Epidemiology, Queen’s Cancer Research Institute, Kingston, ON K7L 3N6, Canada
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Department of Oncology, Queen’s University, Kingston, ON K7L 5P9, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(5), 3297-3315; https://doi.org/10.3390/curroncol28050286
Received: 25 June 2021 / Revised: 13 August 2021 / Accepted: 23 August 2021 / Published: 26 August 2021
Ensuring high quality end of life (EOL) care is necessary for people with advanced non-small-cell lung cancer (NSCLC), given its high incidence, mortality and symptom burden. Aggressive EOL care can adversely affect the quality of life of NSCLC patients without providing meaningful oncologic benefit. Objectives: (1) To describe EOL health services quality indicators and timing of palliative care consultation provided to patients dying of NSCLC. (2) To examine associations between aggressive and supportive care and patient, disease and treatment characteristics. Methods: This retrospective population-based cohort study describes those who died of NSCLC in Ontario, Canada from 2009–2017. Socio-demographic, patient, disease and treatment characteristics as well as EOL health service quality and use of palliative care consultation were investigated. Multivariable logistic regression models examined factors associated with receiving aggressive or supportive care. Results: Aggressive care quality indicators were present in 50.3% and supportive care indicators in 60.3% of the cohort (N = 37,203). Aggressive care indicators decreased between 2009 and 2017 (57.4% to 45.3%) and increased for supportive care (54.2% to 67.5%). Benchmarks were not met by 2017 in 3 of 4 cases. Male sex and greater comorbidity were associated with more aggressive EOL care and less supportive care. Older age was negatively associated and rurality positively associated with aggressive care. No palliative care consultation occurred in 56.0%. Conclusions: While improvements in the use of supportive rather than aggressive care were noted, established Canadian benchmarks were not met. Moreover, there is variation in EOL quality between groups and use of earlier palliative care must improve. View Full-Text
Keywords: lung cancer; end-of-life care; quality indicators; palliative care; health services research; Canada lung cancer; end-of-life care; quality indicators; palliative care; health services research; Canada
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MDPI and ACS Style

Goldie, C.L.; Nguyen, P.; Robinson, A.G.; Goldie, C.E.; Kircher, C.E.; Hanna, T.P. Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study. Curr. Oncol. 2021, 28, 3297-3315. https://doi.org/10.3390/curroncol28050286

AMA Style

Goldie CL, Nguyen P, Robinson AG, Goldie CE, Kircher CE, Hanna TP. Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study. Current Oncology. 2021; 28(5):3297-3315. https://doi.org/10.3390/curroncol28050286

Chicago/Turabian Style

Goldie, Catherine L., Paul Nguyen, Andrew G. Robinson, Craig E. Goldie, Colleen E. Kircher, and Timothy P. Hanna 2021. "Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study" Current Oncology 28, no. 5: 3297-3315. https://doi.org/10.3390/curroncol28050286

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