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Symptom Burden and Complexity in the Last 12 Months of Life among Cancer Patients Choosing Medical Assistance in Dying (MAID) in Alberta, Canada

1
Cancer Care Alberta—Alberta Health Services, Calgary, AB T2S 3C3, Canada
2
Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
3
Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada
4
Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada
5
Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
6
Provincial Seniors Health and Continuing Care, Alberta Health Services, Calgary, AB T2W 1S7, Canada
7
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2022, 29(3), 1605-1618; https://doi.org/10.3390/curroncol29030135
Received: 1 February 2022 / Revised: 24 February 2022 / Accepted: 26 February 2022 / Published: 3 March 2022
(This article belongs to the Section Palliative and Supportive Care)
Background: In 2019, cancer patients comprised over 65% of all individuals who requested and received Medical Assistance in Dying (MAID) in Canada. This descriptive study sought to understand the self-reported symptom burden and complexity of cancer patients in the 12 months prior to receiving MAID in Alberta. Methods: Between July 2017 and January 2019, 337 cancer patients received MAID in Alberta. Patient characteristics were descriptively analyzed. As such, 193 patients (57.3%) completed at least one routine symptom-reporting questionnaire in their last year of life. Mixed effects models and generalized estimating equations were utilized to examine the trajectories of individual symptoms and overall symptom complexity within the cohort over this time. Results: The results revealed that all nine self-reported symptoms, and the overall symptom complexity of the cohort, increased as patients’ MAID provision date approached, particularly in the last 3 months of life. While less than 20% of patients experienced high symptom complexity 12 months prior to MAID, this increased to 60% in the month of MAID provision. Conclusions: Cancer patients in this cohort experienced increased symptom burden and complexity leading up to their death. These findings could serve as a flag to clinicians to closely monitor advanced cancer patients’ symptoms, and provide appropriate support and interventions as needed. View Full-Text
Keywords: Medical Assistance in Dying; medically assisted death; Medical Aid in Dying; MAID; symptom burden; symptom complexity; symptom management; Patient-Reported Outcomes Medical Assistance in Dying; medically assisted death; Medical Aid in Dying; MAID; symptom burden; symptom complexity; symptom management; Patient-Reported Outcomes
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MDPI and ACS Style

Watson, L.; Link, C.; Qi, S.; DeIure, A.; Russell, K.B.; Schulte, F.; Forbes, C.; Silvius, J.; Kelly, B.; Bultz, B.D. Symptom Burden and Complexity in the Last 12 Months of Life among Cancer Patients Choosing Medical Assistance in Dying (MAID) in Alberta, Canada. Curr. Oncol. 2022, 29, 1605-1618. https://doi.org/10.3390/curroncol29030135

AMA Style

Watson L, Link C, Qi S, DeIure A, Russell KB, Schulte F, Forbes C, Silvius J, Kelly B, Bultz BD. Symptom Burden and Complexity in the Last 12 Months of Life among Cancer Patients Choosing Medical Assistance in Dying (MAID) in Alberta, Canada. Current Oncology. 2022; 29(3):1605-1618. https://doi.org/10.3390/curroncol29030135

Chicago/Turabian Style

Watson, Linda, Claire Link, Siwei Qi, Andrea DeIure, K. B. Russell, Fiona Schulte, Caitlin Forbes, James Silvius, Brian Kelly, and Barry D. Bultz. 2022. "Symptom Burden and Complexity in the Last 12 Months of Life among Cancer Patients Choosing Medical Assistance in Dying (MAID) in Alberta, Canada" Current Oncology 29, no. 3: 1605-1618. https://doi.org/10.3390/curroncol29030135

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