Can a performance status questionnaire decrease palliative chemotherpy in the last months of life?
(English)Manuscript (preprint) (Other academic)
Background: Physicians often offer further palliative chemotherapy treatments (PCT) late in the cancer disease trajectory, even when treatment benefits are doubtful.
Objective: Our main aim was to investigate whether routine use of the Performance Status in Palliative Chemotherapy (PSPC) questionnaire would affect the proportions of patients receiving PCT during the last month of life, hospital admissions, documentation of performance status and the decisions to cease PCT, and/or place of death. A secondary aim was to gather registered nurses’ experiences of PSPC in routine use.
Methods: Eighty incurable patients with cancer who had used the PSPC before PCT were compared to 160 matched controls, using non-parametric tests. Patients’ comments in the questionnaires were analyzed and nurses reflections collected in a work-journal.
Results: No significant differences were found between users or non-users of the PSPC in terms of proportions receiving PCT during the last month of life. Higher proportions of patients older than 74 years received PCT than in previous studies (38% versus 17%). Nurses considered the questionnaires superior to verbal communication in providing accurate pictures of patients’ performance status.
Limitations: The results of this interim analysis could have been more significant if the originally planned number of patients had been recruited.
Conclusion: The proportion of patients receiving PCT during the last month of life was lower than in a previous study (25% versus 32%). As we found no significant differences between the study group and the control group, we cannot claim this to be an effect of PSPC use.
cancer, case-control study, decision-making, palliative care, rural hospitals
Cancer and Oncology
Research subject Oncology
IdentifiersURN: urn:nbn:se:umu:diva-87308OAI: oai:DiVA.org:umu-87308DiVA: diva2:708780