Meaningful changes in end-of-life care among patients with myeloma.

Meaningful changes in end-of-life care among patients with myeloma. Haematologica. 2018 May 10;: Authors: Odejide OO, Li L, Cronin AM, Murillo A, Richardson PG, Anderson KC, Abel GA Abstract Patients with advanced myeloma experience a high symptom burden particularly near the end of life, making timely hospice use crucial. Little is known about the quality and determinants of end-of-life care for this population, including if potential increases in hospice use are also accompanied by "late" enrollment (≤ 3 days before death). Using the Surveillance, Epidemiology, and End-Results-Medicare database, we identified patients ≥ 65 years diagnosed with myeloma between 2000 and 2013 that died by December 31, 2013. We assessed prevalence and trends in hospice, including late enrollment. We also examined six established measures of potentially aggressive medical care at the end of life. Independent predictors of late hospice enrollment and aggressive end-of-life care were assessed using multivariable logistic regression analyses. Of 12,686 myeloma decedents, 48.2% enrolled in hospice. Among the 6,111 who enrolled, 17.2% spent ≤ 3 days there. There was a significant trend in increasing hospice use, from 28.5% in 2000 to 56.5% by 2013 (Ptrend <0.001); no significant rise in late enrollment (12.2% in 2000 to 16.3% in 2013, Ptrend=0.19); and a slight decrease in aggressive end-of-life care (59.2% in 2000 to 56.7% in 2013, Ptrend=0.01). Pa...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research