28 Dec End Of Life Discussions Occur Late in Blood Cancer Patients’ Disease
MedicalResearch.com Interview with:
Oreofe O. Odejide, MD
Instructor in Medicine, Harvard Medical School
Dana-Farber Cancer Institute
Medical Research: What is the background for this study? What are the main findings?
Dr. Odejide: The care that patients with hematologic cancers receive near the end of life is distinct from patients with solid tumors. For instance, previous research has shown that patients with blood cancers are more likely to receive intensive care at the end of life such as chemotherapy within 14 days of death, intensive care unit admission within 30 days of death, and they are less likely to enroll in hospice. My colleagues and I hypothesized that timing of discussions regarding end-of-life preferences with patients may contribute to these findings, and we wanted to examine hematologic oncologists’ perspectives regarding end-of-life discussions with this patient population.
We conducted a survey of a national sample of hematologic oncologists obtained from the publicly available clinical directory of the American Society of Hematology. We received responses from 349 hematologic oncologists, giving us a response rate of 57.3%. In our survey, we asked hematologic oncologists about the typical timing of EOL discussions in general, and also about the timing of the first discussion regarding resuscitation status, hospice care, and preferred site of death for patients. Three main findings emerged:
- First, the majority of hematologic oncologists (56%) reported that typical EOL discussions occur “too late.”
- Second, hematologic oncologists practicing primarily in tertiary care settings were more likely to report late discussions compared to those in community settings.
- Third, a substantial proportion of respondents reported that they typically conduct the initial discussions regarding resuscitation status, hospice care, and preferred site of death at less optimal times.
Medical Research: What should clinicians and patients take away from your report?
Dr. Odejide: There is recognition by hematologic oncologists that end-of-life discussions often do not occur in a timely fashion for patients with blood cancers. More research is needed to address barriers to timely end-of-life discussions for patients with hematologic cancers.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Odejide: I believe that future research should focus on identifying barriers to timely and quality end-of-life discussions for patients with blood cancers. Research is also needed to develop and test interventions to improve timeliness of end-of-life discussions/
Oreofe O. Odejide (2015). End Of Life Discussions Occur Late in Blood Cancer Patients Disease