The effect of a palliative care pathway on medical interventions at the end of life: a pre-post-implementation study

Annemieke van der Padt-Pruijsten*, Maria B. L. Leys, Esther Oomen-de Hoop, Agnes van der Heide, Carin C. D. van der Rijt

*Corresponding author for this work

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Abstract

Purpose
Adequate integration of palliative care in oncological care can improve the quality of life in patients with advanced cancer. Whether such integration affects the use of diagnostic procedures and medical interventions has not been studied extensively. We investigated the effect of the implementation of a standardized palliative care pathway in a hospital on the use of diagnostic procedures, anticancer treatment, and other medical interventions in patients with incurable cancer at the end of their life.

Methods
In a pre- and post-intervention study, data were collected concerning adult patients with cancer who died between February 2014 and February 2015 (pre-PCP period) or between November 2015 and November 2016 (post-PCP period). We collected information on diagnostic procedures, anticancer treatments, and other medical interventions during the last 3 months of life.

Results
We included 424 patients in the pre-PCP period and 426 in the post-PCP period. No differences in percentage of laboratory tests (85% vs 85%, p = 0.795) and radiological procedures (85% vs 82%, p = 0.246) were found between both groups. The percentage of patients who received anticancer treatment or other medical interventions was lower in the post-PCP period (40% vs 22%, p 
Conclusions
Implementation of a PCP resulted in fewer medical interventions, including anticancer treatments, in the last 3 months of life. Implementation of the PCP may have created awareness among physicians of patients’ impending death, thereby supporting caregivers and patients to make appropriate decisions about medical treatment at the end of life.
Original languageEnglish
Pages (from-to)9299-9306
Number of pages8
JournalSupportive Care in Cancer
Volume30
Issue number11
DOIs
Publication statusE-pub ahead of print - 7 Sep 2022

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