End-of-life care use of antineoplastic therapy and nonessential medications in veteran patients receiving palliative care

Abstract

BACKGROUND: The use of antineoplastic therapy and nonessential medications at the end of life can lead to poorer quality of life for patients, decreased satisfaction with care among caregivers, financial toxicity, increased use of the emergency depart-ment, and hospitalization. OBJECTIVES: This study evaluated the incidence of antineoplastic therapy administration and use of nonessential medications at 30 and 14 days prior to death among patients with metastatic lung, prostate, colon, or pancreatic cancer who were also receiving palliative care. METHODS: Using retrospective chart review, this study evaluated patients admitted to a U.S. Department of Veterans Affairs healthcare system during a two-year period. Variables assessed included use of antineoplastic therapy and nonessential medications, emergency department visits, hospitalizations, palliative care accessibility, and hospice referrals. FINDINGS: All patients in the study (N = 57) received palliative care. Sixteen percent of patients in this study received antineoplastic therapy, 14% received nonessential medications, and 40% were hospitalized or visited the emergency department within 30 days of death.