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Comparison of Symptom Severity and Progression in Advanced Cancer Patients Among Different Care Settings: A Secondary Analysis

Shiraishi, Ryuto Kizawa, Yoshiyuki Mori, Masanori Maeda, Isseki Hatano, Yutaka Ishiki, Hiroto Miura, Tomofumi Yokomichi, Naosuke Kodama, Maiko Inoue, Keiko Otomo, Sen Yamaguchi, Takashi Hamano, Jun 神戸大学

2023.08

概要

Background: Most people in Japan wish to spend their final days at home, but the majority fail to do so; earlier studies indicated a more pronounced worsening of symptoms if treated at home. Objectives: This study compared the prevalence of symptom worsening and explored associated factors between patients with advanced cancer receiving palliative care in palliative care units (PCUs) and at home. Design: We conducted a secondary analysis of two multicenter, prospective cohort studies involving patients with advanced cancer receiving palliative care in PCUs or at home. Setting/Subjects: One study was conducted at 23 PCUs (January to December 2017) and the other on 45 palliative home care services (July to December 2017) in Japan. Measurements: Symptom changes were categorized as stable, improved, or worse. Results: Of the 2998 registered patients, 2877 were analyzed. Among them, 1890 patients received palliative care in PCUs, and 987 at home. Patients receiving palliative care at home were more likely to have worsening of pain (17.1% vs. 3.8%; p < 0.001) and drowsiness (32.6% vs. 22.2%; p < 0.001) than those in PCUs. By multivariate logistic regression analysis, palliative care at home was significantly associated with worsening of the Palliative Prognostic Index dyspnea subscale in the unadjusted model (odds ratio, 1.42 [95% confidence interval, 1.08–1.88]; p = 0.014) but not for any symptoms in the adjusted model. Conclusions: After adjusting for patient background, the prevalence of symptom worsening was not different between patients with advanced cancer receiving palliative care at home and in PCUs.

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参考文献

1. Bajwah S, Oluyase AO, Yi D, et al. The effectiveness and cost-effectiveness

of hospital-based specialist palliative care for adults with advanced illness

and their caregivers. Cochrane Database Syst Rev 2020;9(9):CD012780;

doi: 10.1002/14651858.CD012780.PUB2

2. Gomes B, Calanzani N, Curiale V, et al. Effectiveness and costeffectiveness of home palliative care services for adults with advanced

illness and their caregivers. Cochrane Database Syst Rev 2013;2016(6):

CD007760; doi: 10.1002/14651858.CD007760.PUB2

3. Kenny P, Street DJ, Hall J, et al. Valuing end-of-life care for older people

with advanced cancer: Is dying at home important? Patient 2021;14(6):

803–813; doi: 10.1007/S40271-021-00517-Z

4. Currow DC, Agar MR, Phillips JL. Role of hospice care at the end of life for

people with cancer. J Clin Oncol 2020;38(9):937–943; doi: 10.1200/JCO.18

.02235

5. Eagar K, Clapham SP, Allingham SF. Palliative care is effective: But hospital

symptom outcomes superior. BMJ Support Palliat Care 2020;10(2):186–

190; doi: 10.1136/BMJSPCARE-2018-001534

6. Brescia FJ, Adler D, Gray G, et al. Hospitalized advanced cancer patients:

A profile. J Pain Symptom Manage 1990;5(4):221–227; doi: 10.1016/08853924(90)90015-C

7. Curtis EB, Krech R, Walsh TD, et al. Common symptoms in patients with

advanced cancer. J Palliat Care 1991;7(2):25–29.

8. Grond S, Zech D, Diefenbach C, et al. Prevalence and pattern of symptoms in patients with cancer pain: a prospective evaluation of 1635

cancer patients referred to a pain clinic. J Pain Symptom Manage 1994;

9(6):372–382; doi: 10.1016/0885-3924(94)90174-0

9. Donnelly S, Walsh D, Walsh D. The symptoms of advanced cancer. Semin

Oncol 1995;22(2 Suppl 3):67–72.

10. Vainio A, Auvinen A. Prevalence of symptoms among patients with

advanced cancer: an international collaborative study. Symptom Prevalence Group. J Pain Symptom Manage 1996;12(1):3–10; doi: 10.1016/

0885-3924(96)00042-5

11. Miyashita M, Sanjo M, Morita T, et al. Good death in cancer care:

A nationwide quantitative study. Ann Oncol 2007;18(6):1090–1097; doi:

10.1093/ANNONC/MDM068

12. Gomes B, Calanzani N, Gysels M, et al. Heterogeneity and changes in

preferences for dying at home: A systematic review. BMC Palliat Care

2013;12(1):7; doi: 10.1186/1472-684X-12-7

13. Sarmento VP, Gysels M, Higginson IJ, et al. Home palliative care works: but

how? A meta-ethnography of the experiences of patients and family

caregivers. BMJ Support Palliat Care 2017;7(4):390–403; doi: 10.1136/

BMJSPCARE-2016-001141

14. Gomes B, Higginson IJ. Factors influencing death at home in terminally ill

patients with cancer: Systematic review. BMJ 2006;332(7540):515–518;

doi: 10.1136/BMJ.38740.614954.55

15. Gomes B, Calanzani N, Koffman J, et al. Is dying in hospital better than

home in incurable cancer and what factors influence this? A

population-based study. BMC Med 2015;13(1):235; doi: 10.1186/

S12916-015-0466-5

Shiraishi et al.; Palliative Medicine Reports 2023, 4.1

http://online.liebertpub.com/doi/10.1089/pmr.2023.0011

16. Ministry of Health, Labor and Welfare. Survey on Attitudes toward in the

End-of-Life Care (In Japanese). n.d. Available from: https://www.mhlw.go

.jp/stf/shingi2/0000200742.html [Last accessed: June 8, 2022].

17. Ministry of Health, Labor and Welfare. Vital Statistics of Japan. The Latest

Trends. n.d. Available from: https://www.mhlw.go.jp/english/database/

db-hw/vs01.html [Last accessed: June 8, 2022].

18. The Yuumi Memorial Foundation for Home Health Care. Barriers of Introducing Home Palliative Care in Japan. A Nationwide Survey among Medical

Social Workers and Discharge Support Nurses in Government Designated

Cancer Hospitals (In Japanese). n.d. Available from: http://118.82.88.171/

main/result.php?year=2014&type=1 [Last accessed: June 8, 2022].

19. Shepperd S, Gonçalves-Bradley DC, Straus SE, et al. Hospital at home:

Home-based end-of-life care. Cochrane Database Syst Rev 2021;3(3); doi:

10.1002/14651858.CD009231.PUB3

20. Yamaguchi T, Maeda I, Hatano Y, et al. Communication and behavior of

palliative care physicians of patients with cancer near end of life in three

East Asian Countries. J Pain Symptom Manage 2021;61(2):315–322.e1;

doi: 10.1016/J.JPAINSYMMAN.2020.07.031

21. Shinjo T, Shimizu M, Miyake K, et al. Survey of the circumstances of cancer

patients treated at home and the presence of doctors and nurses at the

time of death. Palliat Care Res 2020;15(4):259–263; doi: 10.2512/jspm.15.259

22. Sakurai H, Miyashita M, Imai K, et al. Validation of the Integrated Palliative

care Outcome Scale (IPOS)—Japanese Version. Jpn J Clin Oncol 2019;

49(3):257–262; doi: 10.1093/JJCO/HYY203

23. Schildmann EK, Groeneveld EI, Denzel J, et al. Discovering the hidden

benefits of cognitive interviewing in two languages: The first phase of a

validation study of the Integrated Palliative care Outcome Scale. Palliat

Med 2016;30(6):599–610; doi: 10.1177/0269216315608348

24. Hearn J, Higginson IJ. Development and validation of a core outcome

measure for palliative care: The palliative care outcome scale. Palliative

Care Core Audit Project Advisory Group. Qual Health Care 1999;8(4):219–

227; doi: 10.1136/QSHC.8.4.219

25. Sakurai H, Miyashita M, Morita T, et al. Comparison between patientreported and clinician-reported outcomes: Validation of the Japanese

version of the Integrated Palliative care Outcome Scale for staff. Palliat

Support Care 2021;19(6):702–708; doi: 10.1017/S1478951521000018

26. Morita T, Tsunoda J, Inoue S, et al. The Palliative Prognostic Index:

A scoring system for survival prediction of terminally ill cancer patients.

Support Care Cancer 1999;7(3):128–133; doi: 10.1007/S005200050242

27. Dumitrescu L, van den Heuvel-Olaroiu M, van den Heuvel WJA. Changes

in symptoms and pain intensity of cancer patients after enrollment in

palliative care at home. J Pain Symptom Manage 2007;34(5):488–496; doi:

10.1016/J.JPAINSYMMAN.2007.05.004

28. Lim KH, Nguyen NN, Qian Y, et al. Frequency, outcomes, and associated

factors for opioid-induced neurotoxicity in patients with advanced cancer

receiving opioids in inpatient palliative care. J Palliat Med 2018;21(12):

1698–1704; doi: 10.1089/JPM.2018.0169

29. Mercadante S, Fulfaro F, Casuccio A. The impact of home palliative care

on symptoms in advanced cancer patients. Support Care Cancer 2000;

8(4):307–310; doi: 10.1007/S005209900110

30. Koppie TM, Serio AM, Vickers AJ, et al. Age-adjusted Charlson comorbidity

score is associated with treatment decisions and clinical outcomes for

patients undergoing radical cystectomy for bladder cancer. Cancer 2008;

112(11):2384–2392; doi: 10.1002/CNCR.23462

31. Baba M, Maeda I, Morita T, et al. Independent validation of the modified

prognosis palliative care study predictor models in three palliative care

settings. J Pain Symptom Manage 2015;49(5):853–860; doi: 10.1016/J

.JPAINSYMMAN.2014.10.010

32. Gwilliam B, Keeley V, Todd C, et al. Development of prognosis in palliative care

study (PiPS) predictor models to improve prognostication in advanced cancer:

Prospective cohort study. BMJ 2011;343(7821); doi: 10.1136/BMJ.D4920

33. Murtagh FEM, Ramsenthaler C, Firth A, et al. A brief, patient- and proxyreported outcome measure in advanced illness: Validity, reliability and

responsiveness of the Integrated Palliative care Outcome Scale (IPOS).

Palliat Med 2019;33(8):1045–1057; doi: 10.1177/0269216319854264

34. Siriwardana AN, Hoffman AT, Brennan FP, et al. Impact of renal supportive

care on symptom burden in dialysis patients: A prospective observational

cohort study. J Pain Symptom Manage 2020;60(4):725–736; doi: 10.1016/J

.JPAINSYMMAN.2020.04.030

35. Pedersen AB, Mikkelsen EM, Cronin-Fenton D, et al. Missing data and

multiple imputation in clinical epidemiological research. Clin Epidemiol

2017;9:157–166; doi: 10.2147/CLEP.S129785

149

36. Morita T, Hyodo I, Yoshimi T, et al. Association between hydration volume

and symptoms in terminally ill cancer patients with abdominal malignancies. Ann Oncol 2005;16(4):640–647; doi: 10.1093/ANNONC/MDI121

37. Wu CC, Hsu TW, Chang CM, et al. Age-adjusted Charlson comorbidity

index scores as predictor of survival in colorectal cancer patients who

underwent surgical resection and chemoradiation. Medicine 2015;94(2):

e431; doi: 10.1097/MD.0000000000000431

38. Tian Y, Jian Z, Xu B, et al. Age-adjusted Charlson comorbidity index score

as predictor of survival of patients with digestive system cancer who have

undergone surgical resection. Oncotarget 2017;8(45):79453–79461; doi:

10.18632/ONCOTARGET.18401

39. Bruera E, Hui D, Dalal S, et al. Parenteral hydration in patients with advanced

cancer: A multicenter, double-blind, placebo-controlled randomized trial.

J Clin Oncol 2013;31(1):111–118; doi: 10.1200/JCO.2012.44.6518

40. Mercadante S, Marchetti P, Adile C, et al. Characteristics and care pathways of advanced cancer patients in a palliative-supportive care unit

and an oncological ward. Support Care Cancer 2018;26(6):1961–1966; doi:

10.1007/S00520-017-4037-5.

41. Mercadante S, Casuccio A, Pumo S, et al. Factors influencing the opioid

response in advanced cancer patients with pain followed at home: The

effects of age and gender. Support Care Cancer 2000;8(2):123–130; doi:

10.1007/S005200050026

Cite this article as: Shiraishi R, Kizawa Y, Mori M, Maeda I, Hatano Y,

Ishiki H, Miura T, Yokomichi N, Kodama M, Inoue K, Otomo S,

Yamaguchi T, and Hamano J (2023) Comparison of symptom severity

and progression in advanced cancer patients among different care

settings: a secondary analysis, Palliative Medicine Reports 4:1, 139–149,

DOI: 10.1089/pmr.2023.0011.

Abbreviations Used

ACCI

CI

DSM-5

EASED

ECOG PS

IPOS

OME

OR

PCUs

PiPS-A

PPI

age-adjusted Charlson Comorbidity Index

confidence interval

Diagnostic and Statistical Manual of Mental Disorders 5

East Asian collaborative cross-cultural Study to

Elucidate the Dying process

Eastern Cooperative Oncology Group performance status ()

Integrated Palliative Care Outcome Scale

oral morphine equivalent

odds ratio

palliative care units

Prognosis in Palliative Care Study predictor models-A

Palliative Prognostic Index

Publish in Palliative Medicine Reports

Immediate, unrestricted online access

Rigorous peer review

- Compliance with open access mandates

- Authors retain copyright

- Highly indexed

- Targeted email marketing

liebertpub.com/pmr

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