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Determinants of quality of life in patients with incurable cancer - quality of life in incurable cancer

DALY, Louise E. ; DOLAN, Ross D. ; POWER, Derek G. ; NI BHUACHALLA, Éadaoin ; SIM, Wei ; CUSHEN, Samantha J. ; FALLON, Marie T. ; SIMMONS, Claribel ; MCMILLAN, Donald C. ; LAIRD, Barry J. ; RYAN, Aoife M.
Cancer, 08/04/2020, Pagination inconnue

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Thème : Soins.

CANCER ; QUALITE VIE ; FACTEUR ; IRLANDE ; ROYAUME UNI

Background: Optimizing quality of life (QoL) remains the central tenet of care in patients with incurable cancer; however, determinants of QoL are not clear. The objective of the current study was to examine which factors influence QoL in patients with incurable cancer.
Methods: A multicenter study of adult patients with advanced cancer was conducted in Ireland and the United Kingdom between 2011 and 2016. Data were collected from patients at study entry and included patient demographics, Eastern Cooperative Oncology Group performance status (ECOG-PS), nutritional parameters (the percentage weight loss [%WL]), muscle parameters assessed using computed tomography images (skeletal muscle index and skeletal muscle attenuation), inflammatory markers (modified Glasgow Prognostic score [mGPS]), and QoL data (the European Organization for Research and Treatment Quality-of-Life Questionnaire C-30). The relation between clinical, nutritional, and inflammatory parameters with QoL was assessed using the Spearman rank correlation coefficient and multivariate binary logistic regression. Components of the European Organization for Research and Treatment Quality-of-Life Questionnaire C-30 (physical function, fatigue, and appetite loss) and summary QoL scores were mean-dichotomized for the logistic regression analyses.
Results: Data were available for 1027 patients (51% men; median age, 66 years). Gastrointestinal cancer was most prevalent (40%), followed by lung cancer (26%) and breast cancer (9%). Distant metastatic disease was present in 87% of patients. The %WL, ECOG-PS, and mGPS were significantly correlated with deteriorating QoL functional and symptom scales (all P < .001). On multivariate regression analysis, >10% WL (odds ratio [OR], 2.69; 95% CI, 1.63-4.42), an ECOG-PS of 3 or 4 (OR, 14.33; 95% CI, 6.76-30.37), and an mGPS of 2 (OR, 1.58; 95% CI, 1.09-2.29) were independently associated with poorer summary QoL scores. These parameters were also independently associated with poorer physical function, fatigue, and appetite loss (all P < .05). Low skeletal muscle attenuation was independently associated with poorer physical functioning (OR, 1.67; 95% CI, 1.09-2.56), but muscle parameters were not independently associated with fatigue, appetite loss, or QoL summary scores.
Conclusions: The current findings indicate that QoL is determined (at least in part) by WL, ECOG-PS, and the systemic inflammatory response in patients with advanced cancer. Identifying early predictors of poor QoL may allow the identification of patients who may benefit from early referral to palliative and supportive care, which has been shown to improve QoL.

Origine : DOI.org (Crossref

Population-based palliative care planning in Ireland - how many people will live and die with serious illness to 2046?

MAY, Peter ; JOHNSTON, Bridget M. ; NORMAND, Charles E. ; HIGGINSON, Irene J. ; KENNY, Rose Anne ; RYAN, Karen
HRB open research, 2019, vol.2, p. 1-21

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Thème : Santé. Cote : eD01.05

IRLANDE ; DEMARCHE PALLIATIVE ; EPIDEMIOLOGIE ; BESOIN

Background: All countries face growing demand for palliative care services. Projections of need are essential to plan care in an era of demographic change. We aim to estimate palliative care needs in Ireland from 2016 to 2046.
Methods: Static modelling of secondary data. First, we estimate the numbers of people in Ireland who will die from a disease associated with palliative care need. We combine government statistics on cause of death (2007-2015) and projected mortality (2016-2046). Second, we combine these statistics with survey data to estimate numbers of people aged 50+ living and dying with diseases associated with palliative care need. Third, we use these projections and survey data to estimate disability burden, pain prevalence and health care utilisation among people aged 50+ living and dying with serious medical illness.
Results: In 2016, the number of people dying annually from a disease indicating palliative care need was estimated as 22,806, and the number of people not in the last year of life aged 50+ with a relevant diagnosis was estimated as 290,185. Equivalent estimates for 2046 are 40,355 and 548,105, increases of 84% and 89% respectively. These groups account disproportionately for disability burden, pain prevalence and health care use among older people, meaning that population health burdens and health care use will increase significantly in the next three decades. Conclusion: The global population is ageing, although significant differences in intensity of ageing can be seen between countries. Prevalence of palliative care need in Ireland will nearly double over 30 years, reflecting Ireland's relatively young population. People living with a serious disease outnumber those in the last year of life by approximately 12:1, necessitating implementation of integrated palliative care across the disease trajectory. Urgent steps on funding, workforce development and service provision are required to address these challenges.

Origine : PubMed

End-of-life experience for older adults in Ireland - results from the Irish longitudinal study on ageing (TILDA)

MAY, Peter ; ROE, Lorna ; MCGARRIGLE, Christine A. ; KENNY, Rose Anne ; NORMAND, Charles E.
BMC health services research, 14/02/2020, vol.20, n°1, p. 1-10

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Drivers of care costs and quality in the last 3 months of life among older people receiving palliative care - a multinational mortality follow-back survey across England, Ireland and the United States

YI, Deokhee ; JOHNSTON, Bridget M. ; RYAN, Karen ; DAVESON, Barbara A. ; MEIER, Diane E. ; SMITH, Melinda ; McQUILLAN, Regina ; SELMAN, Lucy ; PANTILAT, Steven Z. ; NORMAND, Charles E. ; MORRISON, R. Sean ; HIGGINSON, Irene J.
PALLIATIVE MEDICINE, 03/02/2020, p. 1-11

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Ireland's Assisted Decision Making Capacity Act-the potential for unintended effects in critical emergencies - a cross-sectional study of advanced paramedic decision making

BURY, Gerard ; THOMPSON, Alan ; TOBIN, Helen ; EGAN, Mairead
Irish journal of medical science, 11/2019, vol.188, n°4, p. 1143-1148

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Deprescribing in older people approaching end of life - a randomized controlled trial using STOPPFrail criteria

CURTIN, Denis ; JENNINGS, Emma ; DAUNT, Ruth ; CURTIN, Sara ; RANDLES, Mary ; GALLAGHER, Paul ; O'MAHONY, Denis
Journal of the American Geriatrics Society, 23/12/2019, Pagination inconnue

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Is inpatient hospice care clinically effective? - using phase of illness to evaluate care outcomes for patients admitted to a specialist palliative care unit in Ireland

LUCEY, Michael ; O'REILLY, Martina ; CURROW, David ; EAGAR, Kathy ; WALSH, Declan ; CONROY, Marian ; TWOMEY, Feargal ; O'REILLY, Val ; DOHERTY, Mairéad ; COFFEY, Siobhain ; SHERIDAN, John ; MORAN, Sue
JOURNAL OF PALLIATIVE MEDICINE, 19/12/2019, Pagination inconnue

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Advance care planning in COPD - guidance development for healthcare professionals

MEEHAN, Elaine ; SWEENEY, Catherine ; FOLEY, Tony ; LEHANE, Elaine ; BURGESS KELLEHER, Art ; HALLY, Ruth M. ; SHANAGHER, Deirdre ; KORN, Bettina ; RABBITTE, Mary ; DETERING, Karen Margaret ; CORNALLY, Nicola
BMJ supportive and palliative care, 04/11/2019, Pagination inconnue

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Reducing inappropriate prescribing for older adults with advanced frailty - a review based on a survey of practice in four countries

O'CAOIMH, Ronan ; CORNALLY, Nicola ; MCGLADE, Ciara ; GAO, Yang ; O'HERLIHY, Eileen ; SVENDROVSKI, Anton ; CLARNETTE, Roger ; LAVAN, Amanda Hanora ; GALLAGHER, Paul ; WILLIAM MOLLOY, D.
Maturitas, 08/2019, vol.126, p. 1-10

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Appropriate frameworks for economic evaluation of end of life care - a qualitative investigation with stakeholders

KINGHORN, Philip ; COAST, Joanna
PALLIATIVE MEDICINE, 01/07/2019, vol.33, n°7, p. 823-831

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Development of an eHealth information resource for family carers supporting a person receiving palliative care on the island of Ireland

SCOTT, David ; HUDSON, Peter ; CHARNLEY, Karen ; PAYNE, Cathy ; WESTCOTT, Gareth
BMC palliative care, 30/08/2019, vol.18, n°1, p. 1-11

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Does an interactive, teleconference-delivered, palliative care lecture series improve nursing home staff confidence?

DOWLING, Michael J. ; PAYNE, Cathy ; LARKIN, Philip J. ; RYAN, Daniel J.
JOURNAL OF PALLIATIVE MEDICINE, 02/2020, vol.23, n°2, p. 179-183

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A quasi-experimental evaluation of an intervention to increase palliative medicine referral in the emergency department

TIERNAN, Eoin ; RYAN, John ; CASEY, Mary ; HALE, Aine ; O'REILLY, Valerie ; DEVENISH, Millie ; WHYTE, Barbara ; HOLLINGSWORTH, Siobhan ; PRICE, Olga ; CALLANAN, Ian ; WALSH, Declan ; NORMAND, Charles E. ; MAY, Peter
Journal of health services research and policy, 07/2019, vol.24, n°3, p. 155-163

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Comparison of financial support for family caregivers of people at the end of life across six countries - a descriptive study

GARDINER, Clare ; TAYLOR, Beth ; ROBINSON, Jackie ; GOTT, Merryn
PALLIATIVE MEDICINE, 10/2019, vol.33, n°9, p. 1189-1211

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Grief reactions and coping strategies of trainee doctors working in paediatric intensive care

FFRENCH-O'CARROLL, Robert ; FEELEY, Tara ; CROWE, Suzanne ; DOHERTY, Eva M.
British journal of anaesthesia, 07/2019, vol.123, n°1, p. 74-80

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Non-specialist palliative care - a principle-based concept analysis

NEVIN, Mary ; SMITH, Valerie ; HYNES, Geralyn
PALLIATIVE MEDICINE, 06/2019, vol.33, n°6, p. 634-649

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Patients' knowledge and opinions of ICDs during life, illness and at the time of death

MOONEY, Mary ; MCKEE, Gabrielle ; MCDERMOTT, Eadaoin ; O'DONNELL, Sharon ; RYAN, Paul ; MOSER, Debra ; O'BRIEN, Frances
British journal of nursing, 11/04/2019, vol.28, n°7, p. 446-451

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Delirium management by palliative medicine specialists - a survey from the association for palliative medicine of Great Britain and Ireland

BOLAND, Jason W. ; KABIR, Monisha ; BUSH, Shirley H. ; SPILLER, Juliet Anne ; JOHNSON, Miriam J. ; AGAR, Meera ; LAWLOR, Peter G.
BMJ supportive and palliative care, 04/03/2019, Pagination inconnue

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Assisted ventilation in motor neurone disease during inpatient palliative care - barriers and utilisation

GLEESON, Aoife ; JOHNSON, Faye
BMJ supportive and palliative care, 02/02/2019, Pagination inconnue

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Anencephaly - the maternal experience of continuing with the pregnancy. incompatible with life but not with love

O'CONNELL, O. ; MEANEY, S. ; O'DONOGHUE, K.
Midwifery, 25/12/2018, vol.71, p. 12-18

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