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07.11.2018 | Original Article

Factors associated with the time to first palliative care consultation in Lebanese cancer patients

verfasst von: Ziad Bakouny, Tarek Assi, Elie El Rassy, Karen Daccache, Clarisse Kattan, Aline Tohme, Marie Claire Mouhawej, Joseph Kattan

Erschienen in: Supportive Care in Cancer | Ausgabe 4/2019

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Abstract

Introduction

Early palliative care is recommended for cancer patients. However, palliative care consults (PCC) are often delayed in Lebanon. The aim of this study was to identify the factors associated with timing of PCC and their impact on the place of death.

Methods

This is a retrospective, single institution, study conducted at Hotel Dieu de France University Hospital in Lebanon. The clinical and demographic characteristics of oncology patients who received PCC were obtained. Cox and logistic regression models were used to evaluate the factors determining the time to first PCC and location of death, respectively.

Results

Two hundred and ten patients were included in our analyses with a median age of 69 years (range 22–92 years). The median survival times were: overall survival 18.7 months, time to first PCC 17.9 months, and survival post-PCC 0.6 months. Among patients who were followed-up at home, the median time spent at home was 0.6 months. Late PCC were associated with a childless status (HR = 0.57, 95%CI = 0.37–0.86, p = 0.007), awareness of the diagnosis (HR = 0.64, 95%CI = 0.45–0.91, p = 0.013), and lack of palliative home care (HR = 0.42, 95%CI = 0.25–0.65, p < 0.001). Older patients (OR = 1.03, 95%CI = 1.01–1.05, p = 0.026) and those who had been followed up at home during the PCC (OR = 160.56, 95%CI = 21.39–1205.50, p < 0.001) were significantly more likely to have died at home as opposed to the hospital.

Discussion

Cancer patients often receive PCC only shortly before their death. PCC for Lebanese cancer patients were found to be significantly delayed in patients that are childless, knowledgeable of their diagnosis, and lack home palliative care.

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Titel: Factors associated with the time to first palliative care consultation in Lebanese cancer patients
verfasst von: Ziad Bakouny
Tarek Assi
Elie El Rassy
Karen Daccache
Clarisse Kattan
Aline Tohme
Marie Claire Mouhawej
Joseph Kattan
Publikationsdatum: 07.11.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 4/2019
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4543-0

Springer Medizin

Factors associated with the time to first palliative care consultation in Lebanese cancer patients