Changes of End of Life Practices for Cancer Patients and TheirAssociation with Hospice Palliative Care Referral over 2009-2014:A Single Institution Study / Journal of the Korean Cancer Association, 대한암학회지

ABSTRACT

Purpose@#In Korea, hospice palliative care (HPC) provision for cancer patients has increased recently.However, whether end of life (EoL) care practices have improved along with the developmentof HPC is unclear. We intended to investigate the changes in EoL care practices and theirassociation with HPC referral. @*Materials and Methods@#Retrospective medical record review of adult cancer patients who died at National CancerCenter Korea from 1 January 2009 to 31 December 2014 was performed. Changes of EoLpractices including chemotherapy within 2 weeks from death, death in intensive care unit(ICU), documentation of “do not resuscitate (DNR)” within 7 days from death and referral toHPC from 2009 to 2014 were analyzed as well as the association between referral to HPCand other practices. @*Results@#A total of 2,377 cases were included in the analysis. Between 2009 and 2014, referral toHPC increased and DNR documentation within 7 days from death decreased significantly.Cases for chemotherapy within 2 weeks from death and death in ICU didn’t change overthe study period. Patients referred to HPC were less likely to receive chemotherapy within2 weeks from death, die in ICU and document DNR within 7 days from death. @*Conclusion@#During the study period, EoL practices among cancer patients partly changed toward lessaggressive in our institution. HPC referral was associated with less aggressive cancer careat the EoL. Policies to promote EoL discussion are necessary to improve the EoL practicesof cancer patients.