Evidence map›Paper›PMID 27913873›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2017

Impact of intensity and timing of integrated home palliative cancer care on end-of-life hospitalization in Northern Italy.

M Pellizzari, D Hui, E Pinato, M Lisiero, S Serpentini, L Gubian, F Figoli, M Cancian, C De Chirico, E Ferroni and 2 more

Abstract read
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In one paragraph

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
1.2field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Quality indicators for integrating oncology and home palliative care in Japan: modified Delphi study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Integrating home palliative care in oncology: a qualitative study to identify barriers and facilitators.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
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  7. Article
  8. Article
  9. Article
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  11. Models of Palliative Care Delivery for Patients With Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 2 countries.

M PellizzariEpidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy.
D HuiDepartment of Palliative Care and Rehabilitation Medicine, MD Anderson Cancer Center, Houston, TX, USA.
E PinatoEpidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy.
M LisieroHospital Direction, Local Health Unit n° 8, Asolo, Italy.
S SerpentiniPalliative Care Unit Local Health Unit n° 3, Bassano del Grappa and Veneto Oncology Institute, Padua, Italy.
L GubianInformation Technology Service of the Veneto Region, Venezia, Italy.
F FigoliPalliative Care Unit, Local Health Unit n° 4, Thiene, Italy.
M CancianGP, Local Health Unit n° 7, Conegliano, Italy.
C De ChiricoPalliative Care Unit, Local Health Unit n° 7, Pieve di Soligo, Italy.
E FerroniEpidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy. eliana.ferroni@regione.veneto.it.
F AvossaEpidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy.
M SaugoEpidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy.
Regione del Veneto · ITThe University of Texas MD Anderson Cancer Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Veneto Region implemented a novel integrated home-based palliative cancer care (HPCC) program embedded in primary care. We examined the impact of timing and intensity of this program on the quality of end-of-life (EOL) care.

methodsWe selected adult cancer patients died in the Veneto Region between March and December 2013, excluding those died from haematological malignancies as well as the very elderly (85+ years). We retrieved the claim-based data on hospitalization and homecare visits, and defined two observation windows: 90 to 16 days before death to examine intensity of HPCC exposure, and the last 15 days of life to examine EOL outcomes, including hospital death, any hospital stay for medical reasons and hospital stay ≥7 days for medical reasons. Multivariate analysis was conducted using a Poisson model.

resultsAmong the 2211 adults who died of solid tumours and received 1+ homecare visits during the exposure period, 1077 (48.7%), 552 (25.0%) and 582 (26.3%) had 0.1-1.9, 2-3.9 and 4+ homecare visits/week, respectively. The median duration between an HPCC home visit and death was 92 days (IQR 42-257 days). Hospital death occurred in 856 (38.7%) patients, while 1087 (49.2%) and 556 (25.1%) had a hospital stay and a hospital stay ≥7 days during the exposure period, respectively. In the multivariate analysis, a greater intensity of integrated HPCC (4+ visits/week) was significantly associated with a lower risk of hospital death (relative risk [RR] = 0.67, 0.59-0.76), any hospital stay (RR = 0.69, 0.62-0.77) and hospital stay ≥7 days for medical reasons (RR = 0.59, 0.49-0.71). A late activation (≤30 days before death) of HPCC was also associated with increased both hospital stay (RR = 1.26, 0.11-1.42) and hospital stay ≥7 days (RR = 1.25, 1.01-1.54).

conclusionsA greater HPCC program intensity reduces the risk of hospital death and hospital stay in the end-of-life. An early activation of this program can contribute to improve these EOL outcomes.

Indexed as

AdolescentAdultAgedAged, 80 and overFemaleHospitalizationHumansItalyMaleMiddle AgedPalliative CareTerminal CareYoung AdultEnd-of-lifeHome visitsHospitalizationPalliative cancer carePlace of death

Identifiers

PMID27913873
OpenAlexW2557273352

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.