Evidence map›Paper›PMID 30708125›Full record

ArticleJournal of pain and symptom management2019

A Prospective Cohort Study of Factors Associated With Place of Death Among Patients With Late-Stage Cancer in Southern Africa.

Charmaine L Blanchard, Oluwatosin Ayeni, Daniel S O'Neil, Holly G Prigerson, Judith S Jacobson, Alfred I Neugut, Maureen Joffe, Keletso Mmoledi, Mpho Ratshikana-Moloko, Paul E Sackstein and 1 more

Abstract read
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In one paragraph

Article in Journal of pain and symptom management, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

16 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  13. Illnesses and Symptoms in Older Adults at the End of Life at Different Places of Death in Korea.International journal of environmental research and public health · 2022
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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

11 authors.

Charmaine L BlanchardCentre for Palliative Care, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Non Communicable Diseases Research Division, Wits Health Consortium, Johannesburg, South Africa. Electronic address: charmaine.blanchard@wits.ac.za.
Oluwatosin AyeniMRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Non Communicable Diseases Research Division, Wits Health Consortium, Johannesburg, South Africa.
Daniel S O'NeilHerbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA; Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
Holly G PrigersonCornell Center for Research on End-of-Life Care, Weill Cornell Medicine, New York, New York, USA.
Judith S JacobsonHerbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
Alfred I NeugutHerbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA; Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
Maureen JoffeMRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Non Communicable Diseases Research Division, Wits Health Consortium, Johannesburg, South Africa.
Keletso MmolediChris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; Centre for Palliative Care, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Non Communicable Diseases Research Division, Wits Health Consortium, Johannesburg, South Africa.
Mpho Ratshikana-MolokoChris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; Centre for Palliative Care, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Non Communicable Diseases Research Division, Wits Health Consortium, Johannesburg, South Africa.
Paul E SacksteinDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
Paul RuffDivision of Medical Oncology, Department of Internal Medicine, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa; Non Communicable Diseases Research Division, Wits Health Consortium, Johannesburg, South Africa.

Funding

Tumor Biology and Microenvironment ProgramP30CA013696 · NCI · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI Parisa Tehranifar · 1985 to 2026
$115.3M
Psychosocial Approaches to Better Understanding & End-Stage Cancer Care (PROTECT)R35CA197730 · NCI · WEILL MEDICAL COLL OF CORNELL UNIV · PI Holly Gwen Prigerson · 2015 to 2026
$11.2M
HIV's Effects on Breast Cancer Treatment and Outcomes in South AfricaR01CA192627 · NCI · WITS HEALTH CONSORTIUM (PTY), LTD · PI JACOBSON, JUDITH S, JOFFE, MAUREEN · 2015 to 2019
$1.7M
NCI NIH HHS P30 CA013696NCI NIH HHS R01 CA192627NCI NIH HHS R35 CA197730
6 · The paper itself

Abstract

contextIdentifying factors that affect terminally ill patients' preferences for and actual place of death may assist patients to die wherever they wish.

objectiveThe objective of this study was to investigate factors associated with preferred and actual place of death for cancer patients in Johannesburg, South Africa.

methodsIn a prospective cohort study at a tertiary hospital in Johannesburg, South Africa, adult patients with advanced cancer and their caregivers were enrolled from 2016 to 2018. Study nurses interviewed the patients at enrollment and conducted postmortem interviews with the caregivers.

resultsOf 324 patients enrolled, 191 died during follow-up. Preferred place of death was home for 127 (66.4%) and a facility for 64 (33.5%) patients; 91 (47.6%) patients died in their preferred setting, with a kappa value of congruence of 0.016 (95% CI = -0.107, 0.139). Factors associated with congruence were increasing age (odds ratio [OR]: 1.03, 95% CI: 1.00-1.05), use of morphine (OR: 1.87, 95% CI: 1.04-3.36), and wanting to die at home (OR: 0.44, 95% CI: 0.24-0.82). Dying at home was associated with increasing age (OR 1.03, 95% CI 1.00-1.05) and with the patient wishing to have family and/or friends present at death (OR 6.73, 95% CI 2.97-15.30).

conclusionMost patients preferred to die at home, but most died in hospital and fewer than half died in their preferred setting. Further research on modifiable factors, such as effective communication, access to palliative care and morphine, may ensure that more cancer patients in South Africa die wherever they wish.

Indexed as

DeathAge FactorsAttitude to DeathCaregiversFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasmsPalliative CareProspective StudiesSouth AfricaTerminal CareTerminally Illactual place of deathcancer patientsPalliative carepreferred place of deathprospective studysub-Saharan Africa

Identifiers

PMID30708125
PMCPMC6531674

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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.