Evidence map›Paper›PMID 38587665›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2024

Primary care usage at the end of life: a retrospective cohort study of cancer patients using linked primary and hospital care data.

M Grant, D McCarthy, C Kearney, A Collins, V Sundararajan, J Rhee, J Philip, J Emery

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

M GrantPalliative Nexus Research Group, Department of Medicine, University of Melbourne, Melbourne, Australia. Mgrant2@umcutrecht.nl.
D McCarthyDept of General Practice and Primary Care, Centre for Cancer Research, University of Melbourne, Melbourne, Australia.
C KearneyDept of General Practice and Primary Care, Centre for Cancer Research, University of Melbourne, Melbourne, Australia.
A CollinsPalliative Nexus Research Group, Department of Medicine, University of Melbourne, Melbourne, Australia.
V SundararajanLa Trobe University, Public Health, Melbourne, Australia.
J RheeDiscipline of General Practice, School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.
J PhilipPalliative Nexus Research Group, Department of Medicine, University of Melbourne, Melbourne, Australia.
J EmeryCentre of Expertise in Palliative Care Utrecht, Department of General Practice, Julius Centre, UMC Utrecht, Universiteitsweg 100, 3584CG, Utrecht, The Netherlands.

Funding

National Health and Medical Research Council APP1195302
6 · The paper itself

Abstract

purposeHealth service use is most intensive in the final year of a person's life, with 80% of this expenditure occurring in hospital. Close involvement of primary care services has been promoted to enhance quality end-of-life care that is appropriate to the needs of patients. However, the relationship between primary care involvement and patients' use of hospital care is not well described. This study aims to examine primary care use in the last year of life for cancer patients and its relationship to hospital usage.

methodsRetrospective cohort study in Victoria, Australia, using linked routine care data from primary care, hospital and death certificates. Patients were included who died related to cancer between 2008 and 2017.

resultsA total of 758 patients were included, of whom 88% (n = 667) visited primary care during the last 6 months (median 9.1 consultations). In the last month of life, 45% of patients were prescribed opioids, and 3% had imaging requested. Patients who received home visits (13%) or anticipatory medications (15%) had less than half the median bed days in the last 3 months (4 vs 9 days, p < 0.001, 5 vs 10 days, p = 0.001) and 1 month of life (0 vs 2 days, p = 0.002, 0 vs 3 days, p < 0.001), and reduced emergency department presentations (32% vs 46%, p = 0.006, 31% vs 47% p < 0.001) in the final month.

conclusionThis study identifies two important primary care processes-home visits and anticipatory medication-associated with reduced hospital usage and intervention at the end of life.

Indexed as

DeathNeoplasmsHospitalsHumansPrimary Health CareRetrospective StudiesVictoriaCancerEnd-of-life careHome visitsPalliative carePrimary care

Identifiers

PMID38587665
PMCPMC11001688

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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.