Evidence map›Paper›PMID 39186972›Full record

ArticleChest2024

Differences in Health Care and Palliative Care Use at the End of Life: A Comparison Study Among Lung Cancer, COPD, and Idiopathic Pulmonary Fibrosis.

Angela O Suen, Kara Bischoff, Anand S Iyer, Keerthana Radhakrishnan, Cynthia Fenton, Jonathan P Singer, Rebecca L Sudore, Ashwin Kotwal, Erica Farrand

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. 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
  3. Review
  4. Observational
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

9 authors.

Angela O SuenDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA. Electronic address: angela.suen@ucsf.edu.
Kara BischoffDivision of Palliative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA.
Anand S IyerDivision of Pulmonary, Allergy, and Critical Care Medicine, Division of Gerontology, Geriatrics, and Palliative Care, and School of Nursing, University of Alabama at Birmingham, Birmingham, AL; Birmingham Veterans Affairs Medical Center Geriatrics Research Education and Clinical Center, Birmingham, AL.
Keerthana RadhakrishnanDivision of Hospital Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA.
Cynthia FentonDivision of Hospital Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA.
Jonathan P SingerDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA.
Rebecca L SudoreDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA; Department of Medicine, San Francisco VA Medical Center, San Francisco, CA.
Ashwin KotwalDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA; Department of Medicine, San Francisco VA Medical Center, San Francisco, CA.
Erica FarrandDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA.

Funding

MUTIDISCIPLINARY TRAINING PROGRAM IN LUNG DISEASEST32HL007185 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI David J Erle, LAURENCE HUANG · 1985 to 2026
$24.6M
VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI W. JOHN BOSCARDIN · 2013 to 2026
$19.9M
RESEARCH TRAINING IN GERIATRIC MEDICINET32AG000212 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 1991 to 2026
$7.7M
Mentoring Researchers in Advance Care Planning for Underrepresented Older Adults at Risk for Alzheimer’s Disease and Related Dementias and Their CaregiversK24AG054415 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI REBECCA L SUDORE · 2017 to 2026
$1.7M
NHLBI NIH HHS T32 HL007185NIA NIH HHS K24 AG054415NIA NIH HHS P30 AG044281NIA NIH HHS T32 AG000212
6 · The paper itself

Abstract

backgroundPatients with lung cancer, idiopathic pulmonary fibrosis (IPF), and COPD have high symptom burden, poor quality of life, and high health care use at the end of life. Although proactive integration of palliative care in lung cancer can improve outcomes, it is unclear whether similar practices have been adopted in COPD and IPF care. RESEARCH QUESTION: Do patients with COPD and IPF have different patterns of health care and palliative care use at the end of life compared with patients with lung cancer? STUDY DESIGN AND

methodsWe retrospectively identified deceased patients with lung cancer, COPD, or IPF with ≥ 1 outpatient visit at the University of California, San Francisco, in the last 6 months of life. We compared outpatient palliative care and opioid prescriptions, inpatient palliative care, hospitalizations, intensive care use, and in-hospital death in the last 6 months of life between each group. We used multivariable logistic regression to calculate adjusted ORs (aORs) of each outcome, with lung cancer as the reference group.

resultsAmong 1,819 patients, patients with COPD and IPF were more likely to be male and older at the time of death compared with patients with lung cancer. Compared with patients with lung cancer, patients with COPD and IPF showed a lower adjusted odds (P < .001) of receiving outpatient palliative care (COPD: aOR, 0.26 [95% CI, 0.19-0.36]; IPF: aOR, 0.48 [95% CI, 0.32-0.70]), outpatient opioid prescription (COPD: aOR, 0.50 [95% CI, 0.40-0.63]; IPF: aOR, 0.40 [95% CI, 0.29-0.54]), and a higher odds of end-of-life ICU use (COPD: aOR, 2.88 [95% CI, 2.11-3.93]; IPF: aOR, 4.15 [95% CI, 2.66-6.49]). Patients with IPF showed higher odds of receiving inpatient palliative care (aOR: 2.02 [95% CI, 1.30-3.13]; P = .002).

interpretationThis study showed that patients with COPD and IPF are less likely to receive outpatient palliative care and opioid prescriptions and are more likely to use end-of-life intensive care than patients with lung cancer. Further research should explore health system barriers contributing to differences in care patterns to optimize quality of life and to align with patient goals of care.

Indexed as

Idiopathic Pulmonary FibrosisLung NeoplasmsPalliative CarePulmonary Disease, Chronic ObstructiveTerminal CareAgedAged, 80 and overAnalgesics, OpioidFemaleHospitalizationHumansMaleMiddle AgedQuality of LifeRetrospective StudiesAnalgesics, Opioidadvanced lung diseaseCOPDend of lifeidiopathic pulmonary fibrosispalliative care

Identifiers

PMID39186972
PMCPMC11745200

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.