- Patients with blood cancers who have timely goals of care (GOC) discussions are less likely to experience high-intensity medical care near the end of life (EOL), and are more likely to enroll in hospice.
Why this matters
- These patients have more near-EOL chemotherapy, acute hospitalizations, and ICU admissions and fewer hospice enrollments than those with solid malignancies.
- Researchers analyzed the records of 383 patients (56.1% men, 89.8% white) who died after blood cancer treatment; 70.8% were aged ≥60 years.
- Funding: None disclosed.
- 33.2% of initial GOC discussions occurred >30 days before death, 34.8% occurred in an outpatient setting, and 46.4% included a hematologic oncologist.
- Lower odds of ICU admission ≤30 days before death were associated with first GOC discussions:
- >30 days before death (OR, 0.37; 95% CI, 0.17‐0.81).
- In an outpatient setting (OR, 0.21; 95% CI, 0.09‐0.50).
- With a hematologic oncologist (OR, 0.40; 95% CI, 0.21‐0.77).
- Hospice use >3 days before death was associated with discussions including a hematologic oncologist (OR, 3.07; 95% CI, 1.58‐5.96).
- The study was retrospective, single-center, and observational.
- Unknown effects of GOC discussions on patient/caregiver decision-making.