[CHEMOTHERAPY FOR CANCER PATIENTS - ARE WE CHOOSING WISELY?]

Area of Science:

• Oncology
• Palliative Care
• Health Services Research

Background:

• The American Society of Clinical Oncology highlights non-evidence-based chemotherapy as futile care.
• Chemotherapy administration in the last month of life is a key quality indicator in oncology.

Purpose of the Study:

• To characterize chemotherapy use and palliative care services in the final year of life for cancer patients.
• To analyze healthcare utilization among terminally ill cancer patients in an Israeli Health Maintenance Organization (HMO).

Main Methods:

• A cross-sectional study analyzed data from 2,617 cancer patients who died between 2009-2013 in Leumit Health Services (LHS).
• Patients were stratified based on the time between their last chemotherapy treatment and death.
• Demographics, morbidity, healthcare utilization, and palliative care referrals in the last six months of life were compared.

Main Results:

• 18.8% of patients received chemotherapy within 14 days of death.
• Palliative care referrals were lowest (15.8%) for patients receiving chemotherapy 0-14 days before death.
• Referrals were highest (31.9%) for those whose last chemotherapy was ≥180 days before death (P<0.0001).

Conclusions:

• Chemotherapy administration near the end of life is inversely associated with palliative care utilization.
• Increased awareness among oncologists regarding potentially futile aggressive treatments in the final weeks of life is crucial.