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Care Transitions in Patients with Advanced Cancer

J Clin Oncol; ePub 2017 Oct 25; Lage, et al

Patients with advanced cancer who are discharged to postacute care facilities and hospice tend to experience poorer quality of life and outcomes than those sent home, according to a prospective study involving 932 individuals. Participants had advanced cancer and experienced an unplanned hospitalization over a year and a half period ending in March 2016. Investigators tracked physical symptoms and psychological distress, and looked at their relationship with discharge location and survival. Among the results:

  • Patients discharged to postacute care and hospice experienced high rates of dyspnea, constipation, low appetite, fatigue, depression, and anxiety.
  • Those discharged to these facilities were more likely to be older; live alone; and have impaired mobility, longer hospital stays, worse physical symptoms, and higher depression symptoms.
  • Patients discharged to hospice were more apt to receive palliative care consultation and have shorter stays than those sent to postacute care.
  • Patients discharged to postacute care experienced shorter survival than those who were sent home.
Citation:

Lage D, Nipp R, D'Arpino S, et al. Predictors of posthospital transitions of care in patients with advanced cancer. [Published online ahead of print October 25, 2017]. J Clin Oncol. doi:10.1200/JCO.2017.74.0340. 

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