The extent of pain, depression, and anorexia are rising in the last year of life for oncology patients, based on a survey of their family members.
Moderate or severe pain was experienced for at least a month by over 57% of 7,204 patients in their last year of life, and the incidence of pain appears to have increased between 1998 and 2010, based on data from participants who died during the longitudinal, community-based Health and Retirement study. Patients’ family members also reported that over 51% of patients experienced depression and 64% experienced anorexia in their last year of life.
The data reflect increases in the incidence of moderate to severe pain from nearly 47% in 1998-2000 to nearly 55% in 2008-2010. Increases also were noted in reports of depression and periodic confusion, researchers reported in the Feb. 2 online edition of Annals of Internal Medicine [doi:10.7326/M13-1609]). .
The researchers note other studies indicate that the intensity of treatment and the rate of adverse transitions have been increasing near the end of life. While hospice care is on the rise, it is often “tacked on” to this more intense late-life care; the median hospice stay is less than 3 weeks and such patients may not achieve symptomatic relief. Patients may not have consistent access to palliative services in outpatient, home, and long-term facility settings where most of the course of a terminal illness takes place, wrote Adam E. Singer of the Pardee RAND Graduate School, Santa Monica, Calif., and his colleagues.
The study was supported by the National Institute of Nursing Research and the Medical Scientist Training Program at the University of California.