Abstract:
BACKGROUND:Patients with advanced cancer often have to make difficult decisions, such as how much to spend on moderately life-extending treatments. This and other end-of-life decisions are also influenced by their informal caregivers. Understanding the relative value that patients and their caregivers place on various aspects of end-of-life care can help clinicians tailor treatments to best meet the preferences of their patients. AIM:To quantify willingness to pay of patients with advanced cancer and their caregivers to extend the patients' life by 1 year and to compare this result to their willingness to pay for other end-of-life improvements. DESIGN:Cross-sectional survey using a discrete choice experiment. PARTICIPANTS:A total of 211 patients with stage IV cancer and their informal caregivers. RESULTS:The willingness to pay of patients to extend their life by 1 year (S$18,570; 95% confidence interval: S$6687-S$30,542) was not statistically different from their willingness to pay to avoid severe pain (S$22,199; S$11,648-S$32,450), to die at home (S$31,256; S$21,249-S$41,391), not be a burden on family and friends (S$4051; -S$3543 to S$11,568), or to receive a high-quality health-care experience (S$16,191; S$9266-S$23,037). Consistent with our hypothesis, caregivers had a greater willingness to pay than patients to extend life (S$61,368; S$37,030-S$86,210) and for most other end-of-life improvements. CONCLUSION:Results highlight the importance of pain management, supporting home deaths, and addressing other end-of-life concerns, in addition to efforts to extend life. Differences in willingness to pay of patients and caregivers suggest the need for eliciting patient preferences during treatment decision making as opposed to relying on caregiver input.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Malhotra C,Farooqui MA,Kanesvaran R,Bilger M,Finkelstein Edoi
10.1177/0269216315578803subject
Has Abstractpub_date
2015-10-01 00:00:00pages
842-50issue
9eissn
0269-2163issn
1477-030Xpii
0269216315578803journal_volume
29pub_type
杂志文章abstract::Breakthrough pain (BKP) is a transitory flare of pain that occurs on a background of relatively well controlled baseline pain. Previous surveys have found that BKP is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor qua...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216304pm890oa
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abstract:BACKGROUND:The Palliative Care Problem Severity Score is a clinician-rated tool to assess problem severity in four palliative care domains (pain, other symptoms, psychological/spiritual, family/carer problems) using a 4-point categorical scale (absent, mild, moderate, severe). AIM:To test the reliability and acceptabi...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216315613904
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abstract:BACKGROUND:The Gold Standards Framework (GSF) was developed to improve the delivery of palliative care in general practice. AIM:The aim of the study was to evaluate the first phase of GSF in terms of its acceptability to primary care teams, effectiveness in changing practice and professionals' views on the consequence...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216306072501
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abstract:BACKGROUND:Hospitalizations in patients with metastatic cancer occur commonly at the end of life but have not been well-described in individuals with metastatic breast cancer. AIM:To describe the reasons for admission and frequency of palliative care and hospice utilization in hospitalized patients with metastatic bre...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316637238
更新日期:2016-10-01 00:00:00
abstract::Increasing emphasis is being placed on the need for advanced care planning (ACP) at the end of life. The Preferred Priorities for Care (PPC) document is a patient-held record promoted by the End of Life Care Strategy as an ACP tool to promote discussion and communication amongst patients, family and health care provid...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311399664
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain. AIM:Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital. DES...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216313487569
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abstract::Cyclizine is an antihistamine, which is frequently used to manage nausea and vomiting in cancer patients. Antihistamines can be drugs of misuse/abuse, and the article describes four cancer patients who developed such problems after receiving parenteral cyclizine within the inpatient unit of a cancer centre. The articl...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
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abstract:BACKGROUND:Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking. AIM:To evaluate perceived psychological support in relation to end-of...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319888986
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abstract:BACKGROUND:the right for patients of all diagnoses to be in receipt of palliative care from an early point in the diagnosis of a life-limiting condition is now enshrined in policy in a number of countries and increased emphasis is placed upon the role of generalist palliative care. However, little is known as to how th...
journal_title:Palliative medicine
pub_type: 杂志文章
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abstract::This study looked at the efficacy of drug treatment in managing death rattle in a 30-bedded specialist palliative care unit. The study was conducted in two phases. In the first, patients received hyoscine hydrobromide as the antimuscarinic; glycopyrrolate was used in the second phase. The patients in the two phases we...
journal_title:Palliative medicine
pub_type: 临床试验,杂志文章
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更新日期:2001-07-01 00:00:00
abstract:OBJECTIVES:Exploring terminal patients' perceptions of GPs' role in delivering continuous end-of-life care and identifying barriers to this. DESIGN:Qualitative interview study with patients (two consecutive interviews). SETTING:Primary care Belgium. PARTICIPANTS:Seventeen terminally ill cancer patients, informed abo...
journal_title:Palliative medicine
pub_type: 杂志文章
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abstract::This paper reviews a number of studies relating to religion and coping with chronic illness, emphasizing those aspects relevant to palliative care. After pointing out that religious and existential needs are common in chronic illness, a critical examination is made of those studies which purport to demonstrate associa...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
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abstract::The frequency of the use of laxatives, and the relationship between doses of laxatives and of opioid analgesia, were determined by a prospective study of 498 hospice inpatients with advanced cancer. Laxatives were required by 87% of patients taking oral strong opioids, 74% of those on weak opioids and 64% of those not...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921698674125048
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abstract:BACKGROUND:While several studies have examined 'what' families want with regard to the place of a child's end-of-life care and death, few have explored 'how' parents reach a decision. AIMS:(1) to develop a model explaining how parents of a child with a life-threatening illness in Greece decide about the place of end-o...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320967547
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abstract::This paper reviews the experience of managing 31 patients with severe dysphagia in motor neurone disease. Thirteen patients were fed nasogastrically and the remaining 18 were managed conservatively without a nasogastric tube. The introduction of nasogastric feeding led to the development of new problems in some patien...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800108
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Depressive disorders are common among cancer patients. Ketamine can quickly relieve depression, and its subcutaneous administration appears to be as effective as and probably safer than its standard intravenous administration. Herein, we report a case verifying the antidepressant effect of a subcutaneous esk...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320910351
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase. AIM:To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual mod...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319840275
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The evidence supporting pharmacological treatment of death rattle is poor; yet, anticholinergic drugs feature in end-of-life care pathways and guidelines worldwide as a treatment option. AIM:This qualitative arm of a wider study aimed to explore important issues which health-care professionals associated wi...
journal_title:Palliative medicine
pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
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journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
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journal_title:Palliative medicine
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journal_title:Palliative medicine
pub_type: 杂志文章,meta分析,评审
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journal_title:Palliative medicine
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journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310364877
更新日期:2010-07-01 00:00:00
abstract::The history and development of an extra care sheltered housing complex, specifically designed and built for frail, ambulant, cancer patients is reviewed. Consideration is given to diagnosis, length of stay, place of death, family and social background. Problems are highlighted and the need for future research is discu...
journal_title:Palliative medicine
pub_type: 杂志文章
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更新日期:1995-07-01 00:00:00
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journal_title:Palliative medicine
pub_type: 杂志文章
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更新日期:2006-07-01 00:00:00
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journal_title:Palliative medicine
pub_type: 杂志文章
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更新日期:1999-07-01 00:00:00
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journal_title:Palliative medicine
pub_type: 杂志文章
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更新日期:2015-04-01 00:00:00
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journal_title:Palliative medicine
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journal_title:Palliative medicine
pub_type: 杂志文章,评审
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更新日期:2011-07-01 00:00:00
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journal_title:Palliative medicine
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更新日期:2003-04-01 00:00:00