Timing and outcomes of palliative care integration into care of adolescents and young adults with advanced cancer

Timing and outcomes of palliative care integration into care of adolescents and young adults with advanced cancer
Oncology Practice; by Jeremiah Bonnet, Colin Cernik, Hajime Uno, Lanfang Xu, Cecile A. Laurent, Lauren Fisher, Nancy Cannizzaro, Julie Munneke, Robert M. Cooper, Joshua R. Lakin, Corey M. Schwartz, Mallory Casperson, Andrea Altschuler, Lawrence H. Kushi, Chun R. Chao, Lori Wiener, Jennifer W. Mack; 5/25
Adolescent and young adult (AYA) patients with cancer frequently receive intensive measures at the end of life; many also express care goals that align with a palliative approach. [In this study] nearly three quarters (73%) [of  AYA patients] were referred to palliative care before death. Thirty-six percent of palliative care referrals took place before the last 90 days of life; 30% were in the last month of life. Palliative care referrals and their timing were associated with care received at the end of life, with earlier referrals associated with fewer intensive measures near death, including chemotherapy in the last 14 days of life ... as well as intensive care unit admissions, emergency room visits, and hospitalizations in the last month of life ... Patients who were referred to palliative care were more likely to have symptoms assessed in the last 90 days of life, including pain, dyspnea, nausea, diarrhea, constipation, depression, and anxiety ...