TY - JOUR
T1 - Preferences Regarding End-of-Life Care Among Adolescents and Young Adults With Cancer
T2 - Results From a Comprehensive Multicenter Survey in Japan
AU - Hirano, Hidekazu
AU - Shimizu, Chikako
AU - Kawachi, A.
AU - Ozawa, Miwa
AU - Higuchi, A.
AU - Yoshida, S.
AU - Shimizu, Ken
AU - Tatara, Ryohei
AU - Horibe, K.
N1 - Funding Information:
Chikako Shimizu received grants from Eli-Lilly, Pfizer, and Chugai and personal fees from Pfizer, Eizai, Chugai, Nihon-Kayaku, and Astra Zeneca outside the submitted work; Ken Shimizu received research grants from Tsumura & CO. All authors except the two authors declare that they have no conflict of interest. The authors would like to thank the participants and the following staff: Akira Ohara (Department of Pediatrics, Toho University), Seiichiro Ozono (Department of Urology, Hamamatsu University School of Medicine), Kazuhito Yamamoto (Department of Hematology and Cell Therapy, Aichi Cancer Center), Kimikazu Matsumoto (Children's Cancer Center, National Center for Child Health and Development), Nao Suzuki (Department of Obstetrics and Gynecology, St. Marianna University School of Medicine), Tatsuro Furui (Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine), Mikiya Nakatsuka (Graduate School of Health Sciences, Okayama University), Michio Kitajima (Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences), Fuminori Kimura (Department of Obstetrics and Gynecology, Shiga University of Medical Science), Yasushi Takai (Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University), Kenichiro Morishige (Department of Obstetrics and Gynecology, Graduate School of Medicine, Gifu University), Terukazu Nakamura (Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine), Reiko Suzuki (Department of Food Science and Nutrition Faculty of Human Science and Design, Japan Women's University), Akira Kawai (Department of Musculoskeletal Oncology, National Cancer Center Hospital), Mitsue Maru (Faculty of Nursing and Rehabilitation, Konan Women's University), Miyako Takahashi (Division of Cancer Survivorship Research, Center for Cancer Control and Information Services, National Cancer Center), Shizuhiro Niihira (Department Head of Information and Support, National Institute of Special Needs Education), and Tomoko Takayama (Division of Cancer Information Service, Center for Cancer Control and Information Service, National Cancer Center). This study was supported by a research grant from the Ministry of Health,Labour and Welfare (Health and Labor Sciences Research Grant [Research for Promotion of Cancer Control Program, no. H27-Gantaisaku-Ippan-005]).
Funding Information:
Chikako Shimizu received grants from Eli-Lilly , Pfizer , and Chugai and personal fees from Pfizer, Eizai, Chugai, Nihon-Kayaku, and Astra Zeneca outside the submitted work; Ken Shimizu received research grants from Tsumura & CO . All authors except the two authors declare that they have no conflict of interest.
Publisher Copyright:
© 2019 American Academy of Hospice and Palliative Medicine
PY - 2019/8
Y1 - 2019/8
N2 - Context: Patient preferences influence end-of-life (EOL) care which patients receive. However, preferences regarding EOL care among adolescent and young adult (AYA) cancer population remain unclear. Objectives: The objective of the study was to evaluate preferences regarding EOL care among AYA cancer population. Methods: We evaluated preferences regarding EOL care as a part of a comprehensive multicenter questionnaire study investigating the experience and needs of Japanese AYA cancer population. Results: A total of 349 AYA cancer population (213 AYA cancer patients and 136 AYA cancer survivors) were evaluated. Eighty-six percent (296/344), 53% (180/338), 88% (301/341), and 61% (207/342) of participants with valid response preferred to have prognostic disclosure, receive palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity, actively use palliative care, and stay home at EOL, respectively. In multivariate analysis, the preference regarding prognostic disclosure was associated positively with no child status (odds ratio [OR] = 3.05, P = 0.003) and negatively with history of chemotherapy (OR = 0.23, P = 0.009), the preference regarding palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity was associated positively with status under active cancer treatment (OR = 1.74, P = 0.03), and the preference of staying home at EOL was positively associated with anxiety (OR = 1.72, P = 0.04). Conclusion: This study elucidated preferences regarding EOL care among Japanese AYA cancer population. These findings may help health care practitioners to have better understanding of preferences regarding EOL care among this population.
AB - Context: Patient preferences influence end-of-life (EOL) care which patients receive. However, preferences regarding EOL care among adolescent and young adult (AYA) cancer population remain unclear. Objectives: The objective of the study was to evaluate preferences regarding EOL care among AYA cancer population. Methods: We evaluated preferences regarding EOL care as a part of a comprehensive multicenter questionnaire study investigating the experience and needs of Japanese AYA cancer population. Results: A total of 349 AYA cancer population (213 AYA cancer patients and 136 AYA cancer survivors) were evaluated. Eighty-six percent (296/344), 53% (180/338), 88% (301/341), and 61% (207/342) of participants with valid response preferred to have prognostic disclosure, receive palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity, actively use palliative care, and stay home at EOL, respectively. In multivariate analysis, the preference regarding prognostic disclosure was associated positively with no child status (odds ratio [OR] = 3.05, P = 0.003) and negatively with history of chemotherapy (OR = 0.23, P = 0.009), the preference regarding palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity was associated positively with status under active cancer treatment (OR = 1.74, P = 0.03), and the preference of staying home at EOL was positively associated with anxiety (OR = 1.72, P = 0.04). Conclusion: This study elucidated preferences regarding EOL care among Japanese AYA cancer population. These findings may help health care practitioners to have better understanding of preferences regarding EOL care among this population.
KW - Adolescent and young adult
KW - cancer
KW - chemotherapy
KW - end-of-life care
KW - preference
KW - prognostic disclosure
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UR - http://www.scopus.com/inward/citedby.url?scp=85066334710&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2019.04.033
DO - 10.1016/j.jpainsymman.2019.04.033
M3 - Article
C2 - 31077783
AN - SCOPUS:85066334710
SN - 0885-3924
VL - 58
SP - 235-243.e1
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 2
ER -
