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A Prospective Cohort Study of Stability in Preferred Place of Death Among Patients With Stage IV Cancer in Singapore.

Publication ,  Journal Article
Malhotra, C; Koh, LE; Teo, I; Ozdemir, S; Chaudhry, I; Finkelstein, E
Published in: J Natl Compr Canc Netw
August 5, 2021

BACKGROUND: Advance care planning (ACP) involves documentation of patients' preferred place of death (PoD). This assumes that patients' preferred PoD will not change over time; yet, evidence for this is inconclusive. We aimed to assess the extent and correlates of change in patients' preferred PoD over time. MATERIALS AND METHODS: Using data from a cohort study of patients with advanced cancer in Singapore, we analyzed preferred PoD (home vs institution including hospital, hospice, and nursing home vs unclear) among 466 patients every 6 months for a period of 2 years. At each time point, we assessed the proportion of patients who changed their preferred PoD from the previous time point. Using a multinomial logistic regression model, we assessed patient factors (demographics, understanding of disease stage, ACP, recent hospitalization, quality of life, symptom burden, psychologic distress, financial difficulty, prognosis) associated with change in their preferred PoD. RESULTS: More than 25% of patients changed their preferred PoD every 6 months, with no clear trend in change toward home or institution. Patients psychologically distressed at the time of the survey had increased likelihood of changing their preferred PoD to home (relative risk ratio [RRR], 1.02; 95% CI, 1.00-1.05) and to an institution (RRR, 1.06; 95% CI, 1.02-1.10) relative to no change in preference. Patients hospitalized in the past 6 months were more likely to change their preferred PoD to home (RRR, 1.56; 95% CI, 1.07-2.29) and less likely to change to an institution (RRR, 0.50; 95% CI, 0.28-0.88) relative to no change in preference. CONCLUSIONS: The present study provides evidence of instability in the preferred PoD of patients with advanced cancer. ACP documents need to be updated regularly to ensure they accurately reflect patients' current preference.

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Published In

J Natl Compr Canc Netw

DOI

EISSN

1540-1413

Publication Date

August 5, 2021

Volume

20

Issue

1

Start / End Page

20 / 28

Location

United States

Related Subject Headings

  • Terminal Care
  • Singapore
  • Quality of Life
  • Prospective Studies
  • Oncology & Carcinogenesis
  • Neoplasms
  • Humans
  • Hospices
  • Home Care Services
  • Cohort Studies
 

Citation

APA
Chicago
ICMJE
MLA
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Malhotra, C., Koh, L. E., Teo, I., Ozdemir, S., Chaudhry, I., & Finkelstein, E. (2021). A Prospective Cohort Study of Stability in Preferred Place of Death Among Patients With Stage IV Cancer in Singapore. J Natl Compr Canc Netw, 20(1), 20–28. https://doi.org/10.6004/jnccn.2020.7795
Malhotra, Chetna, Ling En Koh, Irene Teo, Semra Ozdemir, Isha Chaudhry, and Eric Finkelstein. “A Prospective Cohort Study of Stability in Preferred Place of Death Among Patients With Stage IV Cancer in Singapore.J Natl Compr Canc Netw 20, no. 1 (August 5, 2021): 20–28. https://doi.org/10.6004/jnccn.2020.7795.
Malhotra C, Koh LE, Teo I, Ozdemir S, Chaudhry I, Finkelstein E. A Prospective Cohort Study of Stability in Preferred Place of Death Among Patients With Stage IV Cancer in Singapore. J Natl Compr Canc Netw. 2021 Aug 5;20(1):20–8.
Malhotra, Chetna, et al. “A Prospective Cohort Study of Stability in Preferred Place of Death Among Patients With Stage IV Cancer in Singapore.J Natl Compr Canc Netw, vol. 20, no. 1, Aug. 2021, pp. 20–28. Pubmed, doi:10.6004/jnccn.2020.7795.
Malhotra C, Koh LE, Teo I, Ozdemir S, Chaudhry I, Finkelstein E. A Prospective Cohort Study of Stability in Preferred Place of Death Among Patients With Stage IV Cancer in Singapore. J Natl Compr Canc Netw. 2021 Aug 5;20(1):20–28.

Published In

J Natl Compr Canc Netw

DOI

EISSN

1540-1413

Publication Date

August 5, 2021

Volume

20

Issue

1

Start / End Page

20 / 28

Location

United States

Related Subject Headings

  • Terminal Care
  • Singapore
  • Quality of Life
  • Prospective Studies
  • Oncology & Carcinogenesis
  • Neoplasms
  • Humans
  • Hospices
  • Home Care Services
  • Cohort Studies