Grant Details
Grant Number: |
5R29CA079052-04 Interpret this number |
Primary Investigator: |
Mccarthy, Ellen |
Organization: |
Beth Israel Deaconess Medical Center |
Project Title: |
Patterns Care for Cancer Patients at End of Life |
Fiscal Year: |
2001 |
Abstract
DESCRIPTION: This proposal is submitted for a first award (R29).
In recent years, the way that people die in the U.S. has attracted growing
public concern. As suffering cancer patients increasingly request
assistance to end their lives, some argue that too little attention is paid
to the quality of life in the final months. Voters in some states have
sponsored referenda on the right to end one's own life when gravely ill,
although the 1997 Supreme Court ruled against the right to a
physician-assisted suicide. Nonetheless, those continuing to lead public
calls for more individual control over the dying process have frequently
been cancer patients who describe uncontrollable pain or other intolerable
symptoms.
Relatively little is known about the quality of the dying experience for
cancer patients, especially from the patient's perspective, or about
patterns of care used during the final months of life. The overall goal of
this study is to describe the dying experience of cancer patients, focusing
on specific types of care, the resources consumed, and whether that care
complies with a patient s preferences. The project will use two
complimentary databases to achieve this goal: 1. The Study to Understand
Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT)
database, and 2. The Surveillance, Epidemiology, and End Results (SEER)
program database. Both databases have been merged with Medicare claims data
for patients older than 65 years.
The proposed study will be conducted in four overlapping phases, each with
its own specific aims. Phase one will describe the dying experience of the
seriously ill lung and colon cancer patients, including preferences for
care. Phase two will describe patterns of care for cancer patients at the
end of life. Phase three will examine the nature and intensity of care
received at the end of life. Phase four will describe variations in
end-of-life cancer care across place and time.
This study will provide an in-depth description of the quality of the dying
experience for selected cancer patients, and a better understanding of where
cancer patients receive care during their last six months of life, the
intensity of nature of their care, and whether patients' preferences for
care are being respected. Information obtained from the study can be used
to improve the quality of care for patients at the end of life and help to
determine the nature and amount of resources that might be required to meet
patients' needs.
Publications
None