Receipt of hospice care concurrently with chemotherapy or radiation therapy has increased among veterans dying from cancer without reduction in receipt of cancer therapy, according to a recent study published online ahead of print in Cancer.1
Researchers led by Vincent Mor, PhD, of the Providence Veterans Affairs (VA) Health Administration Medical Center in Rhode Island conducted a retrospective cohort study of veteran decedents with cancer from 2006 to 2012, analyzing for hospice and cancer treatment through VA and Medicare administrative data.
“Unlike Medicare, the VA health care system does not require veterans with cancer to make the ‘terrible choice’ between receipt of hospice services or disease-modifying chemotherapy/radiation therapy,” the authors noted. They defined concurrent care as days in the last 6 months of life during which veterans received both hospice and chemotherapy/radiation therapy.
They found that receipt of concurrent care increased from 16.2% to 24.5%, with the proportion of veterans receiving chemotherapy or radiation therapy remaining stable at about 45% and the proportion of those who received hospice increasing from 55% to 68%.
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Median time from hospice initiation and death remained stable at about 21 days. Among patients who received chemotherapy or radiation therapy in the last 6 months of life, median time between treatment termination and death ranged from 35 to 40 days.
“This approach reflects the expansion of hospice services in the VA with VA policy allowing the concurrent receipt of hospice and antineoplastic therapies,” the authors concluded.
- Mor V, Joyce NR, Coté DL, et al. The rise of concurrent care for veterans with advanced cancer at the end of life [published online ahead of print December 15, 2015]. Cancer. doi: 10.1002/cncr.29827.