Early Use of Supportive Medications Not Associated With End of Life Care

Researchers have found no association between early use of any supportive medications and end-of-life care among Medicare beneficiaries with advanced breast cancer, according to a study published in the journal Supportive Care in Cancer.¹

Although previous research of patients with cancer has linked early supportive care to improved hospice use and less aggressive end-of-life care, the early use of supportive interventions and the potential effect on end-of-life care in practice are unclear.

Therefore, researchers sought to characterize early use of medications to treat common breast cancer symptoms, including anxiety, depression, insomnia, and pain, and to evaluate the association between early use of these drugs and end-of life care.

For the study, researchers analyzed data from 947 women included in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database between 2006 and 2012. Patients were included if they had stage 4 breast cancer and died within the observation period.

Results showed that 68% of women used at least 1 supportive medication in the 90 days after their diagnosis. Approximately 60% of patients used opioid pain medications and 28.3% received non-opioid psychotropic medications.

In addition to there being no association between early use of supportive medication and end-of-life care, the study demonstrated that there were no differences in end-of-life care between opioid pain medication users and non-users.

However, researchers observed non-opioid psychotropic medication users to be less likely to receive chemotherapy in the last 14 days of life (adjusted RR, 0.33; 95% CI, 0.12 – 0.88), suggesting that non-opioid psychotropic use was associated with certain aspects of end-of-life care.

Reference

1. Check DK, Rosenstein DL, Dusetzina SB. Early supportive medication use and end-of-life care among Medicare beneficiaries with advanced breast cancer [published online ahead of print March 19, 2016]. Supp Care Cancer. doi: 10.1007/s00520-016-3174-6.