Depressive symptoms in the last days of life of patients with cancer:a nationwide retrospective mortality study

Janberidze, Elene and Martins Pereira, Sandra and Jensen Hjermstad, Marianne and Knudsen, Anne Kari and Kaasa, Stein and van der Heide, Agnes and Onwuteaka-Philipsen, Bregje D. and Deliens, Luc and Van den Block, Lieve and de Groote, Zeger and Cohen, Joachim and Pardon, Koen and Francke, Anneke and Pasman, H. Roeline and Harding, Richard and Higginson, Irene J. and Brearley, Sarah Grace and Payne, Sheila Alison and Caraceni, Augusto and Miccinesi, Guido and Pautex, Sophie and Linden, Karen (2016) Depressive symptoms in the last days of life of patients with cancer:a nationwide retrospective mortality study. BMJ Supportive and Palliative Care, 6 (2). pp. 201-209. ISSN 2045-435X

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Abstract

Objectives Depressive symptoms are common in patients with cancer and tend to increase as death approaches. The study aims were to examine the prevalence of depressive symptoms in patients with cancer in their final 24 h, and their association with other symptoms, sociodemographic and care characteristics. Methods A stratified sample of deaths was drawn by Statistics Netherlands. Questionnaires on patient and care characteristics were sent to the physicians (N=6860) who signed the death certificates (response rate 77.8%). Adult patients with cancer with non-sudden death were included (n=1363). Symptoms during the final 24 h of life were assessed on a 1–5 scale and categorised as 1=no, 2–3=mild/moderate and 4–5=severe/very severe. Results Depressive symptoms were registered in 37.6% of the patients. Patients aged 80 years or more had a reduced risk of having mild/moderate depressive symptoms compared with those aged 17–65 years (OR 0.70; 95% CI 0.50 to 0.99). Elderly care physicians were more likely to assess patients with severe/very severe depressive symptoms than patients with no depressive symptoms (OR 4.18; 95% CI 1.48 to 11.76). Involvement of pain specialists/palliative care consultants and psychiatrists/psychologists was associated with more ratings of severe/very severe depressive symptoms. Fatigue and confusion were significantly associated with mild/moderate depressive symptoms and anxiety with severe/very severe symptoms. Conclusions More than one-third of the patients were categorised with depressive symptoms during the last 24 h of life. We recommend greater awareness of depression earlier in the disease trajectory to improve care.

Item Type:
Journal Article
Journal or Publication Title:
BMJ Supportive and Palliative Care
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2900/2914
Subjects:
ID Code:
85891
Deposited By:
Deposited On:
11 Apr 2017 10:14
Refereed?:
Yes
Published?:
Published
Last Modified:
07 Jan 2020 05:21