Characteristics of patients with cancer in European long-term care facilities

TitleCharacteristics of patients with cancer in European long-term care facilities
Publication TypeJournal Article
Year of Publication2022
AuthorsVillani E.R, Fusco D., Franza L., Onder G., Bernabei R., Colloca G.F
JournalAging Clinical and Experimental Research
Keywords*cancer patient, *long term care, *malignant neoplasm/di [Diagnosis], *malignant neoplasm/dm [Disease Management], *malignant neoplasm/dt [Drug Therapy], *malignant neoplasm/ep [Epidemiology], *nursing home, acetylsalicylic acid/dt [Drug Therapy], Aged, antidepressant agent/dt [Drug Therapy], article, benzodiazepine derivative/dt [Drug Therapy], bisphosphonic acid derivative/dt [Drug Therapy], breast cancer, cancer diagnosis, cancer therapy, clinical feature, colon cancer, consciousness level, controlled study, cross-sectional study, do not resuscitate order, enteric feeding, European, executive function, fatigue, Female, functional status, Geriatric Depression Scale, Human, hydroxymethylglutaryl coenzyme A reductase inhibitor/dt [Drug Therapy], laxative/dt [Drug Therapy], major clinical study, Male, mental performance, neuroleptic agent/dt [Drug Therapy], non melanoma skin cancer, nonsteroid antiinflammatory agent/dt [Drug Therapy], opiate, oxygen therapy, pain, palliative therapy, paracetamol/dt [Drug Therapy], Polypharmacy, Terminal Care, very elderly, vitamin D/dt [Drug Therapy], wound care

Purpose: Up to 26% of residents in nursing homes (NHs) are affected by cancer. Their care represents a challenge, because NHs are not usually considered a setting focused on oncologic management and care. The aim of this paper is to describe socio-demographic and clinical features of patients with cancer residing in European NHs. Method(s): Cross-sectional study based on data from the Services and Health for Elderly in Long TERm care (SHELTER) study. Participants were assessed through the interRAI-LTCF, which includes cancer assessment. Result(s): Among 4140 participants (mean age 83.4 years; female 73%), 442 (10.7%) had cancer. Patients with cancer had a higher prevalence of do-not-resuscitate directives compared to those without cancer (21.1% vs 16.5%, p = 0.019). Variables directly associated with cancer were male sex (adj OR 1.67, 95% CI 1.36-2.05), pain (adj OR 1.43, 95% CI 1.16-1.77), fatigue (adj OR 1.25, 95% CI 1.01-1.55), polypharmacy (adj OR 1.59, 95% CI 1.21-2.08) and falls (adj OR. 1.30, 95% CI 1.01-1.67). Dementia was inversely associated with cancer (adj OR 0.74, 95% CI 0.58-0.94). Symptomatic drugs such as opioids (23.5% vs 12.2, p <.001), NSAIDS (7.2% vs 3.9%, p = 0.001), antidepressants (39.1% vs 33.8%, p = 0.026) and benzodiazepines (40.3% vs 34.3, p = 0.012) were all prescribed more in participants with cancer compared to those without cancer. Conclusion(s): Cancer patients are prevalent in European NHs and they show peculiar characteristics. Studies are needed to evaluate the impact of a supportive care approach on the management of NHs residents with cancer throughout all its phases, until the end-of-life care.Copyright © 2021, The Author(s).

Short TitleAging clinical and experimental research