TY - JOUR

T1 - Depressive symptoms in the last days of life of patients with cancer

T2 - a nationwide retrospective mortality study

AU - Janberidze, Elene

AU - Martins Pereira, Sandra

AU - Jensen Hjermstad, Marianne

AU - Knudsen, Anne Kari

AU - Kaasa, Stein

AU - van der Heide, Agnes

AU - Onwuteaka-Philipsen, Bregje D.

AU - Deliens, Luc

AU - Van den Block, Lieve

AU - de Groote, Zeger

AU - Cohen, Joachim

AU - Pardon, Koen

AU - Francke, Anneke

AU - Pasman, H. Roeline

AU - Harding, Richard

AU - Higginson, Irene J.

AU - Brearley, Sarah Grace

AU - Payne, Sheila Alison

AU - Caraceni, Augusto

AU - Miccinesi, Guido

AU - Pautex, Sophie

AU - Linden, Karen

AU - Euro Impact

PY - 2016/6/1

Y1 - 2016/6/1

N2 - 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.

AB - 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.

U2 - 10.1136/bmjspcare-2014-000722

DO - 10.1136/bmjspcare-2014-000722

M3 - Journal article

VL - 6

SP - 201

EP - 209

JO - BMJ Supportive and Palliative Care

JF - BMJ Supportive and Palliative Care

SN - 2045-435X

IS - 2

ER -