Advance care planning in older patients with acute myeloid leukemia and myelodysplastic syndromes.

Humans Aged Myelodysplastic Syndromes / therapy Leukemia, Myeloid, Acute / therapy Delivery of Health Care Advance Care Planning
Acute myeloid leukemia Advance care planning Hematologic malignancy Myelodysplastic syndromes Qualitative study

Journal

Journal of geriatric oncology
ISSN: 1879-4076
Titre abrégé: J Geriatr Oncol
Pays: Netherlands
ID NLM: 101534770

Informations de publication

Date de publication:
Jan 2023
Historique:
received: 27 07 2022
revised: 29 08 2022
accepted: 02 09 2022
pubmed: 14 9 2022
medline: 3 3 2023
entrez: 13 9 2022
Statut: ppublish

Résumé

Older patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) have worse survival rates compared to younger patients, and experience more intense inpatient healthcare at the end of life (EOL) compared to patients with solid tumors. Advance care planning (ACP) has been shown to limit aggressive and burdensome care at EOL for patients with AML and MDS. The purpose of this study was to better understand ACP from the perspective of clinicians, older patients with AML and MDS, and their caregivers. We conducted semi-structured interviews with 45 study participants. Interviews were audio-recorded and transcribed. Open coding and focused content analysis were used to organize data and develop and contextualize categories and subcategories. Guided by our specific aims, we developed four themes: (1) The language of ACP and medical order for life-sustaining treatment (MOLST) does not resonate with patients, (2) There is no uniform consensus on when ACP is currently happening, (3) Oncology clinician-perceived barriers to ACP (e.g., patient discomfort, patient lack of knowledge, and lack of time), and (4) Patients felt that they are balancing fear and hope when navigating their AML or MDS diagnosis. The results of this study can be used to develop interventions to promote serious illness conversations for patients with AML and MDS and their caregivers to ensure that patient care aligns with patient values.

Identifiants

DOI: 10.1016/j.jgo.2022.09.003 PMID: 36100548 PMC: PMC9974785
pubmed: 36100548
pii: S1879-4068(22)00222-3
doi: 10.1016/j.jgo.2022.09.003
pmc: PMC9974785
mid: NIHMS1860479
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101374

Subventions

Organisme : NCI NIH HHS
ID : R00 CA237744
Pays : United States
Organisme : NIA NIH HHS
ID : R21 AG059206
Pays : United States
Organisme : NIA NIH HHS
ID : K02 AG062745
Pays : United States
Organisme : NIA NIH HHS
ID : K24 AG055693
Pays : United States
Organisme : NCI NIH HHS
ID : K99 CA237744
Pays : United States
Organisme : NIA NIH HHS
ID : R33 AG059206
Pays : United States

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Dr. Loh has served as a consultant to Pfizer and Seattle Genetics and has received honoraria from Pfizer.

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Auteurs

Marissa LoCastro (M)

School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA. Electronic address: Marissa_locastro@urmc.rochester.edu.

Chandrika Sanapala (C)

Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: Chandrika.sanapala@burrell.edu.

Jason H Mendler (JH)

Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: Jason_mendler@urmc.rochester.edu.

Sally Norton (S)

School of Nursing, University of Rochester, Rochester, NY, USA. Electronic address: Sally_norton@urmc.rochester.edu.

Rachelle Bernacki (R)

Department of Palliative Care, Harvard Medical School, Boston, MA, USA. Electronic address: RachelleE_Bernacki@DFCI.HARVARD.EDU.

Thomas Carroll (T)

Division of General Medicine and Palliative Care, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: Thomas_carroll@urmc.rochester.edu.

Heidi Klepin (H)

Department of Hematology/Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: hklepin@wakehealth.edu.

Erin Watson (E)

Princeton University, NJ, USA. Electronic address: eewatson@princeton.edu.

Jane Liesveld (J)

Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: Jane_liesveld@urmc.rochester.edu.

Eric Huselton (E)

Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: Eric_huselton@urmc.rochester.edu.

Kristen O'Dwyer (K)

Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: Kristen_odwyer@urmc.rochester.edu.

Andrea Baran (A)

Department of Biostatistics and Computational Biology, University of Rochester, New York, USA. Electronic address: Andrea_baran@urmc.rochester.edu.

Marie Flannery (M)

School of Nursing, University of Rochester, Rochester, NY, USA. Electronic address: Marie_flannery@urmc.rochester.edu.

Benzi M Kluger (BM)

Division of General Medicine and Palliative Care, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: Benzi_kluger@urmc.rochester.edu.

Kah Poh Loh (KP)

Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: Kahpoh_loh@urmc.rochester.edu.

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Classifications MeSH

Recherchemedicale.com › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Advance care planning in older patients with...
Recherchemedicale.com › Personnes › Tranches d'âge › Adulte › Sujet âgé › Advance care planning in older patients with...
Recherchemedicale.com › Hémopathies et maladies lymphatiques › Hémopathies › Maladies de la moelle osseuse › Syndromes myélodysplasiques › Advance care planning in older patients with...
Recherchemedicale.com › Tumeurs › Tumeurs par type histologique › Leucémies › Leucémie myéloïde › Leucémie aigüe myéloïde › Advance care planning in older patients with...
Recherchemedicale.com › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Advance care planning in older patients with...
Recherchemedicale.com › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Planification des soins du patient › Planification anticipée des soins › Advance care planning in older patients with...