Home-based end of life care may prolong survival
A new study has backed home-based end of life care, finding that cancer patients who chose to die at home tended to live longer than those in hospitals.
Dr Jun Hamano and his colleagues at the University of Tsukuba in Japan studied 2069 palliative care patients – 1582 in hospital and 487 at home.
The investigators found that in the final weeks and days of life, home-based patients survived for as much as a week longer than those in hospitals, even after adjusting for demographic and clinical characteristics.
“The survival of patients who died at home was significantly longer than the survival of patients who died in a hospital in the days’ prognosis group (estimated median survival time, 13 days [95% confidence interval (CI), 10.3-15.7 days] vs 9 days [95% CI, 8.0-10.0 days]; P = .006) and in the weeks’ prognosis group (36 days [95% CI, 29.9-42.1 days] vs 29 days [95% CI, 26.5-31.5 days]; P = .007) as defined by Prognosis in Palliative Care Study predictor model A,” the researchers wrote.
The findings suggest oncologists should not hesitate to recommend home-based care simply because less medical treatment may be provided.
“The cancer patient and family tend to be concerned that the quality of medical treatment provided at home will be inferior to that given in a hospital and that survival might be shortened,” Dr Hamano said.
“However, our finding – that home death does not actually have a negative influence on the survival of cancer patients at all, and rather may have a positive influence – could suggest that the patient and family can choose the place of death in terms of their preference and values.
“Patients, families and clinicians should be reassured that good home hospice care does not shorten patient life, and may even achieve longer survival.”
The study was published online in CANCER, a peer-reviewed journal of the American Cancer Society.