Quality of dying and death in patients with interstitial lung disease compared with lung cancer: an observational study.

Abstract

BACKGROUND:

There is limited knowledge regarding the quality of dying and death (QODD) and end-of-life interventions in patients with interstitial lung disease (ILD). Hence, differences in QODD and end-of-life interventions between patients with ILD and those with lung cancer (LC) remain poorly understood.

METHODS:

The primary aim of this study was to explore the differences in QODD and end-of-life interventions among patients dying with ILD versus those dying with LC. We performed a mail survey to quantify the QODD of a bereaved family's perspective using the Good Death Inventory (GDI) score. Moreover, we examined the end-of-life interventions by medical chart review.

RESULTS:

Of 361 consecutive patients analysed for end-of-life interventions, 167 patients whose bereaved families completed questionnaires were analysed for QODD. Patients with ILD had lower GDI scores for QODD than those with LC (p=0.04), particularly in domains related to 'physical and psychological distress relief' and 'prognosis awareness and participation in decision making' (p=0.02, respectively). In end-of-life interventions, patients with ILD were less likely to receive specialised palliative care services (8.5% vs 54.3%; p<0.001) and opioids (58.2% vs 73.4%; p=0.003). Additionally, lower frequencies of participation of patients with ILD in end-of-life discussion were also observed (40.8% vs 62.4%; p=0.007).

CONCLUSION:

Patients with ILD had lower QODD and poorer access to palliative care and decision making than those with LC. Additional efforts to improve QODD in patients with ILD, particularly in symptom relief and decision-making processes, are urgently warranted.

• Authors: Takafumi Koyauchi, Yuzo Suzuki, Kazuki Sato, Hironao Hozumi, Masato Karayama, Kazuki Furuhashi, Tomoyuki Fujisawa, Noriyuki Enomoto, Yutaro Nakamura, Naoki Inui, Koshi Yokomura, Shiro Imokawa, Hidenori Nakamura, Tatsuya Morita, Takafumi Suda
• Journal: Thorax (Thorax) Vol. 76 Issue 3 Pg. 248-255 (03 2021) ISSN: 1468-3296 [Electronic] England
• PMID: 33298580 (Publication Type: Journal Article, Multicenter Study, Observational Study)
• Copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• Aged
• Family (psychology)
• Female
• Humans
• Japan (epidemiology)
• Lung Diseases, Interstitial (mortality, psychology)
• Lung Neoplasms (mortality, psychology)
• Male
• Quality of Life
• Surveys and Questionnaires
• Survival Rate (trends)
• Terminal Care