An observational study to determine the prevalence of alcohol use disorders in advanced cancer patients

Context: observational studies in North America suggest alcohol dependence is a common problem in advanced cancer patients and is associated with a high burden of physical and psychological symptoms. The prevalence of all types of alcohol use disorders, and the relationship between alcohol use disorders and symptoms, has not been studied. Objectives: this observational, cross-sectional study was designed to determine the prevalence of alcohol use disorders in patients with advanced cancer and establish if such patients have a higher symptom burden. Methods: sequential patients referred to the palliative medicine team at a United Kingdom cancer centre completed the Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale (HADS) and Memorial Symptom Assessment Scale-Short Form (MSAS-SF). Results: 120 patients participated in the study. Twenty-two (18%) patients screened positively for the presence of an alcohol use disorder. This study found no significant association between alcohol use disorders and the presence of anxiety ( P = 0.38) or depression ( P = 0.81) on the HADS or the global distress index subscale ( P = 0.142), physical symptom distress index subscale ( P = 0.734), or the psychological distress index subscale ( P = 0.154) on the MSAS-SF. Current smoking status was the only independent predictor for the presence of an alcohol use disorder ( P < 0.001). Seven (6%) patients screened positively for high-risk alcohol use disorders. Current smoking status ( P < 0.001) and male gender ( p < 0.001) were independent predictors of this problem. Conclusions: alcohol use disorders in this cohort of patients were not associated with a higher symptom burden, and the prevalence was lower than the general United Kingdom population.

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Associations between pain and current smoking status among cancer patients

Pain ◽

10.1016/j.pain.2010.09.001 ◽

2011 ◽

Vol 152 (1) ◽

pp. 60-65 ◽

Cited By ~ 40

Author(s):

Joseph W. Ditre ◽

Brian D. Gonzalez ◽

Vani N. Simmons ◽

Leigh Anne Faul ◽

Thomas H. Brandon ◽

...

Keyword(s):

Cancer Patients ◽

Smoking Status ◽

Current Smoking Status ◽

Current Smoking

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Are anxiety and depressed mood related to physical symptom burden? A study in hospitalized advanced cancer patients

Palliative Medicine ◽

10.1177/0269216307079067 ◽

2007 ◽

Vol 21 (4) ◽

pp. 341-346 ◽

Cited By ~ 79

Author(s):

S.C.C.M. Teunissen ◽

A. de Graeff ◽

E.E. Voest ◽

J.C.J.M. de Haes

Keyword(s):

Cancer Patients ◽

Advanced Cancer ◽

Depressed Mood ◽

Symptom Burden ◽

Physical Symptom ◽

Advanced Cancer Patients

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Symptom burden and characteristics of patients who die in the acute palliative care unit of a tertiary cancer center.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.53 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 53-53

Author(s):

YuJung Kim ◽

Grace S. Ahn ◽

Hak Ro Kim ◽

Beodeul Kang ◽

Sung Soun Hur ◽

...

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Advanced Cancer ◽

Tertiary Care ◽

Symptom Burden ◽

Symptom Assessment ◽

Assessment System ◽

Cancer Center ◽

Advanced Cancer Patients ◽

Tertiary Cancer Center

53 Background: Acute Palliative Care Units (ACPUs) are novel inpatient programs in tertiary care centers that provide aggressive symptom management and assist transition to hospice. However, patients often die in the APCU before successfully transferring to hospice. The aim of this study was to evaluate the symptom burden and characteristics of advanced cancer patients who die in the APCU. Methods: We retrospectively reviewed the medical records of all advanced cancer patients admitted to the APCU between April, 2015 and March, 2016 at a tertiary cancer center in Korea. Basic characteristics and symptom burden assessed by the Edmonton Symptom Assessment System (ESAS) were obtained from consultation upon APCU admission. Statistical analyses were conducted to compare patients who died in the APCU with those who were discharged alive. Results: Of the 267 patients analyzed, 87 patients (33%) died in the APCU. The median age of patients was 66 (range, 23-97). Patients who died in the APCU had higher ESAS scores of drowsiness (6 vs 5, P = 0.002), dyspnea (4 vs 2, P = 0.001), anorexia (8 vs 6, P = 0.014) and insomnia (6 vs 4, P = 0.001) compared to patients who discharged alive. Total symptom distress scores (SDS) were also significantly higher (47 vs 40, P = 0.001). Patients who died in the APCU were more likely to be male (odds ratio [OR] for female patients 0.38, 95% confidence interval [CI] 0.22-0.67, P < 0.001) and have higher ESAS scores of drowsiness (OR 2.08, 95% CI, 1.08-3.99, P = 0.029) and dyspnea (OR 2.19, 95% CI 1.26-3.80, P = 0.005). These patients showed significantly shorter survival after APCU admission (7 days vs 31 days, P < 0.001). Conclusions: Advanced cancer patients who die in the APCU are more likely to be male and have significantly higher symptom burden that include drowsiness and dyspnea. These patients show rapid clinical deterioration after APCU admission. More proactive and timely end-of-life care is needed for these patients.

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Can we use Chinese revised version of Edmonton Symptom Assessment System to assess symptom burden of Chinese caregivers of advanced cancer patients? PACSSIVE-6

Annals of Oncology ◽

10.1093/annonc/mdx673.003 ◽

2017 ◽

Vol 28 ◽

pp. x144-x145 ◽

Cited By ~ 4

Author(s):

K.W. Woo ◽

H.C.T. Wang ◽

J.L.S. Au ◽

V.W.C. Cho ◽

C.Y. Poon ◽

...

Keyword(s):

Cancer Patients ◽

Advanced Cancer ◽

Symptom Burden ◽

Symptom Assessment ◽

Assessment System ◽

Advanced Cancer Patients ◽

Edmonton Symptom Assessment System ◽

Chinese Caregivers

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Hypermetabolism and symptom burden in advanced cancer patients evaluated in a cachexia clinic

Journal of Cachexia Sarcopenia and Muscle ◽

10.1002/jcsm.12014 ◽

2015 ◽

Vol 6 (1) ◽

pp. 95-98 ◽

Cited By ~ 26

Author(s):

Rony Dev ◽

David Hui ◽

Gary Chisholm ◽

Marvin Delgado-Guay ◽

Shalini Dalal ◽

...

Keyword(s):

Cancer Patients ◽

Advanced Cancer ◽

Symptom Burden ◽

Advanced Cancer Patients

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Symptom Prevalence and Place of Death Preference in Advanced Cancer Patients: Factors Associated With the Achievement of Home Death

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211048767 ◽

2021 ◽

pp. 104990912110487

Author(s):

Julia Fee Voon Ho ◽

Nur Syafiqah Marzuki ◽

Nur Syuhadah Monica Meseng ◽

Viknaswary Kaneisan ◽

Yin Khek Lum ◽

...

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Advanced Cancer ◽

Symptom Burden ◽

Place Of Death ◽

Hospital Death ◽

Advanced Cancer Patients ◽

Home Death ◽

Factors Associated ◽

Symptom Prevalence

Objectives: Achievement of patients’ preferred place of death is recognized as a component of a good death. This study aimed to investigate the symptom burden in advanced cancer patients, achievement of their place of death preferences and factors associated with home death. Methods: In this retrospective review of 287 patient deaths, we examined patients’ symptom prevalence, preferred and actual place of death and achievement of their place of death preferences using descriptive statistics. Associations between patient factors, home death preference and actual home death were further analyzed using multivariate logistic regression. Results: The most prevalent symptoms were weakness, pain and poor appetite, with a mean of 5.77(SD: 2.37) symptoms per patient. The median interval from palliative care referral to death was 21 (IQR: 74) days. Of the 253 patients with documented place of death preference, 132 (52.1%) preferred home death, 111(43.9%) preferred hospital death, 1 (0.4%) preferred to die at a temple and 9(3.6%) expressed no preference. Overall, 221 of 241(91.7%) patients with known actual place of death achieved their preference. Older patients were more likely to prefer home death (OR 1.021; 95% CI 1.004-1.039, p = 0.018) and die at home (OR 1.023; 95% CI 1.005-1.041, p = 0.014). Gender, marital status, cancer diagnosis and symptoms were not associated with preference for or actual home death. Conclusion: Despite a high symptom burden, most patients preferred and achieved a home death. Late palliative care referral and difficult symptom management contributed to failure to fulfill home death preference. Preference for home death should be considered when managing terminally ill geriatric patients.

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Determinants of cigarette smoking status in a national cohort of black and white adult ever smokers in the USA: a cross-sectional analysis of the REGARDS study

BMJ Open ◽

10.1136/bmjopen-2018-027175 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027175 ◽

Cited By ~ 2

Author(s):

Trisha M Parekh ◽

Chengyi Wu ◽

Leslie A McClure ◽

Virginia J Howard ◽

Mary Cushman ◽

...

Keyword(s):

Alcohol Use ◽

Racial Differences ◽

Smoking Status ◽

Cross Sectional ◽

Current Smoking Status ◽

Current Smoking ◽

Factors Associated ◽

Cross Sectional Analysis ◽

Regards Study ◽

Sectional Analysis

ObjectivesWhile awareness of cigarette smoking’s harmful effects has increased, determinants associated with smoking status remain understudied, including potential racial differences. We aim to examine factors associated with former versus current smoking status and assess whether these associations differed by race.SettingWe performed a cross-sectional analysis using the population-based Reasons for Geographic and Racial Differences in Stroke(REGARDS)study.Outcome measuresLogistic regression was used to calculate the OR of former smoking status compared with current smoking status with risk factors of interest. Race interactions were tested using multiplicative interaction terms.Results16 463 participants reported smoking at least 100 cigarettes in their lifetime. Seventy-three per cent (n=12 067) self-reported former-smoker status. Physical activity (reference (REF) <3×/week; >3×/week: OR=1.26, 95% CI 1.11 to 1.43), adherence to Mediterranean diet (REF: low; medium: OR=1.46, 95% CI 1.27 to 1.67; high: OR=2.20, 95% CI 1.84 to 2.64), daily television viewing time (REF: >4 hours; <1 hour: OR=1.32, 95% CI 1.10 to 1.60) and abstinence from alcohol use (REF: heavy; none: OR=1.50, 95% CI 1.18 to 1.91) were associated with former-smoker status. Male sex, higher education and income $35 000–$74 000 (REF: <$20 000) were also associated with former-smoker status. Factors associated with lower odds of reporting former-smoker status were younger age (REF: ≥65 years; 45–64 years: OR=0.34, 95% CI 0.29 to 0.39), black race (OR=0.62, 95% CI 0.53 to 0.72) and single marital status (REF: married status; OR=0.66, 95% CI 0.51 to 0.87), being divorced (OR=0.60, 95% CI 0.50 to 0.72) or widowed (OR=0.70, 95% CI 0.57 to 0.85). Significant interactions were observed between race and alcohol use and dyslipidaemia, such that black participants had higher odds of reporting former-smoker status if they were abstinent from alcohol (OR=2.32, 95% CI 1.47 to 3.68) or had a history of dyslipidaemia (OR=1.31, 95% CI 1.06 to 1.62), whereas these relationships were not statistically significant in white participants.ConclusionEfforts to promote tobacco cessation should consist of targeted behavioural interventions that incorporate racial differences.

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