Abstract | BACKGROUND: The objective of this study was to identify targets for interventions to reduce end-of-life care disparities among patients with advanced cancer. To do this, the authors evaluated the degree to which end-of-life care values and preferences are associated with advance care planning within racial/ethnic minority groups. METHODS: The Coping with Cancer study recruited patients with advanced cancer from outpatient clinics in 5 states from 2002 to 2008. Then, the rates of 1 type of advance care planning-do-not-resuscitate ( DNR) orders-reported at baseline interviews by 606 patients were investigated. Bivariate tests determined associations among DNR order completion, religious values, and treatment preferences within racial/ethnic groups. RESULTS: Non-Latino white patients were significantly more likely to have a DNR order (45%) than black (25%) and Latino (20%) patients (P<.001). A preference against specific life-prolonging treatment (eg, chemotherapy, ventilation) was the only factor significantly associated with higher DNR order likelihood in each group, with non-Latino white patients more likely than Latino or black patients to express preferences against life-prolonging care (eg, 26% of non-Latino white patients, 46% of black patients, and 41% of Latino patients wanted a feeding tube if it would extend life for 1 more day; P<.001). CONCLUSIONS: Preferences against life-prolonging care differ dramatically by race/ethnicity, but they have a uniform significant association with DNR order completion rates across racial/ethnic groups of patients with advanced cancer. Advance care planning interventions that target preferences associated with DNR orders across racial/ethnic groups may reach a broad patient population and reduce end-of-life care disparities.
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Authors | Melissa M Garrido, Shannon T Harrington, Holly G Prigerson |
Journal | Cancer
(Cancer)
Vol. 120
Issue 24
Pg. 3981-6
(Dec 15 2014)
ISSN: 1097-0142 [Electronic] United States |
PMID | 25145489
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S.)
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Copyright | © 2014 American Cancer Society. |
Topics |
- Adult
- Advance Care Planning
(statistics & numerical data)
- Aged
- Attitude to Death
- Ethnicity
(statistics & numerical data)
- Female
- Healthcare Disparities
(ethnology, statistics & numerical data)
- Humans
- Male
- Middle Aged
- Neoplasms
(epidemiology, psychology, therapy)
- Patient Preference
(ethnology)
- Racial Groups
(statistics & numerical data)
- Terminal Care
(statistics & numerical data)
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