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End of life breast cancer care in women with severe mental illnesses
Little is known on the end-of-life (EOL) care of terminal breast cancer in women with severe psychiatric disorder (SPD). The objective was to determine if women with SPD and terminal breast cancer received the same palliative and high-intensity care during their end-of-life than women without SPD. S...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119688/ https://www.ncbi.nlm.nih.gov/pubmed/33986419 http://dx.doi.org/10.1038/s41598-021-89726-y |
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author | Fond, Guillaume Pauly, Vanessa Duba, Audrey Salas, Sebastien Viprey, Marie Baumstarck, Karine Orleans, Veronica Llorca, Pierre-Michel Lancon, Christophe Auquier, Pascal Boyer, Laurent |
author_facet | Fond, Guillaume Pauly, Vanessa Duba, Audrey Salas, Sebastien Viprey, Marie Baumstarck, Karine Orleans, Veronica Llorca, Pierre-Michel Lancon, Christophe Auquier, Pascal Boyer, Laurent |
author_sort | Fond, Guillaume |
collection | PubMed |
description | Little is known on the end-of-life (EOL) care of terminal breast cancer in women with severe psychiatric disorder (SPD). The objective was to determine if women with SPD and terminal breast cancer received the same palliative and high-intensity care during their end-of-life than women without SPD. Study design, setting, participants. This population-based cohort study included all women aged 15 and older who died from breast cancer in hospitals in France (2014–2018). Key measurements/outcomes. Indicators of palliative care and high-intensity EOL care. Multivariable models were performed, adjusted for age at death, year of death, social deprivation, duration between cancer diagnosis and death, metastases, comorbidity, smoking addiction and hospital category. The analysis included 1742 women with SPD (287 with bipolar disorder, 1075 with major depression and 380 with schizophrenia) and 36,870 women without SPD. In multivariate analyses, women with SPD had more palliative care (adjusted odd ratio aOR 1.320, 95%CI [1.153–1.511], p < 0.001), longer palliative care follow-up before death (adjusted beta = 1.456, 95%CI (1.357–1.555), p < 0.001), less chemotherapy, surgery, imaging/endoscopy, and admission in emergency department and intensive care unit. Among women with SPD, women with bipolar disorders and schizophrenia died 5 years younger than those with recurrent major depression. The survival time was also shortened in women with schizophrenia. Despite more palliative care and less high-intensity care in women with SPD, our findings also suggest the existence of health disparities in women with bipolar disorders and schizophrenia compared to women with recurrent major depression and without SPD. Targeted interventions may be needed for women with bipolar disorders and schizophrenia to prevent these health disparities. |
format | Online Article Text |
id | pubmed-8119688 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-81196882021-05-17 End of life breast cancer care in women with severe mental illnesses Fond, Guillaume Pauly, Vanessa Duba, Audrey Salas, Sebastien Viprey, Marie Baumstarck, Karine Orleans, Veronica Llorca, Pierre-Michel Lancon, Christophe Auquier, Pascal Boyer, Laurent Sci Rep Article Little is known on the end-of-life (EOL) care of terminal breast cancer in women with severe psychiatric disorder (SPD). The objective was to determine if women with SPD and terminal breast cancer received the same palliative and high-intensity care during their end-of-life than women without SPD. Study design, setting, participants. This population-based cohort study included all women aged 15 and older who died from breast cancer in hospitals in France (2014–2018). Key measurements/outcomes. Indicators of palliative care and high-intensity EOL care. Multivariable models were performed, adjusted for age at death, year of death, social deprivation, duration between cancer diagnosis and death, metastases, comorbidity, smoking addiction and hospital category. The analysis included 1742 women with SPD (287 with bipolar disorder, 1075 with major depression and 380 with schizophrenia) and 36,870 women without SPD. In multivariate analyses, women with SPD had more palliative care (adjusted odd ratio aOR 1.320, 95%CI [1.153–1.511], p < 0.001), longer palliative care follow-up before death (adjusted beta = 1.456, 95%CI (1.357–1.555), p < 0.001), less chemotherapy, surgery, imaging/endoscopy, and admission in emergency department and intensive care unit. Among women with SPD, women with bipolar disorders and schizophrenia died 5 years younger than those with recurrent major depression. The survival time was also shortened in women with schizophrenia. Despite more palliative care and less high-intensity care in women with SPD, our findings also suggest the existence of health disparities in women with bipolar disorders and schizophrenia compared to women with recurrent major depression and without SPD. Targeted interventions may be needed for women with bipolar disorders and schizophrenia to prevent these health disparities. Nature Publishing Group UK 2021-05-13 /pmc/articles/PMC8119688/ /pubmed/33986419 http://dx.doi.org/10.1038/s41598-021-89726-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Fond, Guillaume Pauly, Vanessa Duba, Audrey Salas, Sebastien Viprey, Marie Baumstarck, Karine Orleans, Veronica Llorca, Pierre-Michel Lancon, Christophe Auquier, Pascal Boyer, Laurent End of life breast cancer care in women with severe mental illnesses |
title | End of life breast cancer care in women with severe mental illnesses |
title_full | End of life breast cancer care in women with severe mental illnesses |
title_fullStr | End of life breast cancer care in women with severe mental illnesses |
title_full_unstemmed | End of life breast cancer care in women with severe mental illnesses |
title_short | End of life breast cancer care in women with severe mental illnesses |
title_sort | end of life breast cancer care in women with severe mental illnesses |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119688/ https://www.ncbi.nlm.nih.gov/pubmed/33986419 http://dx.doi.org/10.1038/s41598-021-89726-y |
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