The Effect of Palliative Care on the Life Sustaining Treatment in End-of-Life Care of Cancer Patients

Abstract

BACKGROUND: In the terminal stage of cancer, patients frequently experience severe symptoms that require palliative care to manage distressing conditions effectively. However, evidence on the effects of palliative care on the utilization of life-sustaining treatments among hospitalized cancer patients at the end of life in Thailand remains limited.

OBJECTIVES:  To compare life-sustaining treatment utilization and associated charges between patients receiving palliative care versus usual care and to examine the association between advance care planning and end-of-life life-sustaining treatment decisions.

METHODS: This retrospective study included 181 cancer patients aged 18 years and older who died at Queen Savang Vadhana Memorial Hospital between January 1, 2023, and January 1, 2025. The patients were divided into two groups: 87 cases received palliative care, and 94 cases received standard care. Data were analyzed using descriptive and inferential statistics.

RESULTS: The patients in the palliative care group demonstrated significantly reduced utilization of life-sustaining treatments and lower associated charges (p=0.006 and p=0.033, respectively). Advance care planning was significantly associated with avoidance of mechanical ventilation and cardiopulmonary resuscitation (CPR) (p<0.001 for both interventions); however, no significant association was observed with central venous catheter insertion (p=0.062). Additionally, the collaborative palliative care group had a significantly lower rate of hospital readmissions within the three months before death (p<0.001).

CONCLUSIONS: Palliative care reduces mechanical ventilation and CPR use, thereby decreasing end-of-life healthcare charges. Furthermore, advance care planning promotes alignment of treatment with patient preferences and values.

Thaiclinicaltrials.org number, TCTR20250914003