Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Are there any associations between ethnicity, burdensome end-of-life care and advance care planning among people with cancer?  (125810)

Ashfaq Chauhan 1 , Ramya Walsan 1 , Davinia Seah 2 , Ursula M Sansom-Daly 3 , Reema Harrison 1
  1. Australian Institute of Health Innovation, Macquarie University, Macquarie University, NSW, Australia
  2. Sacred Heart Supportive and Palliative Care Service, St Vincent's Sydney , Sydney , New South Wales, Australia
  3. Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital , Randwick, New South Wales, Australia

Objective/purpose:

International evidence suggests that people from culturally and linguistically diverse (CALD) backgrounds have lower uptake of advance care planning (ACP) and are more likely to experience potentially burdensome care at the end-of-life, but there is lack of such evidence in the Australian cancer care context. This study aimed to determine the prevalence of ACP documentation and potentially burdensome end-of-life care experienced by patients with cancer from CALD backgrounds with those from non-CALD backgrounds.

Sample/setting: 

A retrospective medical record review was conducted at two cancer service, one providing care to adults (≥18 years) and another to children (<18 years of age). 

Procedure:

A list of patients diagnosed with poor-prognosis cancers between 2017-2020 was generated. Stratified randomisation was used to include eligible medical records of patients from CALD and non-CALD backgrounds. A data extraction tool was used to collect data on socio-demographic characteristics, presence and type of ACP documentation, and presence of any indicator of burdensome care at the end-of-life documented in the medical records.

Results:

To date, 108 patient records have been reviewed at one cancer service providing care to adults; 57/108 (54%) belonged to patient born outside of Australia. Eighty-three (79%) records documented the occurrence of ACP communication. Formal ACP communication was more commonly documented than informal ACP communication. Initial analysis suggests informal ACP communication occurred less among patients that required interpreters. Eighty-one (75%) of medical records documented death,16 of these records documented death in hospital (indicator of burdensome care at the end-of-life) of which 12 (75%) belonged to people born outside of Australia. Data extraction is underway at the cancer service providing care to children.

Conclusion/clinical implications

Preparing cancer clinicians and interpreters in ACP communication and timely referral to palliative care may result in person-centric end-of-life care for people from CALD backgrounds affected by cancer.