Aims
The aim of this study was to assess the feasibility of collecting data and analysing clinician-patient discussion regarding cessation of systemic anti-cancer therapy using medical records. The primary objective was to assess the rate of documentation of the discussion in our cohort.
Methods
We reviewed all referrals for advanced lung cancer to our institution during a specified two year period. We excluded patients who did not receive systemic therapy, and patients who were alive at the time of data collection.
We undertook manual review of medical records and populated a research database. We sought explicit documentation recording a discussion between clinician and patient regarding the intention to cease further systemic anti-cancer therapy. We recorded the date, setting (inpatient vs outpatient) of this discussion and rationale for decision.
Results
197 patients were referred to our unit with advanced lung cancer during the specified period. Of these patients, 68 were able to be included for analysis.
Explicit documentation of a clinician patient discussion on cessation of systemic therapy was identified in 43/68 patients (63.2%). No documentation was identified in 25/68 patients (36.8%).
In 15/43 patients (34.9%) where a discussion was documented, this occurred during an inpatient admission. 7/15 patients (46.7%) died during that admission and 8/15 (53.3%) died within 30 days of the discussion. In those where the discussion occurred as an outpatient, 3/28 (10.8%) died within 30 days of the discussion.
Conclusions
In this study we demonstrate it is feasible to retrospectively review medical records to assess documentation of a clinician patient discussion regarding cessation of systemic anti-cancer therapy. In our cohort, documentation of this discussion was identified in approximately two-thirds of patients. Our data is the first attempt to assess the occurrence and documentation of this common aspect of clinical cancer care.