e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Voluntary Assisted Dying (VAD) in Victoria - a case series of patient characteristics 2019-2021 (#375)

Cameron McLaren 1 , Ross Jennens 2 , Suzanne Kosmider 3 , Peter Lange 4 , Theresa Hayes 5 , Nick Carr 6 , Deborah Harley 7 , Ingra Bringmann 8 , Chris Grossman 9 , Eli Ristevski 10 , Eva Segelov 1
  1. School of Clinical Sciences, Monash University, Clayton, VIC, 3806
  2. Epworth Healthcare, Richmond, VIC, Australia
  3. Medical Oncology, Western Health, St Albans, VIC, Australia
  4. Medicine and Aged Care, The University of Melbourne, The Royal Melbourne Hospital, Parkville, VIC, 3050
  5. South West Oncology - South West Regional Cancer Centre, Warrnambool, VIC, 3280
  6. St Kilda Medical Group, St Kilda, VIC, Australia
  7. Medical One, Waurn Ponds, VIC, Australia
  8. General Surgery, Western Health, St Albans, VIC, Australia
  9. Palliative Care, Holmesglen Private Hospital, Moorabbin, VIC, Australia
  10. Monash Rural Health, Monash University, Warragul, VIC, Australia

Aims:

Understanding the characteristics of participants in the Victorian Voluntary Assisted Dying (VAD) scheme will inform policy, procedures, education and refinement of the service.

 

Methods:

Deidentified consultation records were submitted by members of the VAD Community of Practice (CoP), an online forum group representing 25% of doctors who have been involved in one or more case. Demographics were compared to the VAD Review Board (VADRB) report July-December 2020(1) where available. Postcode data was converted to Modified Monash Model (MMM) 2019 category(2) to preserve anonymity. Descriptive statistical analysis was undertaken.

 

Results:

344 cases were submitted by 10 CoP members between July 2019 and June 2021. 254 patients underwent first assessment during the period of the VADRB report that included 562 patients (comprising 45% of the VADRB case data). Demographic characteristics compared to the VADRB cohort were similar for age, sex, country of birth, language spoken at home, living situation, and Indigenous status.

Demographic data not reported by the VADRB report included:

  • Partnered relationship (63%)
  • Accessed palliative care (86%)
  • Mean duration of palliative care access: 6 months (median 3 months, range 1-60 months)
  • Most common diagnosis: solid organ malignancy (n = 298):
    • Gastrointestinal (125)
    • Thoracic (61)
    • Genitourinary (39)

Geographic distribution of patients according to MMM category compared to Victorian population distribution(3) was:

  • Metropolitan areas: 68% (76%)
  • Regional centres: 3% (7%)
  • Large rural towns: 9% (5%)
  • Small rural towns and remote communities: 20% (12%)

Conclusion:

This case series represents approximately half of all Victorian VAD cases reported to-date. Demographic parameters were similar to the VADRB cohort. Most patients had accessed palliative care services for a clinically meaningful period of time. Presuming even distribution of cancer across MMM areas, there was greater representation of patients from rural and remote communities.

  1. State of Victoria, Safer Care Victoria. Report of Operations: July-December 2020. 2021;(December). Available from: https://www.bettersafercare.vic.gov.au/vad
  2. Health Workforce Locator | Australian Government Department of Health [Internet]. [cited 2021 Aug 11]. Available from: https://www.health.gov.au/resources/apps-and-tools/health-workforce-locator/health-workforce-locator
  3. Demography | NRHA - National Rural Health Alliance [Internet]. [cited 2021 Aug 10]. Available from: https://www.ruralhealth.org.au/book/demography