O9.08 * END OF LIFE CARE IN HIGH-GRADE GLIOMA PATIENTS IN THREE EUROPEAN COUNTRIES: A COMPARATIVE STUDY

Abstract

OBJECTIVES: Exploring cross-national differences is useful to evaluate whether different patterns of end of life (EOL) care meet patient's specific needs. This study compared the EOL care processes for high-grade glioma (HGG) in three European countries: The Netherlands, Austria and Scotland. Aspects of EOL care associated with good quality of care (QOC) were identified. METHODS: We analyzed 207 questionnaires from relatives of deceased HGG patients, using a similar retrospective study design in three countries, and examined the subthemes: 1) organization of EOL care, such as residence of care, transitions and place of death; 2) treatment preferences; 3) experiences with EOL care; 4) perceived QOC. A multivariate logistic regression was performed to identify independent predictors of good QOC (≥6 on a 7-point Likert scale). RESULTS: Three months before death 75% of patients were at home. In all three countries, on average, 50% was transferred to a hospital at least once and received effective symptom treatment during the last 3mo. In The Netherlands, Austria and Scotland, respectively, home (60%), a hospital (41%) or a hospice (41%) were the most common places where patients died (p < 0.001). Advance directives were present in 46% of the Dutch, 36% of Scottish and 6% of Austrian patients (p < 0.001). Fifty-three percent of patients experienced good QOC, irrespective of country. Dying at the preferred place, satisfaction with information provided and effective symptom treatment were independently associated with good QOC. CONCLUSION: There are remarkable cross-national differences in organization and experiences with EOL care for HGG, although patient's perceived QOC is similar in the three countries. As symptom treatment was considered effective in only half of all HGG patients, and independently predicted good QOC, this particularly needs further improvement in all countries.