Prevalence of Preferences for End-of-Life Place of Care and Death Among Patients With Cancer in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Authors

Andrew Donkor, Kwame Nkrumah University of Science & Technology
Prince Nyansah Adotey, Kwame Nkrumah University of Science & Technology
Esther Oparebea Ofori, Kwame Nkrumah University of Science & Technology
Jennifer Akyen Ayitey, Kwame Nkrumah University of Science & Technology
Caleb Ferguson, Faculty of Science, Medicine and Health
Tim Luckett, University of Technology Sydney
Verna Vanderpuye, Korle Bu Teaching Hospital
Ernest Baawuah Osei-Bonsu, Komfo Anokye Teaching Hospital
Caroline Phelan, Flinders University
Katherine Hunt, University of Southampton

Publication Name

JCO global oncology

Abstract

PURPOSE: There is limited information on preferences for place of care and death among patients with cancer in low- and middle-income countries (LMICs). The aim was to report the prevalence and determinants of preferences for end-of-life place of care and death among patients with cancer in LMICs and identify concordance between the preferred and actual place of death. METHODS: Systematic review and meta-analysis guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted. Four electronic databases were searched to identify studies of any design that reported on the preferred and actual place of care and death of patients with cancer in LMICs. A random-effects meta-analysis estimated pooled prevalences, with 95% CI, with subgroup analyses for region and risk of bias. RESULTS: Thirteen studies were included. Of 3,837 patients with cancer, 62% (95% CI, 49 to 75) preferred to die at home; however, the prevalence of actual home death was 37% (95% CI, 13 to 60). Subgroup analyses found that preferences for home as place of death varied from 55% (95% CI, 41 to 69) for Asia to 64% (95% CI, 57 to 71) for South America and 72% (95% CI, 48 to 97) for Africa. The concordance between the preferred and actual place of death was 48% (95% CI, 41 to 55) for South Africa and 92% (95% CI, 88 to 95) for Malaysia. Factors associated with an increased likelihood of preferred home death included performance status and patients with breast cancer. CONCLUSION: There is very little literature from LMICs on the preferences for end-of-life place of care and death among patients with cancer. Rigorous research is needed to help understand how preferences of patients with cancer change during their journey through cancer.

Open Access Status

This publication is not available as open access

Volume

10

First Page

e2400014