The incurable cancer patient at the end of life : Medical care utilization, quality of life and the additive analgesic effect of paracetamol in concurrent morphine therapy

Abstract: Only 12% of the patients died at home. When the period between diagnosis and death was less than one month, every patient died in an institution. Younger patients, marriedpatients, and those living within the 40 km radius of the hospital utilized more hospital days. The "length of terminal hospitalisation" and the "proportion of days at home/ total inclusion days" seemed to be feasible outcome varibles when evaluating a palliative support service. The hospital-based palliative support service in this study defrayed its own costs due to a median saving of 10 hospital days/patient, compared with matched historical controls.A 19-item quality of life questionnaire (AQEL) was developed which evidenced good signs of reliability and validity. The item most closely correlated to global quality of life was the sense of meaningfulness. This was true for both patients and their spouses. Patients´ levels of pain and anxiety did not increase at the end of life. In this study we could not find convincing evidence for an additive analgesic effect of paracetamol in morphine therapy of pain in cancer patients.