Resource use in the last year of life of prostate cancer patients - A register-based analysis

BACKGROUND: Given the paucity of literature on the end of life (EOL) of prostate-cancer (PC) patients, we investigated medication prescription pattern and hospitalization during their final year of life. METHODS: The data base of the Österreichische Gesundheitskasse Vienna (ÖGK-W) was used to identify all men who died with the diagnosis PCa between 1.1.2015 and 31.12.2021 and who were under androgen deprivation therapy and/or new hormonal therapy. Patient age, prescription patterns and hospitalizations during the last year of life were recorded, odds ratios for age groups were analyzed. RESULTS: A total of 1 109 patients were included. ADT was given in 86.7% (n=962) and NHT in 62.8% (n=696). Overall, prescription of analgesics increased from 41% (n=455) during the first to 65.1% (n=722) in the last quarter of the final year of life. Prescription of NSAIDs was almost consistent (18-20%) whereas the number of patients receiving other non-opioids (paracetamol, metamizole) more than doubled (18% to 39%). Older men had lower prescription rates for NSAID (OR: 0.47, 95% CI: 0.35-0.64), non-opioids (OR: 0.43, 95% CI: 0.32-0.57), opioids (OR: 0.45, 95% CI: 0.34-0.6) and adjuvant analgesics (OR: 0.42, 95% CI: 0.28-0.65). Approximately 2/3 of patients (n=733) died in the hospital with a median of four hospitalizations. The length of admission was less than 50d in 61.9%, 51-100d in 30.6% and >100d in 7.6%. Younger patients (<70yrs) were more likely to die in the hospital (OR: 1.66, 95% CI: 1.15-2.39), had a higher median rate of hospitalizations (n=6) and longer duration of admissions. CONCLUSIONS: Resource use increases during the last year life of PCa patients with highest rates in younger men. Hospitalization rates were high and 2/3 died in the hospital, both showing clear age dependency with higher rates, duration and death in the hospital for younger men.