Publications by authors named "Corey M Schwartz"
Importance: Little is known about the nature of change in goals of care (GOC) over time among adolescents and younger adult (AYA) patients aged 12 to 39 years with cancer near the end of life. Understanding how GOC evolve may guide clinicians in supporting AYA patients in making end-of-life decisions.
Objective: To assess frequency, timing, and evolution of documented GOC among AYA patients with cancer in the last 90 days of life.
Article Synopsis
- A study investigated how adolescents and young adults with cancer received different types of cancer treatments, such as chemotherapy, targeted therapy, and immunotherapy, in their last 90 days of life between 2009 and 2019.
- Out of 1,836 patients, 35% received chemotherapy, while 24% got targeted therapy, 7% immunotherapy, and 5% investigational drugs, showing a trend toward increased use of these therapies over time.
- Over 50% of the patients received at least one form of systemic cancer-directed therapy in their last three months, highlighting the need to align treatment decisions with the patients' preferences during advanced illness.
Background: Adolescents and young adults (AYAs) with advanced cancer identify maintaining a good quality of life (QoL) as a central goal of end-of-life care. QoL is a dynamic and subjective overarching concept that refers to an individual's relative satisfaction with their own life. Despite its importance to AYAs with advanced cancer, a patient-centered definition of QoL is lacking in this population.
View Article and Find Full Text PDFAdolescents, young adults with cancer receive limited psychosocial and spiritual support near death.
View Article and Find Full Text PDFPurpose: Adolescents and young adults (AYAs) with cancer receive high rates of medically intensive measures at the end of life. This study aimed to characterize the prevalence and timing of conversations about goals of care and advance care planning among AYAs at the end of life as one potential influence on care received.
Methods: This was a review of electronic health data and medical records for 1,929 AYAs age 12-39 years who died after receiving care at one of three sites between 2003 and 2019, including documented conversations about goals of care and advance care planning, and care received.
Importance: The patient-clinician therapeutic alliance is an important aspect of high-quality cancer care. However, components of the therapeutic alliance in adolescents and young adults (AYAs, aged 12-39 years) with cancer have not been defined.
Objective: To identify components of and barriers to the therapeutic alliance between AYAs, caregivers, and clinicians from the perspective of all key stakeholders.
Context: Quality measures have been devised for end-of-life care of older adults with cancer, but are lacking for adolescents and young adults (AYAs).
Objective: We previously conducted interviews with AYAs, family caregivers, and clinicians to identify priority domains for high quality care of AYAs with advanced cancer. The goal of this study was to use a modified Delphi process to form consensus around the highest priority quality indicators.
Background: Adolescents and young adults (AYAs) with advanced cancer identify normalcy as an important component of quality end-of-life care. We sought to define domains of normalcy and identify ways in which clinicians facilitate or hinder normalcy during advanced cancer care.
Procedure: This was a secondary analysis of a qualitative study that aimed to identify priority domains for end-of-life care.
Purpose: Adolescents and young adults (AYAs) with cancer have high rates of hospital deaths. It is not clear if this reflects their preferences or barriers to dying at home.
Methods: Between December 2018 and January 2021, we conducted in-depth interviews with AYAs (age 12-39 years) with stage IV or recurrent cancer, family caregivers including bereaved caregivers, and clinicians of AYAs with cancer.
Importance: End-of-life care quality indicators specific to adolescents and young adults (AYAs) aged 12 to 39 years with cancer have not been developed.
Objective: To identify priority domains for end-of-life care from the perspectives of AYAs, family caregivers, and clinicians, and to propose candidate quality indicators reflecting priorities.
Design, Setting, And Participants: This qualitative study was conducted from December 6, 2018, to January 5, 2021, with no additional follow-up.