PT - JOURNAL ARTICLE AU - Maria Vittoria Chiaruttini AU - Oscar Corli AU - Massimo Pizzuto AU - Alessandro Nobili AU - Gianpaolo Fortini AU - Ida Fortino AU - Olivia Leoni AU - Cristina Bosetti TI - Palliative medicine favourably influences end-of-life cancer care intensity: a large retrospective database study AID - 10.1136/spcare-2022-004050 DP - 2022 Dec 15 TA - BMJ Supportive & Palliative Care PG - spcare-2022-004050 4099 - http://spcare.bmj.com/content/early/2022/12/14/spcare-2022-004050.short 4100 - http://spcare.bmj.com/content/early/2022/12/14/spcare-2022-004050.full AB - Objectives Hospice and home palliative care have been associated to a reduction of aggressive treatments in the end-of-life, but data in the Italian context are scanty. Therefore, we aim to investigate the role of palliative care on indicators of end-of-life intensity of care among patients with cancer in Lombardy, the largest Italian region.Methods Within a retrospective study using the healthcare utilisation databases of Lombardy, Italy, we selected all residents who died in 2019 with a diagnosis of cancer. We considered as exposure variables admission to palliative care and time at palliative care admission, and as indicators of aggressive care hospitalisations, diagnostic/therapeutic procedures, in-hospital death, emergency department visits and chemotherapy over a time window of 30 days before death; chemotherapy in the last 14 days was also considered.Results Our cohort included 26 539 individuals; of these, 14 320 (54%) were admitted to palliative care before death. Individuals who were admitted to palliative care had an odds ratio (OR) of 0.27 for one hospitalisation, 0.14 for ≥2 hospitalisations, 0.25 for hospital stay ≥12 days, 0.38 for minor diagnostic/therapeutic procedures, 0.18 for major diagnostic/therapeutic procedures, 0.02 for in-hospital death, 0.35 for one emergency department visit, 0.29 for ≥2 emergency department visits and 0.66 for chemotherapy use in the last 30 days; the OR was 0.56 for chemotherapy use in the last 14 days.Conclusions This large real-world analysis confirms and further support the importance of palliative care assistance for patients with cancer in the end- of- life; this is associated to a significant reduction in unnecessary treatments.Data may be obtained from a third party and are not publicly available.