An exploration of medical emergency team intervention at the end of life for people with advanced cancer

Abstract

Purpose: Recent advances in cancer therapies offer survival benefit when cure is no longer possible. The contribution of the Medical Emergency Teams (METs) in the context of advancing disease has received little empirical consideration. This study set out to explore MET intervention at the end of life for people with advanced cancer in an Australian comprehensive cancer centre, and its impact on quality of death.

Method: A retrospective medical chart review was undertaken to explore MET response for people with advanced (incurable) cancer nearing end of life. Occurrence of MET interventions at the end of life and a quality of death score were recorded for two randomly selected cohorts of patients, those who experienced a MET response within their last week of life (n = 50) and those who did not (n = 50).

Results: The cohort who did not receive MET intervention had a significantly higher (better) quality of death score when compared with patients who did receive a MET intervention (p = 0.01). Within the cohort who received a MET intervention, a subgroup (n = 19) where the MET influenced end-of-life decision-making had a significantly higher quality of death score (p = 0.02) than patients in the MET cohort (n = 31) where the MET did not influence end-of-life care.

Conclusion: The contribution of the MET to end-of-life care for patients with cancer has not previously been reported. Further research is now needed to prospectively examine MET involvement at the end of life with consideration to quality of patient care and death, family experience, and support requirements of MET members.

Keywords: Cancer; End-of-life care; Medical emergency team (MET); Quality of death.