title: Initiation of chemotherapy in cancer patients with poor performance status: a population-based analysis.
abstract: OBJECTIVE
  Practice guidelines indicate that patients who have months to weeks left to live should not be offered chemotherapy. We examined factors associated with clinician-reported poor performance status as determined by the Palliative Performance Scale (PPS) and subsequent initiation of intravenous (IV) chemotherapy in an ambulatory cancer population in Ontario, Canada.
  
  
  METHODS
  In this retrospective study, patients who had at least one PPS assessment indicating poor performance status (a PPS score of 50 or lower) comprised the study cohort. Using linked administrative databases, we observed the cohort for initiation of IV chemotherapy within 30 days of the first (index) poor PPS assessment.
  
  
  RESULTS
  We excluded patients for whom IV or oral chemotherapy was ongoing or recently completed or whose performance status improved following the index assessment. Of the remaining cohort, 9.3 percent (264/2,842) received IV chemotherapy within 30 days of the index PPS.
  
  
  CONCLUSIONS
  A small number of cancer patients with poor performance status began IV chemotherapy in the month following assessment.
authors.forename: Joan
authors.initials: J
authors.lastname: Porter
authors.forename: Craig
authors.initials: C
authors.lastname: Earle
authors.forename: Clare
authors.initials: C
authors.lastname: Atzema
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Doris
authors.initials: D
authors.lastname: Howell
authors.forename: Hsien
authors.initials: H
authors.lastname: Seow
authors.forename: Rinku
authors.initials: R
authors.lastname: Sutradhar
authors.forename: Deborah
authors.initials: D
authors.lastname: Dudgeon
authors.forename: Amna
authors.initials: A
authors.lastname: Husain
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sussman
authors.forename: Lisa
authors.initials: L
authors.lastname: Barbera
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003657:Decision Making; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D009864:Ontario; D010166:Palliative Care; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment
chemical_list: D000970:Antineoplastic Agents