@article{f3d10bc2d006473d9190f3d13a790407,
title = "End-of-life prescribing of aspirin in patients with breast or colorectal cancer",
abstract = "Objectives The aim of this study was to evaluate the influence of an approaching cancer death on end-of-life aspirin use, a frequently prescribed medication for cardiovascular disease prevention. Methods This study was conducted using linked cancer registry and prescribing data. Breast (n=1151) and colorectal (n=1859) cancer decedents were matched to cancer survivors and the probability of either initiating aspirin, or continuing established aspirin use, was estimated in consecutive periods over the 5 years approaching a cancer-specific death (decedents) or matched index date (survivors). Results Using the linked data sets, we identified patients who died of their cancer (decedents) between 1 January 2001 and 31 December 2009. In the 5 years prior to death, we compared (1) the probability of initiating aspirin use for the first time, and (2) the probability of continuing aspirin use. In comparison to matched cancer survivors, an approaching cancer death was not associated with a reduction in aspirin initiation by breast or colorectal cancer decedents. However, the probability of continuing established aspirin use declined considerably in the 24 months approaching death and at the time of a death was significantly lower for breast (risk difference (RD) -0.26, 95% CI -0.33 to -0.20) and colorectal (RD -0.38, 95% CI -0.46 to -0.30) cancer decedents versus matched survivors. Conclusion A significant proportion of patients discontinue their aspirin in the time approaching a breast or colorectal cancer-specific death. The safety and benefits of this are unclear and empirical data are needed to guide decisions about aspirin use in the end of life.",
keywords = "aspirin, breast cancer, colorectal cancer, end of life",
author = "Laura Murphy and Chris Brown and Amelia Smith and Faith Cranfield and Linda Sharp and Kala Visvanathan and Kathleen Bennett and Barron, {Thomas Ian}",
note = "Funding Information: Funding This work was supported by the Irish Cancer Society Funding Information: This work was supported by the Irish Cancer Society Collaborative Cancer Research Centre BREAST-PREDICT (CCRC13GAL to KB, TIB) and the Health Research Board Ireland (ICE20119 to KB, LS). LM and AS's positions are funded by the Irish Cancer Society Collaborative Cancer Research Centre BREAST-PREDICT (CCRC13GAL to KB, TIB). TIB's position is funded by the Health Research Board Ireland (ICE20119 to KB, LS). CB's position is funded by the Health Research Board Ireland (HSR201230 to LS, KB, TIB). The Health Research Board Ireland and the Irish Cancer Society had no role in the study design; collection, analysis and interpretation of data; writing of the report; or the decision to submit for publication. The interpretation and reporting of these data are the responsibility of the authors and should in no way be seen as the official policy or interpretation of the National Cancer Registry Ireland or the Irish Health Services Executive Primary Care Reimbursements Services. Funding Information: Collaborative Cancer Research Centre BREAST-PREDICT (CCRC13GAL to KB, TIB) and the Health Research Board Ireland (ICE20119 to KB, LS). LM and AS{\textquoteright}s positions are funded by the Irish Cancer Society Collaborative Cancer Research Centre BREAST-PREDICT (CCRC13GAL to KB, TIB). TIB{\textquoteright}s position is funded by the Health Research Board Ireland (ICE20119 to KB, LS). CB{\textquoteright}s position is funded by the Health Research Board Ireland (HSR201230 to LS, KB, TIB). The Health Research Board Ireland and the Irish Cancer Society had no role in the study design; collection, analysis and interpretation of data; writing of the report; or the decision to submit for publication. The interpretation and reporting of these data are the responsibility of the authors and should in no way be seen as the official policy or interpretation of the National Cancer Registry Ireland or the Irish Health Services Executive Primary Care Reimbursements Services. Publisher Copyright: {\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",
year = "2019",
month = mar,
day = "1",
doi = "10.1136/bmjspcare-2017-001370",
language = "English (US)",
volume = "9",
journal = "BMJ Supportive and Palliative Care",
issn = "2045-435X",
publisher = "BMJ Publishing Group",
number = "1",
}