Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
Oncology-embedded supportive care and end-of-life outcomes: a comparative study of hospice-eligible Muslim patients with cancer and non-cancer diagnoses.
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Imran Manahil, Alshehri Basel Ghurm, Akhtar Muhammad Ali, Imran Raafey, Iqbal Umar, Imran Maryam, Iqbal Aaliyaan, Imran Ibrahim M, Malik Ibrahim T, Khalid Tabindeh Jabeen, Iqbal Mohsin, Sharaf Belal Mohammad, Khalid Imran
Аннотация
PURPOSE: Oncology-embedded supportive care facilitates comfort-focused end-of-life care in cancer patients, but its effectiveness in Muslim-majority settings is unknown. We compared end-of-life outcomes between hospice-eligible Muslim cancer patients managed within this model and non-cancer patients without such integration.
METHODS: This retrospective cohort study (2021-2024) at a Middle Eastern tertiary hospital included hospice-eligible Muslim adults who died during an acute-care admission. Cancer patients were managed by an oncology-embedded supportive service and compared with non-cancer patients. The primary outcome was a comfort-oriented care composite reflecting goal-concordant care (do-not-attempt-resuscitation [DNAR] at death without ICU admission). Multivariable analysis adjusted for key confounders, including age, comorbidities, and palliative care involvement.
RESULTS: Of 54,122 admissions and 2171 deaths, 796 hospice-eligible patients were analyzed (401 cancer, 395 non-cancer). The comfort-oriented care composite was achieved more often in cancer patients (71% vs 35%, p < 0.001). Cancer patients had earlier DNAR transitions (median 7 vs 13 days after admission), lower ICU utilization (21% vs 58%), and fewer aggressive interventions in the final 24 h (34% vs 70%), all p < 0.001. In multivariable analysis, cancer diagnosis (aOR 2.24, 95% CI 1.39-3.59) and palliative involvement (aOR 3.18, 95% CI 2.03-4.99) independently predicted comfort-oriented care.
CONCLUSIONS: An oncology-embedded supportive care model in a Muslim-majority setting was associated with earlier transitions to comfort-focused care and less aggressive end-of-life interventions among hospice-eligible cancer patients. The contrast with non-cancer patients highlights the importance of structured supportive care integration and demonstrates that models adapted to cultural and religious contexts can effectively support comfort-focused care.
METHODS: This retrospective cohort study (2021-2024) at a Middle Eastern tertiary hospital included hospice-eligible Muslim adults who died during an acute-care admission. Cancer patients were managed by an oncology-embedded supportive service and compared with non-cancer patients. The primary outcome was a comfort-oriented care composite reflecting goal-concordant care (do-not-attempt-resuscitation [DNAR] at death without ICU admission). Multivariable analysis adjusted for key confounders, including age, comorbidities, and palliative care involvement.
RESULTS: Of 54,122 admissions and 2171 deaths, 796 hospice-eligible patients were analyzed (401 cancer, 395 non-cancer). The comfort-oriented care composite was achieved more often in cancer patients (71% vs 35%, p < 0.001). Cancer patients had earlier DNAR transitions (median 7 vs 13 days after admission), lower ICU utilization (21% vs 58%), and fewer aggressive interventions in the final 24 h (34% vs 70%), all p < 0.001. In multivariable analysis, cancer diagnosis (aOR 2.24, 95% CI 1.39-3.59) and palliative involvement (aOR 3.18, 95% CI 2.03-4.99) independently predicted comfort-oriented care.
CONCLUSIONS: An oncology-embedded supportive care model in a Muslim-majority setting was associated with earlier transitions to comfort-focused care and less aggressive end-of-life interventions among hospice-eligible cancer patients. The contrast with non-cancer patients highlights the importance of structured supportive care integration and demonstrates that models adapted to cultural and religious contexts can effectively support comfort-focused care.