Symptom relief is fundamental to palliative care. Aboriginal and Torres Strait Islander 25 (Indigenous) Australians are known to experience inequities in health care delivery and outcomes, 26 but large-scale studies of end-of-life symptoms in this population are lacking. We compared 27 symptom-related distress among Indigenous and non-Indigenous Australian patients in specialist 28 palliative care using the multi-jurisdictional Palliative Care Outcomes Collaboration dataset. Based 29 on patient-reported rating scale responses, adjusted relative risk (aRRs) stratified by care setting 30 were calculated for occurrence of (i) symptom-related moderate-to-severe distress and worsening 31 distress during a first episode of care, and (ii) symptom-related moderate-to-severe distress at the 32 final pre-death assessment. The p-value significance threshold was corrected for multiple 33 comparisons. First-episode frequencies of symptom-related distress were similar among Indigenous 34 (n=1,180) and non-Indigenous (n=107,952) patients in both inpatient and community settings. In 35 final pre-death assessments (681 Indigenous and 67,339 non-Indigenous patients), both groups had 36 similar occurrence of moderate-to-severe distress when care was provided in hospital. In 37 community settings, Indigenous compared with non-Indigenous patients had lower pre-death risks 38 of moderate-to-severe distress from any overall symptom occurrence (aRR 0.78; p=0.001; confidence 39 interval [CI] 0.67–0.91) or from ≥3 different symptoms (aRR 0.65; CI 0.45–0.96). These findings 40 provide reassurance of reasonable equivalence of end-of-life outcomes for Indigenous patients who 41 have been accepted for specialist palliative care.
|Number of pages||14|
|Journal||International Journal of Environmental Research and Public Health|
|Publication status||Published - 1 May 2020|
Woods, J., Johnson, C., Ngo, H., Katzenellenbogen, J., Murray, K., & Thompson, S. (2020). Symptom-related distress among indigenous Australians in specialist end-of-life care: Findings from the multi-jurisdictional palliative care outcomes collaboration data. International Journal of Environmental Research and Public Health, 17(9), . https://doi.org/10.3390/ijerph17093131