Analysis of the Time Interval between the Physician Order for Life-Sustaining Treatment Completion and Death
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Background: This study aimed to explore the time interval distribution pattern between the Physicians Order for Life-Sustaining Treatment (POLST) form completion and death at a tertiary hospital in South Korea. It also examined the association between various independent parameters and POLST form completion timing. Methods: A total of 150 critically ill patients admitted to Korea University Guro Hospital between June 1, 2018 and December 31, 2018 who completed the POLST form were retrospectively analyzed and included in this study. Data were analyzed with descriptive statistics, and group comparisons were performed using the chi-square test for categorical variables. Fisher’s exact test was also used to compare cancer versus non-cancer groups. Results: More than half the decedents (54.7%) completed their POLST within 15 days of death and 73.4% within 30 days. The non-cancer group had the highest percentage of patients (77.8%) who died within 15 days of POLST form completion while the colorectal (39.1%) and other cancer (37.5%) groups had the lowest (P=0.336). Conclusion: Our findings demonstrated a current need for more explicit guidance to assist physicians with initiating more timely, proactive end-of-life discussions.
Abstract
Background: This study aimed to explore the time interval distribution pattern between the Physicians Order for Life-Sustaining Treatment (POLST) form completion and death at a tertiary hospital in South Korea. It also examined the association between various independent parameters and POLST form completion timing. Methods: A total of 150 critically ill patients admitted to Korea University Guro Hospital between June 1, 2018 and December 31, 2018 who completed the POLST form were retrospectively analyzed and included in this study. Data were analyzed with descriptive statistics, and group comparisons were performed using the chi-square test for categorical variables. Fisher’s exact test was also used to compare cancer versus non-cancer groups. Results: More than half the decedents (54.7%) completed their POLST within 15 days of death and 73.4% within 30 days. The non-cancer group had the highest percentage of patients (77.8%) who died within 15 days of POLST form completion while the colorectal (39.1%) and other cancer (37.5%) groups had the lowest (P=0.336). Conclusion: Our findings demonstrated a current need for more explicit guidance to assist physicians with initiating more timely, proactive end-of-life discussions.
참고문헌 (24)
- Wright AA, "Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment", JAMA, 300, pp.1665~1673 (2008)
- Bischoff KE, "Advance care planning and the quality of end-of-life care in older adults", J Am Geriatr Soc, 61, pp.209~214 (2013)
- Sanders JJ, "Achieving goal-concordant care : a conceptual model and approach to measuring serious illness communication and its impact", J Palliat Med, 21, pp.S17~S27 (2018)
- Hickman SE, "Hope for the future : achieving the original intent of advance directives", Hastings Cent Rep, (Spec No), pp.S26~S30 (2005)
- Hickman SE, "A comparison of methods to communicate treatment preferences in nursing facilities : traditional practices versus the physician orders for life-sustaining treatment program", J Am Geriatr Soc, 58, pp.1241~1248 (2010)
- Zive DM, "Timing of POLST form completion by cause of death", J Pain Symptom Manage, 50, pp.650~658 (2015)
- Araw AC, "Medical orders for life-sustaining treatment : is it time yet?", Palliat Support Care, 12, pp.101~105 (2014)
- Haines L, "Factors that impact family perception of goal-concordant care at the end of life", J Palliat Med, 22, pp.927~932 (2019)
- Ho TH, "Trends in the aggressiveness of end-of-life cancer care in the universal health care system of Ontario, Canada", J Clin Oncol, 29, pp.1587~1591 (2011)
- Temel JS, "Early palliative care for patients with metastatic non-smallcell lung cancer", N Engl J Med, 363, pp.733~742 (2010)
- von Gruenigen V, "Indicators of survival duration in ovarian cancer and implications for aggressiveness of care", Cancer, 112, pp.2221~2227 (2008)
- Father John Tuohey, "End of life : POLST reflects patient wishes, clinical reality", Health Prog, 92, pp.60~64 (2011)
- Dhaliwal R, "The Canadian critical care nutrition guidelines in 2013 : an update on current recommendations and implementation strategies", Nutr Clin Pract, 29, pp.29~43 (2014)
- Lewin SN, "Resource utilization for ovarian cancer patients at the end of life: how much is too much?", Gynecol Oncol, 99, pp.261~266 (2005)
- Keating NL, "Physician factors associated with discussions about end-of-life care", Cancer, 116, pp.998~1006 (2010)
- Smith AK, "Uncertainty : the other side of prognosis", N Engl J Med, 368, pp.2448~2450 (2013)
- Yamaguchi T, "Effects of end-of-life discussions on the mental health of bereaved family members and quality of patient death and care", J Pain Symptom Manage, 54, pp.17~26 (2017)
- Walling A, "Evi-dence-based recommendations for information and care planning in cancer care", J Clin Oncol, 26, pp.3896~3902 (2008)
- Committee on Approaching Death: Addressing Key End-of-Life Issues, "Dying in America: improving quality and honoring individual preferences near the end of life" (2015), National Academies Press
- Legare F, "Shared decision making : moving from theorization to applied research and hopefully to clinical practice", Patient Educ Couns, 91, pp.129~130 (2013)
- Huff NG, "Therapeutic alliance between the caregivers of critical illness survivors and intensive care unit clinicians", Ann Am Thorac Soc, 12, pp.1646~1653 (2015)
- Kumar P, "Family perspectives on hospice care experiences of patients with cancer", J Clin Oncol, 35, pp.432~439 (2017)
- Lopez-Acevedo M, "Timing of end-of-life care discussion with performance on end-of-life quality indicators in ovarian cancer", Gynecol Oncol, 130, pp.156~161 (2013)
- Foglia MB, "A comprehensive approach to eliciting, documenting, and honoring patient wishes for care near the end of life : the Veterans Health Administration’s LifeSustaining Treatment Decisions Initiative", Jt Comm J Qual Patient Saf, 45, pp.47~56 (2019)