Not All Terminally Ill Receive Desired End-of-Life Care

Patients are more likely to receive preferred care after discussion with a physician

05 feb 2010-- Most terminally ill patients receive end-of-life care consistent with their stated preferences, and are more likely to receive the care they prefer if they have discussed their preferences with a physician, according to a study published online Feb. 1 in the Journal of Clinical Oncology.

Jennifer W. Mack, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues surveyed 325 patients with advanced cancer about their preferences for life-extending versus symptom-directed care and the actual end-of-life care they received.

The researchers found that 68 percent of patients received end-of-life care consistent with their preferences. However, 74 percent of patients who recognized that they were terminally ill received such care, and most preferred symptom-directed care. The 39 percent of patients who reported having discussed their end-of-life preferences with a physician were more likely to receive care consistent with their preferences (odds ratio, 2.26), particularly if they recognized that they were terminally ill (odds ratio, 3.94).

"Patients with cancer are more likely to receive end-of-life care that is consistent with their preferences when they have had the opportunity to discuss their wishes for end-of-life care with a physician," Mack and colleagues conclude.

Abstract
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