Benefits of physician orders for scope of treatment (POST) forms on end-of-life care in cancer patients: Insights from the West Virginia registry.

Impact of the Physician Orders for Life-Sustaining Treatment (POLST) Program Maturity Status on the Nursing Home Resident’s Place of Death

“…While the use of POLST program was positively associated with increased hospice referrals, 35,36 and EoL care discussions, 33,37 -39 an association between a state’s POLST program maturity status and NH residents outcomes is unclear. The aim of this study is to examine the impact of POLST maturity status on the NH death among elderly residents.…”

The Oncology Specialist’s Role in POLST Form Completion

“…Studies have demonstrated clear associations between the POLST Scope of Treatment orders and transitions near the EOL and location of death. [16][17][18][19][20][21][22] For example, when patients have POLST orders for comfort measures only, they receive fewer unwanted treatments, are less likely to die in the hospital, and are more likely to die at home. [16][17][18][19][20][21] Little is known about POLST use in patients with cancer and specifically the role that oncology specialists play.…”

Highlights of Recent Findings on Quality-of-Life Management for Patients With Cancer and Their Survivors

“…7 One key difference is that using the POST translates patient preferences for end-of-life care into specific physician medical orders, whereas advance directives do not serve as medical orders. Knestrick et al 8 retrospectively reviewed cancer deaths between 2011 and 2014 reported to the West Virginia University Cancer Registry. A nonrandomized cohort of over 500 patients had a POST, and over 500 patients had advanced directives.…”

“…These 4 ASCO presentations [1][2][3]8 are relevant to the transition from a fee-for-service world into a value-of-care world with bundled payments for episodes of care. We must acquire an understanding of how comorbidities affect cancer itself, its treatments, and adverse effects; we must develop feasible, low-cost interventions that are relevant for most patients with cancer treated in the community and not in resource-intensive cancer centers; we must understand the essential elements of PC interventions and under what conditions they work best; and finally, we must more broadly adopt tools like POST, which are underutilized but which the available data suggest are associated with fewer in-hospital deaths and more hospice use, broadly viewed as a good thing.…”