Preferences for Palliative and End-of-Life Care: A Systematic Review of Discrete Choice Experiments

Community Preferences for the Care of Older People at the End of Life: How Important is the Disease Context?

“…The results suggest that the most important aspects of care, irrespective of the illness, are patient comfort, carer coping, and costs to the patient and family, which is consistent with the findings of other DCE studies where pain control, quality of life and the costs of care to the patient were found to be highly ranked attributes [ 13 ]. However, our finding is more nuanced for dementia patients (relative to the cancer and heart failure contexts) in terms of lower tolerance for medical intervention to prolong life, higher tolerance of care and death in hospital, and a preference to not have the patient awake in the final weeks.…”

“…However, our finding is more nuanced for dementia patients (relative to the cancer and heart failure contexts) in terms of lower tolerance for medical intervention to prolong life, higher tolerance of care and death in hospital, and a preference to not have the patient awake in the final weeks. Most of the evidence on preferences for care at the end of life is in the context of advanced cancer or does not specify a disease context [ 11 , 13 , 34 ], and this study adds information on preferences in the context of heart failure and dementia where preferences are relatively underresearched.…”

“…DCEs have been used in end-of-life studies, with many focused on preferences for life extension over a relatively limited number of other aspects of end-of-life care. Generally, these studies (among different populations) have found pain control to be prioritised over other attributes, with quality of life, cost of care and length of life also highly ranked [ 13 ]. These other aspects of care were found to be more important than place of care and place of death among both bereaved carers [ 14 ] and a general population sample [ 15 ].…”

“…While DCEs provide a useful method for investigating the trade-offs people are willing to make regarding care at the end of life, most of the DCE research has focused on the context of advanced cancer [ 13 ]. However, little is known about preferences for care at the end of life in other disease contexts where the symptoms, patterns of functional decline and potential for use of life-extending therapies may be different.…”

Do People Prefer Home Palliative Care? A Survey Study and Assessment of Associated Factors in China

“…We also found that compared to people who worked in the services market, those who had an occupation in health and social work were more likely to have a home preference for palliative care. Although no previous study examined such relationships, it could be the reason that those who worked in clinical settings have received training and education on palliative care 37 that equips them with knowledge and skills so that they think they do not need to stay in clinical settings for more professional services. In addition, it could also be that they have seen too many negative and chaotic situations at work, which serves as an additional factor in not choosing to receive palliative care in clinical settings for their "future self."…”