Terminal cancer care and patients' preference for place of death: a prospective study.

Townsend, Joy; Frank, Andrew; Fermont, D.C.; Dyer, Sandra; Karran, O; Walgrove, A; Piper, Mary

doi:10.1136/bmj.301.6749.415

Cited by 482 publications

(329 citation statements)

References 8 publications

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“…28 The present finding that the majority of patients prefer to die at home in the presence of their loved ones fits well with other studies. 12,13,29 Overall, the number of patients dying in their place of choice in Belgium is quite high compared with other studies, in which percentages between 30% and 94% are found, depending on the methodology used. 12,13,[30][31][32][33][34][35][36][37][38] Since congruence could only be measured for those patients whom GPs were informed about, it can be assumed that the high congruence found in the present study is probably an overestimation.…”

Section: Original Papers Original Papersmentioning

confidence: 68%

GPs' awareness of patients' preference for place of death

Meeussen

Block²,

Bossuyt³

et al. 2009

Br J Gen Pract

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BackgroundBeing able to die in one's place of choice is an indicator of the quality of end-of-life care. GPs may play a key role in exploring and honouring patients' preferences for place of death. AimTo examine how often GPs are informed about patients' preferred place of death, by whom and for which patients, and to study the expressed preferred place of death and how often patients die at their preferred place. Design of studyOne-year nationwide mortality retrospective study. SettingSentinel Network of GPs in Belgium, 2006. MethodGPs' weekly registration of all deaths (patients aged ≥1 year). ResultsA total of 798 non-sudden deaths were reported. GPs were informed of patients' preferred place of death in 46% of cases. GPs obtained this information directly from patients in 63%. GP awareness was positively associated with patients not being hospitalised in the last 3 months of life (odds ratio [OR] = 3.9; 95% confidence interval [CI] = 2.8 to 5.6), involvement of informal caregivers (OR = 3.3; 95% CI = 1.8 to 6.1), use of a multidisciplinary palliative care team (OR = 2.5; 95% CI = 1.8 to 3.5), and with presence of more than seven contacts between GP and patient or family in the last 3 months of life (OR = 3.0; 95% CI = 2.2 to 4.3). In instances where GPs were informed, more than half of patients (58%) preferred to die at home. Overall, 80% of patients died at their preferred place. ConclusionGPs are often unaware of their patients' preference for place of death. However, if GPs are informed, patients often die at their preferred location. Several healthcare characteristics might contribute to this and to a higher level of GP awareness. Keywordsadvance care planning; end-of-life care; general practitioner; palliative care; preferred place of death; terminal care.

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Section: Original Papers Original Papersmentioning

confidence: 68%

GPs' awareness of patients' preference for place of death

Meeussen

Block²,

Bossuyt³

et al. 2009

Br J Gen Pract

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show abstract

“…In a prospective cohort study, Townsend et al showed that 67% of patients dying of cancer, given favorable circumstances, would prefer to die at home. 11 Hays et al, found the same wishes in a study performed in a continuing-care retirement community, in which 62% of patients said they would prefer to die in their residence or nursing facility. 12 Earle et al, in a study of potential indicators of good end of life cancer care, confirmed that home death is preferred, as opposed to hospital death.…”

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confidence: 59%

Patterns of care at end of life for people with primary intracranial tumors: lessons learned

et al. 2014

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“…In fact, many patients express a wish to be at home during the last day of life. 29 As noted by Cobbs 30 and Grand et al, 31 homebased end-of-life care and dying at home is a gold standard of quality care. Our study also showed that with the support of the combined hospice team offered by consulting system, 21.3% of the patients preferred to be discharged in predying status to die at home, and 2.96% were discharged and continued care by a hospice home team.…”

Section: Discussionmentioning

confidence: 99%

Impact of Combined Hospice Care on Terminal Cancer Patients

Loke

Rau

Huang

2011

Journal of Palliative Medicine

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Background: Many patients with advanced cancer will develop physical and psychological symptoms related to their disease. These symptoms are infrequently treated by conventional care. Palliative care programs have been developed to fill this gap in care. However, there are limited beds in hospice units. To allow more terminal cancer patients to receive care from a hospice team, a combined hospice care system was recently developed in Taiwan. This study is a report of our experiences with this system. Patients and Methods: From January to December 2009, terminal cancer patients who accepted consultation from a hospice team for combined hospice care were enrolled in the study. Demographic data, clinical symptoms, referring department, type of cancer, and outcome were analyzed. Results: A total of 354 terminal cancer patients in acute wards were referred to a hospice consulting team. The mean patient age was 61 years, and the proportion of males was 63.28%. After combined hospice care, there was a significant improvement in the sign rate of do-not-resuscitate (DNR) orders from 41.53% to 71.47% ( p < 0.0001), and awareness of disease prognosis from 46.05% to 57.69% ( p ¼ 0.0006). Combined hospice care also enabled 64.21% of terminal cancer patients who were not transferred to hospice ward to receive combined care by a hospice consulting team while in acute wards, thus increasing the hospice utilization of terminal cancer patients. The major symptoms presented by the patients were pain (58%), dyspnea (52%), constipation (45%), and fatigue (23%). Conclusions: Through the hospice consulting system, hospice combined care has a positive effect on the utilization of hospice care, rate of DNR signing and quality of end-of-life care for terminal cancer patients.

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Terminal cancer care and patients' preference for place of death: a prospective study.

Cited by 482 publications

References 8 publications

GPs' awareness of patients' preference for place of death

GPs' awareness of patients' preference for place of death

Patterns of care at end of life for people with primary intracranial tumors: lessons learned

Impact of Combined Hospice Care on Terminal Cancer Patients

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