Improvements needed in end-of-life care for patients with organ failure

June 26, 2016

Historically, efforts to improve end-of-life care have focused primarily on patients with cancer. But few studies have looked at the quality of end-of-life care for patients with other serious illnesses, such as lung, kidney or heart failure or dementia. In a study of patients who died at 146 inpatient facilities within the Veteran Affairs health system, a research team led by investigators from Brigham and Women's Hospital has found that family-reported end-of-life care was significantly better for patients with cancer or dementia than for patients with other serious illnesses. The team's findings were presented today at AcademyHealth's Annual Research Meeting and simultaneously published in JAMA Internal Medicine.

"We need to broaden our attention to improve the quality of for all , not just those with cancer or dementia," said lead author Melissa Wachterman, MD, MPH, MSc, an assistant professor of medicine at Harvard Medical School and a physician both in the Department of Psychosocial Oncology and Palliative Care at Dana-Farber/Brigham and Women's Cancer Center and at VA Boston Healthcare System. "Our study shows that while there is room for improvement in the quality of end-of-life care for all patients, this is particularly true for patients dying of heart failure, and renal failure."

The study examined medical records and family surveys for more than 34,000 patients who died in the VA health system between 2009 and 2012. The researchers found that patients with end-stage renal disease, cardiopulmonary failure (congestive or chronic obstructive pulmonary disease) and frailty were far less likely to receive palliative care consultations than patients with cancer or dementia. Approximately one-third of these patients died in the , more than double the rates for those with cancer or dementia, and they were less likely to have do-not-resuscitate orders.

In general, the research team found that patients who had been seen by a palliative care doctor - a physician who specializes in symptom management and support around medical decision-making for seriously-ill patients -received better end-of-life care, according to their families.

"Increasing access to at the end of life may improve the quality of end-of-life care for those with heart, lung, and kidney diseases - a group that is rapidly growing with the increasing number of aging Americans dying of these conditions," said Wachterman.

Explore further: Study examines quality of end life care for patients with different illnesses

More information: JAMA Internal Medicine, DOI: 10.1001/jamainternmed.2016.1200

Related Stories

Study examines quality of end life care for patients with different illnesses

June 26, 2016
Families reported better quality of end-of-life care for patients with cancer or dementia than for patients with end-stage renal disease, cardiopulmonary failure or frailty because patients with cancer or dementia had higher ...

Palliative care lacking for chronic lung disease patients

February 1, 2016
(HealthDay)—Among patients who die in the intensive care unit (ICU), patients with chronic lung diseases receive fewer elements of palliative care than cancer patients, according to a study published online Jan. 19 in the ...

Palliative, hospice care lacking among dying cancer patients, Stanford researcher finds

May 27, 2016
Medical societies, including the American Society of Clinical Oncology, recommend that patients with advanced cancer receive palliative care soon after diagnosis and receive hospice care for at least the last three days of ...

Advanced cancer patients receive aggressive care at high rates at the end of life

June 6, 2016
In the last month of their lives, younger cancer patients continued to be hospitalized and receive other aggressive treatment at high rates, a University of North Carolina Lineberger Comprehensive Cancer Center-led study ...

ASCO: Early palliative care beneficial for caregivers

May 20, 2016
(HealthDay)—Palliative care that's offered soon after a terminal cancer diagnosis can also help caregivers, according to a study released Wednesday during a media briefing that previewed some of the research to be presented ...

Palliative care viewed as a stigma, despite improving quality of life

April 18, 2016
The term palliative care carries a stigma for patients and their caregivers, who regard it as synonymous with impending death. Education, and possibly a name change, will be necessary to be able to integrate palliative care ...

Recommended for you

Americans misinformed about smoking

August 22, 2017
After voluminous research studies, numerous lawsuits and millions of deaths linked to cigarettes, it might seem likely that Americans now properly understand the risks of smoking.

Women who sexually abuse children are just as harmful to their victims as male abusers

August 21, 2017
"That she might seduce a helpless child into sexplay is unthinkable, and even if she did so, what harm can be done without a penis?"

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

Schoolchildren who use e-cigarettes are more likely to try tobacco

August 17, 2017
Vaping - or the use of e-cigarettes - is widely accepted as a safer option for people who are already smoking.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.