Potentially Inappropriate Treatments at the End of Life in Nursing Home Residents: Findings From the PACE Cross-Sectional Study in Six European Countries

Autor: Jenny T. van der Steen, Yvonne Engels, Lara Pivodic, Eddy M. M. Adang, Luc Deliens, Katarzyna Szczerbińska, Jo Hockley, Anne B. Wichmann, Elisabeth Honinx, Ivan Segat, Sheila Payne, Marc Tanghe, Nele Van Den Noortgate, Suvi Leppaaho, Outi Kuitunen-Kaija, H. Roeline W. Pasman, Lieve Van den Block, Rose Miranda, Tinne Smets, Agnieszka Pac, Maud ten Koppel, Violetta Kijowska, Ilona Baranska, Danielle Collingridge Moore, Sophie Pautex, Emilie Morgan de Paula, Martina Mercuri, Bregje D. Onwuteaka-Philipsen, Mariska Oosterveld-Vlug, Marika Kylänen, Catherine Bassal, Giovanni Gambassi, Harriet Finne-Soveri, Paula Andreasen, Myrra Vernooij-Dassen, Agata Stodolska, Hein P.J. van Hout, Paola Rossi, Sander M. J. van Kuijk, Yuliana Gatsolaeva, Federica Mammarella, Katherine Froggatt, Ruth Piers
Přispěvatelé: Public and occupational health, APH - Aging & Later Life, APH - Quality of Care, General practice, RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: KIO Kemta (9), Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, End-of-life Care Research Group
Rok vydání: 2021
Předmět:
Zdroj: Journal of Pain and Symptom Management, 61, 4, pp. 732-742.e1
Journal of Pain and Symptom Management, 61(4), 732-742.e1. Elsevier Inc.
Journal of Pain and Symptom Management, 61, 732-742.e1
Journal of Pain and Symptom Management, 61(4), 732-742.e1. Elsevier Science
Honinx, E, Van den Block, L, Piers, R, Van Kuijk, S M J, Onwuteaka-Philipsen, B D, Payne, S A, Szczerbińska, K, Gambassi, G G, Finne-Soveri, H, Deliens, L, Smets, T, Gatsolaeva, Y, Miranda, R, Pivodic, L, Tanghe, M, van Hout, H, Van Den Noortgate, N, Froggatt, K, Pasman, H R W, Baranska, I, Oosterveld-Vlug, M, Wichmann, A B, Engels, Y, Vernooij-Dassen, M, Hockley, J, Leppäaho, S, Pautex, S, Bassal, C, Mammarella, F, Mercuri, M, Rossi, P, Segat, I, Stodolska, A, Adang, E, Kylänen, M, Andreasen, P, Kuitunen-Kaija, O, Moore, D C, Pac, A, Kijowska, V, Ten Koppel, M, van der Steen, J T & de Paula, E M 2021, ' Potentially Inappropriate Treatments at the End of Life in Nursing Home Residents : Findings From the PACE Cross-Sectional Study in Six European Countries ', Journal of Pain and Symptom Management, vol. 61, no. 4, pp. 732-742.e1 . https://doi.org/10.1016/j.jpainsymman.2020.09.001
ISSN: 0885-3924
Popis: Context. Certain treatments are potentially inappropriate when administered to nursing homes residents at the end of life and should be carefully considered. An international comparison of potentially inappropriate treatments allows insight into common issues and country-specific challenges of end-of-life care in nursing homes and helps direct health-care policy in this area.Objectives. To estimate the prevalence of potentially inappropriate treatments in the last week of life in nursing home residents and analyze the differences in prevalence between countries.Methods. A cross-sectional study of deceased residents in nursing homes (2015) in six European countries: Belgium (Flanders), England, Finland, Italy, The Netherlands, and Poland. Potentially inappropriate treatments included enteral administration of nutrition, parental administration of nutrition, artificial fluids, resuscitation, artificial ventilation, blood transfusion, chemotherapy/radiotherapy, dialysis, surgery, antibiotics, statins, antidiabetics, new oral anticoagulants. Nurses were questioned about whether these treatments were administered in the last week of life.Results. We included 1384 deceased residents from 322 nursing homes. In most countries, potentially inappropriate treatments were rarely used, with a maximum of 18.3% of residents receiving at least one treatment in Poland. Exceptions were antibiotics in all countries (between 11.3% in Belgium and 45% in Poland), artificial nutrition and hydration in Poland (54.3%) and Italy (41%) and antidiabetics in Poland (19.7%).Conclusion. Although the prevalence of potentially inappropriate treatments in the last week of life was generally low, antibiotics were frequently prescribed in all countries. In Poland and Italy, the prevalence of artificial administration of food/fluids in the last week of life was high, possibly reflecting country differences in legislation, care organization and culture, and the palliative care competences of staff. (C) 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Databáze: OpenAIRE
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