Patient Preferences for Communication with Physicians about End-of-Life Decisions

• DOI: 10.7326/0003-4819-127-1-199707010-00001
• Publication Date: 2013-04-12T17:19:30Z
• Authors: Jan C. Hofmann; Neil S. Wenger; Roger B. Davis; Joan Teno; Alfred F. Connors; Norman Desbiens; Joanne Lynn; Russell S. Phillips
• Keywords: Advance Care Planning; End-of-Life Care; Odds

Background: Physicians are frequently unaware of patient preferences for end-of-life care. Identifying and exploring barriers to patient–physician communication about issues may help guide physicians their patients toward more effective discussions. Objective: To examine correlates associated outcomes with cardiopulmonary resuscitation prolonged mechanical ventilation. Design: Prospective cohort study. Setting: Five tertiary care hospitals. Patients: 1832 (85%) 2162 eligible completed interviews. Measurements: Surveys characteristics care; perceptions prognosis, decision making, quality life; decisions. Results: Fewer than one fourth (23%) seriously ill had discussed physicians. Of who not resuscitation, 58% were interested in doing so. did want discuss preferences, 25% resuscitation. In multivariable analyses, factors independently wanting included being an ethnicity other black (adjusted odds ratio [OR], 1.48 [95% CI, 1.10 1.99], having advance directive (OR, 1.35 [CI, 1.04 1.76]), estimating excellent prognosis 1.72 1.32 2.59]), reporting fair life 1.36 1.05 desiring active involvement medical decisions 1.33 1.07 1.65]). Factors but so 1.53 1.11 2.11]) younger 1.14 per 10-year interval 1.25]). Conclusions: Among hospitalized adults, is uncommon. A majority have do For as well unmet need such discussions, failure ventilation result unwanted interventions.