BACKGROUND: Recognising patients who will die in the near future is important for adequate planning and provision of end-of-life care. GPs can play a key role in this. AIM: To explore the following questions: How long before death do GPs recognise patients likely to die in the near future? Which patient, illness, and care-related characteristics are related to such recognition? How does recognising death in the near future, before the last week of life, relate to care in during this period? DESIGN AND SETTING: One-year follow-back study via a surveillance GP network in the Netherlands. METHOD: Registration of demographic and care-related characteristics. RESULTS: Of 252 non-sudden deaths, 70% occurred in the home or care home and 30% in hospital. GP recognition of death in the near future was absent in 30%, and occurred prior to the last month in 15%, within the last month in 19%, and in the last week in 34%. Logistic regression analyses showed cancer and low functional status were positively associated with death in the near future; cancer and discussing palliative care options were positively associated with recognising death in the near future before the last week of life. Recognising death in the near future before patients' last week of life was associated with fewer hospital deaths, more GP-patient contacts in the last week, more deaths in a preferred place, and more-frequent GP-patient discussions about specific topics in the last 7 days of life. CONCLUSION: Recognising death in the near future precedes several aspects of end-of-life care. The proportion in whom death in the near future is never recognised is large, suggesting GPs could be assisted in this process through training and implementation of care protocols that promote timely recognition of the dying phase.
BACKGROUND: Recognising patients who will die in the near future is important for adequate planning and provision of end-of-life care. GPs can play a key role in this. AIM: To explore the following questions: How long before death do GPs recognise patients likely to die in the near future? Which patient, illness, and care-related characteristics are related to such recognition? How does recognising death in the near future, before the last week of life, relate to care in during this period? DESIGN AND SETTING: One-year follow-back study via a surveillance GP network in the Netherlands. METHOD: Registration of demographic and care-related characteristics. RESULTS: Of 252 non-sudden deaths, 70% occurred in the home or care home and 30% in hospital. GP recognition of death in the near future was absent in 30%, and occurred prior to the last month in 15%, within the last month in 19%, and in the last week in 34%. Logistic regression analyses showed cancer and low functional status were positively associated with death in the near future; cancer and discussing palliative care options were positively associated with recognising death in the near future before the last week of life. Recognising death in the near future before patients' last week of life was associated with fewer hospital deaths, more GP-patient contacts in the last week, more deaths in a preferred place, and more-frequent GP-patient discussions about specific topics in the last 7 days of life. CONCLUSION: Recognising death in the near future precedes several aspects of end-of-life care. The proportion in whom death in the near future is never recognised is large, suggesting GPs could be assisted in this process through training and implementation of care protocols that promote timely recognition of the dying phase.
Authors: Tim Stokes; Carolyn Tarrant; Arch G Mainous; Henk Schers; George Freeman; Richard Baker Journal: Ann Fam Med Date: 2005 Jul-Aug Impact factor: 5.166
Authors: Laetitia Veerbeek; Lia van Zuylen; Siebe J Swart; Paul J van der Maas; Agnes van der Heide Journal: Support Care Cancer Date: 2007-03-15 Impact factor: 3.603
Authors: Henk Schers; Sophie Webster; Henk van den Hoogen; Anthony Avery; Richard Grol; Wil van den Bosch Journal: Br J Gen Pract Date: 2002-06 Impact factor: 5.386
Authors: M B Hamel; L Goldman; J Teno; J Lynn; R B Davis; F E Harrell; A F Connors; R Califf; P Kussin; P Bellamy Journal: JAMA Date: 1995-06-21 Impact factor: 56.272
Authors: F Amos Bailey; Beverly R Williams; Lesa L Woodby; Patricia S Goode; David T Redden; Thomas K Houston; U Shanette Granstaff; Theodore M Johnson; Leslye C Pennypacker; K Sue Haddock; John M Painter; Jessie M Spencer; Thomas Hartney; Kathryn L Burgio Journal: J Gen Intern Med Date: 2014-06 Impact factor: 5.128
Authors: Maria C De Korte-Verhoef; H Roeline W Pasman; Bart P M Schweitzer; Anneke L Francke; Bregje D Onwuteaka-Philipsen; Luc Deliens Journal: Support Care Cancer Date: 2013-10-22 Impact factor: 3.603
Authors: Bregje D Onwuteaka-Philipsen; H Roeline W Pasman; Ida J Korfage; Erica Witkamp; Masha Zee; Liza Gg van Lent; Anne Goossensen; Agnes van der Heide Journal: Palliat Med Date: 2021-04-07 Impact factor: 4.762
Authors: F Amos Bailey; Beverly R Williams; Patricia S Goode; Richard E Kennedy; David T Redden; Elizabeth Kvale; Marie Bakitas; J Nicholas Dionne-Odom; Kathryn L Burgio Journal: J Gen Intern Med Date: 2021-02-05 Impact factor: 6.473
Authors: Susanne J J Claessen; Anneke L Francke; Michael A Echteld; Bart P M Schweitzer; Gé A Donker; Luc Deliens Journal: BMC Fam Pract Date: 2013-07-22 Impact factor: 2.497