The influence of age on the likelihood of receiving end-of-life care consistent with patient treatment preferences. Academic Article Article uri icon

Overview

MeSH

  • Adult
  • Age Factors
  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Interviews as Topic
  • Likelihood Functions
  • Male
  • Medical Audit
  • Middle Aged
  • Neoplasms
  • Prospective Studies
  • United States
  • Young Adult

MeSH Major

  • Patient Preference
  • Terminal Care

abstract

  • Age differences may help to explain discrepancies in medical care received by cancer patients near death. Understanding age differences in advanced cancer patients' end-of-life experiences. NCI and NIMH funded multi-site prospective cohort study. 396 deceased cancer patients, mean age (58.6 +/- 12.5), in the Coping with Cancer study. Baseline interviews (Treatment Preference) and 1 week postmortem chart reviews (Treatment Received). 14.1% of patients were 20-44 years old, 54.0% were 45-64 years old, and 31.8% were > or = 65 years old. Compared to younger patients, middle-aged patients wanted less life-prolonging care (OR 0.32; CI 0.16-0.64). In the last week of life, older patients were less likely to undergo ventilation (OR 0.27; CI 0.07-1.00) than younger patients. Middle-aged patients who preferred life-prolonging care were less likely to receive it than younger patients (OR 0.21; CI 0.08-0.54), but were more likely to avoid unwanted life-prolonging care (OR 2.38; CI 1.20-4.75) than younger patients. Older patients were less likely to receive desired life-prolonging care than younger patients (OR 0.23; CI 0.08-0.68), however, they were not more likely to avoid unwanted life-prolonging care than younger patients (OR 1.74; CI 0.87-3.47). Likelihood of a patient's treatment preference being consistent with care differ by age and treatment preferences. Older patients preferring life-prolonging therapies are less likely to receive them than younger patients; middle-aged patients who want to avoid life-prolonging care are more likely to do so than younger patients. Both findings have implications for patients' quality-of-death, indicating a need for further research.

publication date

  • June 2010

has subject area

  • Adult
  • Age Factors
  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Interviews as Topic
  • Likelihood Functions
  • Male
  • Medical Audit
  • Middle Aged
  • Neoplasms
  • Patient Preference
  • Prospective Studies
  • Terminal Care
  • United States
  • Young Adult

Research

keywords

  • Journal Article
  • Multicenter Study

Identity

Language

  • eng

PubMed Central ID

  • PMC2938891

Digital Object Identifier (DOI)

  • 10.1089/jpm.2009.0337

PubMed ID

  • 20597704

Additional Document Info

start page

  • 719

end page

  • 726

volume

  • 13

number

  • 6