The Importance of a Comprehensive, Patient-Centered Approach to End-of-Life Care
Relieving suffering of the dying patient is a core mission not only of palliative care providers, but of every clinician who participates in the care of seriously ill patients. Too often, patients and families suffer unnecessarily at the end of life because dying is not recognized, providers do not communicate about prognosis, and symptom management is inadequate. Several studies have documented unmet needs related to communication and symptom management for patients who die in the hospital in the United States.1,2 This problem is multi-factorial. Despite the fact that early advance care planning discussions are associated with better patient and caregiver outcomes,3,4 studies suggest that these discussions are often delayed5 and quality measures in this domain are often not met.6,7 There is, instead, a tendency to focus on disease-focused rather than patient-centered treatments, which often leads to patients receiving care inconsistent with preferences or prognosis.
Even when patients
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- Williams BR, Woodby LL, Bailey FA, et al. Formative Evaluation of a Multi-Component, Education-Based Intervention to Improve Processes of End of Life Care. Gerontol Geriatr Educ. 2013; Nov 14 [Epub ahead of print]
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- Chan R, Webster J. End-of-life care pathways for improving outcomes in caring for the dying (Review). The Cochrane Collaboration. 2011. Wiley Publishers.
- Dy SM, Aslakson R, Wilson RF, et al. Improving Health Care and Palliative Care for Advanced and Serious Illness. Closing the Quality Gap: Revisiting the State of the Science. Evidence Report No. 208. (Prepared by the Johns Hopkins University Evidence-based Practice Center under Contract No. 290-2007-10061-I.) AHRQ Publication No. 12(13)-E014-EF. Rockville, MD: Agency for Healthcare Research and Quality. October 2012.
- The Importance of a Comprehensive, Patient-Centered Approach to End-of-Life Care
Journal of General Internal Medicine
Volume 29, Issue 6 , pp 822-823
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- 1. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- 2. Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
- 3. Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- 4. Harry J. Duffey Family Pain and Palliative Care Program, Johns Hopkins Kimmel Cancer Center, Baltimore, MD, USA