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End-of-life discussions in residential care homes improves symptom control : A national register study

Andersson, Sofia LU ; Martinsson, Lisa ; Fürst, Carl Johan LU and Brännström, Margareta (2021) In BMJ Supportive and Palliative Care
Abstract

Background: In Europe, residential care homes (RCHs) rather than hospitals are the most common care facilities for the older adult and the place where most deaths occur in this age group. There is a lack of knowledge regarding end-of-life (EOL) discussions and how they correlate with symptoms and symptom relief. Objective: The aim was to examine the correlation between EOL discussions and symptom occurrence, symptom relief and prescriptions or PRN drugs against symptoms for care home residents. Methods: All expected deaths at RCHs from 1 October 2015 to 31 December 2016 and registered in the Swedish Register of Palliative Care were included. Univariate and multivariate logistic regression were used to compare the RCH residents, or their... (More)

Background: In Europe, residential care homes (RCHs) rather than hospitals are the most common care facilities for the older adult and the place where most deaths occur in this age group. There is a lack of knowledge regarding end-of-life (EOL) discussions and how they correlate with symptoms and symptom relief. Objective: The aim was to examine the correlation between EOL discussions and symptom occurrence, symptom relief and prescriptions or PRN drugs against symptoms for care home residents. Methods: All expected deaths at RCHs from 1 October 2015 to 31 December 2016 and registered in the Swedish Register of Palliative Care were included. Univariate and multivariate logistic regression were used to compare the RCH residents, or their family members, who had received documented EOL discussions with a physician (the EOL discussion group) and the non-EOL discussion group. Results: The EOL discussion group (n=17 071) had a higher prevalence of pain, nausea, anxiety, death rattles and shortness of breath reported, compared with the non-EOL discussion group (n=4164). Those with symptoms were more often completely relieved and had more often been prescribed PRN drugs against that symptom in the EOL discussion group. All differences remained significant when adjusting for age, time living in unit and cause of death. Conclusion: The results indicate that EOL discussions are correlated with higher prevalence of symptoms, but also with better symptom relief and prescription of symptom drugs PRN when symptomatic. A possible explanation for this is that the EOL discussion can work as an opportunity to discuss symptoms and treatment for symptom relief.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
nursing home care, symptoms and symptom management
in
BMJ Supportive and Palliative Care
publisher
BMJ Publishing Group
external identifiers
  • scopus:85108851122
  • pmid:34162583
ISSN
2045-435X
DOI
10.1136/bmjspcare-2021-002983
language
English
LU publication?
yes
additional info
Publisher Copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
id
a08ac52b-4060-4829-a0f1-a8bcba345eae
date added to LUP
2021-08-13 14:44:54
date last changed
2024-06-15 14:11:54
@article{a08ac52b-4060-4829-a0f1-a8bcba345eae,
  abstract     = {{<p>Background: In Europe, residential care homes (RCHs) rather than hospitals are the most common care facilities for the older adult and the place where most deaths occur in this age group. There is a lack of knowledge regarding end-of-life (EOL) discussions and how they correlate with symptoms and symptom relief. Objective: The aim was to examine the correlation between EOL discussions and symptom occurrence, symptom relief and prescriptions or PRN drugs against symptoms for care home residents. Methods: All expected deaths at RCHs from 1 October 2015 to 31 December 2016 and registered in the Swedish Register of Palliative Care were included. Univariate and multivariate logistic regression were used to compare the RCH residents, or their family members, who had received documented EOL discussions with a physician (the EOL discussion group) and the non-EOL discussion group. Results: The EOL discussion group (n=17 071) had a higher prevalence of pain, nausea, anxiety, death rattles and shortness of breath reported, compared with the non-EOL discussion group (n=4164). Those with symptoms were more often completely relieved and had more often been prescribed PRN drugs against that symptom in the EOL discussion group. All differences remained significant when adjusting for age, time living in unit and cause of death. Conclusion: The results indicate that EOL discussions are correlated with higher prevalence of symptoms, but also with better symptom relief and prescription of symptom drugs PRN when symptomatic. A possible explanation for this is that the EOL discussion can work as an opportunity to discuss symptoms and treatment for symptom relief.</p>}},
  author       = {{Andersson, Sofia and Martinsson, Lisa and Fürst, Carl Johan and Brännström, Margareta}},
  issn         = {{2045-435X}},
  keywords     = {{nursing home care; symptoms and symptom management}},
  language     = {{eng}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Supportive and Palliative Care}},
  title        = {{End-of-life discussions in residential care homes improves symptom control : A national register study}},
  url          = {{http://dx.doi.org/10.1136/bmjspcare-2021-002983}},
  doi          = {{10.1136/bmjspcare-2021-002983}},
  year         = {{2021}},
}