End-of-life discussions in residential care homes improves symptom control : A national register study
(2024) In BMJ Supportive and Palliative Care 14(1). p.1008-1015- 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.
(Less)
- author
- Andersson, Sofia LU ; Martinsson, Lisa ; Fürst, Carl Johan LU and Brännström, Margareta
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- nursing home care, symptoms and symptom management
- in
- BMJ Supportive and Palliative Care
- volume
- 14
- issue
- 1
- pages
- 1008 - 1015
- 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
- 2024-09-21 23:14:25
@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}}, number = {{1}}, pages = {{1008--1015}}, 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}}, volume = {{14}}, year = {{2024}}, }