Actual and Missed Opportunities for End-of-Life Care Discussions With Oncology Patients: A Qualitative Study.

JAMA Network Open
Kristin E KnutzenAmber E Barnato

Abstract

Early discussion of end-of-life (EOL) care preferences improves clinical outcomes and goal-concordant care. However, most EOL discussions occur approximately 1 month before death, despite most patients desiring information earlier. To describe successful navigation and missed opportunities for EOL discussions (eg, advance care planning, palliative care, discontinuation of disease-directed treatment, hospice care, and after-death wishes) between oncologists and outpatients with advanced cancer. This study is a secondary qualitative analysis of outpatient visits audio-recorded between November 2010 and September 2014 for the Studying Communication in Oncologist-Patient Encounters randomized clinical trial. The study was conducted at 2 US academic medical centers. Participants included medical, gynecological, and radiation oncologists and patients with stage IV malignant neoplasm, whom oncologists characterized as being ones whom they "…would not be surprised if they were admitted to an intensive care unit or died within one year." Data were analyzed between January 2018 and August 2020. The parent study randomized participants to oncologist- and patient-directed interventions to facilitate discussion of emotions. Encounters were ...Continue Reading

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Citations

Oct 6, 2021·Pediatric Blood & Cancer·Chirag ShahTejas Kotwal

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