ArticlePloS one2013
End-of-life decisions: a cross-national study of treatment preference discussions and surrogate decision-maker appointments.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Perspectives of elders and their adult children of Black and minority ethnic heritage on end-of-life conversations: A meta-ethnography.Palliative medicine · 2020Pooled it
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- Treatment and survival of patients with esophageal and gastric cancer in the Netherlands and Belgium: A population-based comparison.International journal of cancer · 2026Article
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- Advance care planning before and during the COVID-19 pandemic: an observational cohort study of 73 675 patients' records.BJGP open · 2024Article
- The patient's relationship with the General Practitioner before and after Advance Care Planning: pre/post-implementation study.BMC geriatrics · 2022Article
- Nonoperative management of hip fractures in very frail elderly patients may lead to a predictable short survival as part of advance care planning.Acta orthopaedica · 2021Article
- Healthcare Use during the Last Six Months of Life in Patients with Advanced Breast Cancer.Cancers · 2021Article
- Life-sustaining treatment preferences in older patients when referred to the emergency department for acute geriatric assessment: a descriptive study in a Dutch hospital.BMC geriatrics · 2021Article
- Article
- Association Between Region of Birth and Advance Care Planning Documentation Among Older Australian Migrant Communities: A Multicenter Audit Study.The journals of gerontology. Series B, Psychological sciences and social sciences · 2021Article
- Preferences in end of life care substantially differ between the Netherlands and Japan: Results from a cross-sectional survey study.Medicine · 2020Article
- Frequency of discussing and documenting advance care planning in primary care: secondary analysis of a multicenter cross-sectional observational study.BMC palliative care · 2020Observational
- Does the Experience of Caring for a Severely Disabled Relative Impact Advance Care Planning? A Qualitative Study of Caregivers of Disabled Patients.International journal of environmental research and public health · 2020Article
- Medical end-of-life practices in Swiss cultural regions: a death certificate study.BMC medicine · 2018Article
- Physician-related determinants of medical end-of-life decisions - A mortality follow-back study in Switzerland.PloS one · 2018Article
- Themes and variations: An exploratory international investigation into resuscitation decision-making.Resuscitation · 2016Article
- Development of a complex intervention to support the initiation of advance care planning by general practitioners in patients at risk of deteriorating or dying: a phase 0-1 study.BMC palliative care · 2016Article
- Trends in Continuous Deep Sedation until Death between 2007 and 2013: A Repeated Nationwide Survey.PloS one · 2016Article
- How Do General Practitioners Conceptualise Advance Care Planning in Their Practice? A Qualitative Study.PloS one · 2016Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMaking treatment decisions in anticipation of possible future incapacity is an important part of patient participation in end-of-life decision-making. This study estimates and compares the prevalence of GP-patient end-of-life treatment discussions and patients' appointment of surrogate decision-makers in Italy, Spain, Belgium and the Netherlands and examines associated factors.
methodsA cross-sectional, retrospective survey was conducted with representative GP networks in four countries. GPs recorded the health and care characteristics in the last three months of life of 4,396 patients who died non-suddenly. Prevalences were estimated and logistic regressions were used to examine between country differences and country-specific associated patient and care factors.
resultsGP-patient discussion of treatment preferences occurred for 10%, 7%, 25% and 47% of Italian, Spanish, Belgian and of Dutch patients respectively. Furthermore, 6%, 5%, 16% and 29% of Italian, Spanish, Belgian and Dutch patients had a surrogate decision-maker. Despite some country-specific differences, previous GP-patient discussion of primary diagnosis, more frequent GP contact, GP provision of palliative care, the importance of palliative care as a treatment aim and place of death were positively associated with preference discussions or surrogate appointments. A diagnosis of dementia was negatively associated with preference discussions and surrogate appointments.
conclusionsThe study revealed a higher prevalence of treatment preference discussions and surrogate appointments in the two northern compared to the two southern European countries. Factors associated with preference discussions and surrogate appointments suggest that delaying diagnosis discussions impedes anticipatory planning, whereas early preference discussions, particularly for dementia patients, and the provision of palliative care encourage participation.
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