ArticleBMC palliative care2015
Variation in physician recommendations, knowledge and perceived roles regarding provision of end-of-life care.
Article in BMC palliative care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Discrete Choice Experiments in Health Economics: Past, Present and Future.PharmacoEconomics · 2019Pooled it
- Pooled it
- Using Best-Worst Scaling to Investigate Preferences in Health Care.PharmacoEconomics · 2016Pooled it
- Association between physician age and patterns of end-of-life care among older Americans.Journal of the American Geriatrics Society · 2024Article
- Hearing, sharing and applying: a qualitative study of the experiences of family caregivers' end-of-life decision-making in Singapore.BMJ public health · 2024Article
- Preferences for treatments to prevent rheumatoid arthritis in Canada and the influence of shared decision-making.Clinical rheumatology · 2020Article
- Treatment decisions in end-stage COPD: who decides how? A cross-sectional survey of different medical specialties.ERJ open research · 2019Article
- Preventing rheumatoid arthritis: Preferences for and predicted uptake of preventive treatments among high risk individuals.PloS one · 2019Article
- The clinical and economic consequences of practice style variations in common surgical interventions: A protocol for systematic review.Medicine · 2018Article
- Physician Preferences for Aggressive Treatment at the End of Life and Area-Level Health Care Spending: The Johns Hopkins Precursors Study.Gerontology & geriatric medicineArticle
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is high variability in end-of-life (EOL) treatments. Some of this could be due to differences in physician treatment recommendations, their knowledge/attitude regarding palliative care, and their perceived roles in treating patients with advanced serious illness (ASI). Thus, the objective of this paper was to identify potential variation in physician recommendations, their knowledge/attitude regarding palliative care and perceived roles in treating ASI patients.
methodsA cross-sectional survey consisting of vignettes describing patient characteristics that varied by age, expected survival, cognitive status and treatment costs and asked physicians whether they would recommend life-extending treatments for each scenario, was administered to 285 physicians who treat ASI patients in Singapore. Physicians were also assessed on their knowledge/attitude in palliative care. They were administered a best-worst scaling exercise requiring them to select their most and least important role as a physician caring for an ASI patient.
resultsThere was a wide variation in physician recommendations for life-extending treatments for patients with similar profiles, which can partly be attributed to physician characteristics (years of experience and place of training). Only about one-fourth of the physicians answered all knowledge/attitude questions correctly. Statements assessing knowledge/attitude regarding pain management had the fewest correct responses. The most important perceived role regarding provision of EOL care concerned symptom management.
conclusionsResults suggest that variation in physician treatment recommendations may be partly related to their own characteristics, raising concerns regarding the EOL care being provided to patients. Efforts should be made to better understand this variation and to provide the physicians with additional training in key aspects of palliative care management.
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