ArticleJournal of general internal medicine2021
Do Life-sustaining Treatment Orders Match Patient and Surrogate Preferences? The Role of POLST.
Article in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed.
- Family Caregiver Perspectives on Advance Care Planning Discussions for Residents With Dementia Led by Trained Nursing Home Staff: Insights From the APPROACHES Project.Journal of the American Medical Directors Association · 2026Article
- An Integrative Review of the State of POLST Science: What Do We Know and Where Do We Go?Journal of the American Medical Directors Association · 2024Review
- Relationship of POLST to Hospitalization and ICU Care Among Nursing Home Residents in California.Journal of general internal medicine · 2023Article
- Reasons for Discordance Between Life-Sustaining Treatment Preferences and Medical Orders in Nursing Facilities Without POLST.The American journal of hospice & palliative care · 2023Article
- Perspectives of healthcare professionals and older patients on shared decision-making for treatment escalation planning in the acute hospital setting: a systematic review and qualitative thematic synthesis.EClinicalMedicine · 2023Article
- POLST completion and continuity in California nursing homes.Journal of the American Geriatrics Society · 2022Article
- Measuring Goal-Concordant Care in Palliative Care Research.Journal of pain and symptom management · 2021Review
- Reasons for discordance and concordance between POLST orders and current treatment preferences.Journal of the American Geriatrics Society · 2021Article
- Factors associated with concordance between POLST orders and current treatment preferences.Journal of the American Geriatrics Society · 2021Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundIt is essential to high-quality medical care that life-sustaining treatment orders match the current, values-based preferences of patients or their surrogate decision-makers. It is unknown whether concordance between orders and current preferences is higher when a POLST form is used compared to standard documentation practices.
objectiveTo assess concordance between existing orders and current preferences for nursing facility residents with and without POLST forms.
designChart review and interviews.
settingForty Indiana nursing facilities (29 where POLST is used and 11 where POLST is not in use).
participantsOne hundred sixty-one residents able to provide consent and 197 surrogate decision-makers of incapacitated residents with and without POLST forms. MAIN MEASUREMENTS: Concordance was measured by comparing life-sustaining treatment orders in the medical record (e.g., orders about resuscitation, intubation, and hospitalization) with current preferences. Concordance was analyzed using population-averaged binary logistic regression. Inverse probability weighting techniques were used to account for non-response. We hypothesized that concordance would be higher in residents with POLST (n = 275) in comparison to residents without POLST (n = 83). KEY
resultsConcordance was higher for residents with POLST than without POLST (59.3% versus 34.9%). In a model adjusted for resident, surrogate, and facility characteristics, the odds were 3.05 times higher that residents with POLST had orders for life-sustaining treatment match current preferences in comparison to residents without POLST (OR 3.05 95% CI 1.67-5.58, p < 0.001). No other variables were significantly associated with concordance.
conclusionsNursing facility residents with POLST are significantly more likely than residents without POLST to have concordance between orders in their medical records and current preferences for life-sustaining treatments, increasing the likelihood that their treatment preferences will be known and honored. However, findings indicate further systems change and clinical training are needed to improve POLST concordance.
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