ArticleBMJ supportive & palliative care2021
Advance directives and real-world end-of-life clinical practice: a case-control study.
Article in BMJ supportive & palliative care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 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.
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Who cites it
8 citing papers in PubMed.
- Impact of nurse-led advance care planning in a primary care setting.Palliative & supportive care · 2026Article
- Healthcare utilization and end-of-life care based on life-sustaining treatment decisions in patients with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- End-of-life discussions, preference concordance, and good death: insights from a nationwide mortality follow-back survey.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Observational
- Article
- Advance Directives in Portugal: A Qualitative Survey.Healthcare (Basel, Switzerland) · 2024Article
- Don't Throw the Baby Out With the Bathwater: Meta-Analysis of Advance Care Planning and End-of-life Cancer Care.Journal of pain and symptom management · 2023Review
- Underutilization of palliative care in advanced COPD and heart failure: associations, disparities, and the role of specialists.Therapeutic advances in respiratory diseaseObservational
- End-of-Life Care Preferences of Terminally Ill Patients: A Cross-Sectional Study.Indian journal of palliative careArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdvance directives (ADs) have been legally regulated to promote autonomy over health decisions among patients who later lose decision-making capacity. AIMS AND
objectivesTo analyse the differences in clinical practice at end of life among people who had completed an AD versus those who had not.
methodsRetrospective case-control study (1:2), matched by age, sex, year, cause of death and region of residence. The data sources used were the ADs registry, central registry of insured persons, hospital discharge, pharmacy and billing databases, and the mortality registry. Conditional logistic regression models (crude and adjusted by socioeconomic level) were performed. The outcome variable was the frequency of medical procedures performed during the last year of life.
results1723 people with ADs who died in Catalonia during 2014-2015 were matched with 3446 dead controls (without ADs). Thoracentesis was the procedure with the greatest reduction among women with an AD (adjusted OR (OR
conclusionsADs are an effective tool to adjust the realisation of some procedures at end of life. These results can help better plan for the treatment of patients with ADs, as well as increase the awareness among clinical personnel, families and the general population.
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