It is feasible to flag 'near end-of-life' status in older patients from routine general practice data

Magnolia Cardona, Margaret Williamson, Mark Jones, Danielle Ní Chróinín, John Gullotta, Ken Hillman, Ebony T Lewis, Mark Morgan

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background

Prognostic uncertainty delays discussions and leads to unnecessary treatments for older patients who are dying. The aim of this study was to investigate the feasibility of using routinely collected data from MedicineInsight, a large Australian general practice database, to flag indicators of near end-of-life (nEOL) in patients aged ≥75 years and evaluate their association with death over 12 months.

Methods

A retrospective chart review was used to assess the feasibility of identifying these indicators in the data (160,897 patients from 464 practices across Australia). Conditional logistic regression was used to assess the independent contribution of nEOL indicators in patients aged 75–84 and ≥85 years using a case-control design matching by practice.

Results

The strongest indicators for nEOL status were advanced malignancy, residential aged care, nutritional vulnerability, anaemia, cognitive impairment and heart failure. Other indicators included hospital attendance, pneumonia, decubitus ulcer, chronic obstructive pulmonary disease, antipsychotic prescription, male sex and stroke.

DiscussionConsideration of routinely collected patient data may suggest nEOL status and trigger advance care planning discussions.
Original languageEnglish
Pages (from-to)752-758
Number of pages7
JournalAustralian journal of general practice
Volume49
Issue number11
DOIs
Publication statusPublished - Nov 2020

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