TY - JOUR
T1 - It is feasible to flag 'near end-of-life' status in older patients from routine general practice data
AU - Cardona, Magnolia
AU - Williamson, Margaret
AU - Jones, Mark
AU - Ní Chróinín, Danielle
AU - Gullotta, John
AU - Hillman, Ken
AU - Lewis, Ebony T
AU - Morgan, Mark
PY - 2020/11
Y1 - 2020/11
N2 - BackgroundPrognostic 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.MethodsA 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.ResultsThe 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.
AB - BackgroundPrognostic 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.MethodsA 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.ResultsThe 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.
UR - http://www.scopus.com/inward/record.url?scp=85094935293&partnerID=8YFLogxK
U2 - 10.31128/AJGP-08-19-5033
DO - 10.31128/AJGP-08-19-5033
M3 - Article
C2 - 33123717
SN - 2208-7958
VL - 49
SP - 752
EP - 758
JO - Australian Journal of General Practice
JF - Australian Journal of General Practice
IS - 11
ER -