TY  - JOUR
A1  - González-González, Ana I.
A1  - Schmucker, Christine
A1  - Nothacker, Julia
A1  - Nury, Edris
A1  - Dinh, Truc Sophia
A1  - Brückle, Maria-Sophie
A1  - Blom, Jeanet Wilhelmina
A1  - Akker, Marjan van den
A1  - Röttger, Kristian
A1  - Wegwarth, Odette
A1  - Hoffmann, Tammy
A1  - Gerlach, Ferdinand M.
A1  - Straus, Sharon E.
A1  - Meerpohl, Jörg J.
A1  - Muth, Christiane
T1  - End-of-life care preferences of older patients with multimorbidity: a mixed methods systematic review
T2  - Journal of clinical medicine
N2  - Unpredictable disease trajectories make early clarification of end-of-life (EoL) care preferences in older patients with multimorbidity advisable. This mixed methods systematic review synthesizes studies and assesses such preferences. Two independent reviewers screened title/abstracts/full texts in seven databases, extracted data and used the Mixed Methods Appraisal Tool to assess risk of bias (RoB). We synthesized findings from 22 studies (3243 patients) narratively and, where possible, quantitatively. Nineteen studies assessed willingness to receive life-sustaining treatments (LSTs), six, the preferred place of care, and eight, preferences regarding shared decision-making processes. When unspecified, 21% of patients in four studies preferred any LST option. In three studies, fewer patients chose LST when faced with death and deteriorating health, and more when treatment promised life extension. In 13 studies, 67% and 48% of patients respectively were willing to receive cardiopulmonary resuscitation and mechanical ventilation, but willingness decreased with deteriorating health. Further, 52% of patients from three studies wished to die at home. Seven studies showed that unless incapacitated, most patients prefer to decide on their EoL care themselves. High non-response rates meant RoB was high in most studies. Knowledge of EoL care preferences of older patients with multimorbidity increases the chance such care will be provided.
KW  - end of life care
KW  - patient preferences
KW  - multimorbidity
KW  - elderly
KW  - patient centered care
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/57220
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-572208
SN  - 2077-0383
VL  - 10.2021
IS  - Article 91
PB  - MDPI
CY  - Basel
ER  -