Ana I. González-González, Christine Schmucker, Julia Nothacker, Edris Nury, Truc Sophia Dinh, Maria-Sophie Brückle, Jeanet Wilhelmina Blom, Marjan van den Akker, Kristian Röttger, Odette Wegwarth, Tammy Hoffmann, Ferdinand M. Gerlach, Sharon E. Straus, Jörg J. Meerpohl, Christiane Muth
- 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.
MetadatenAuthor: | Ana I. González-GonzálezORCiDGND, Christine Schmucker, Julia Nothacker, Edris Nury, Truc Sophia DinhORCiDGND, Maria-Sophie BrückleGND, Jeanet Wilhelmina Blom, Marjan van den AkkerORCiDGND, Kristian Röttger, Odette Wegwarth, Tammy Hoffmann, Ferdinand M. GerlachORCiDGND, Sharon E. Straus, Jörg J. Meerpohl, Christiane MuthORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-572208 |
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DOI: | https://doi.org/10.3390/jcm10010091 |
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ISSN: | 2077-0383 |
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Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/33383951 |
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Parent Title (German): | Journal of clinical medicine |
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Publisher: | MDPI |
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Place of publication: | Basel |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2020/12/29 |
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Date of first Publication: | 2020/12/29 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2021/01/11 |
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Tag: | elderly; end of life care; multimorbidity; patient centered care; patient preferences |
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Volume: | 10.2021 |
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Issue: | Article 91 |
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Page Number: | 24 |
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Institutes: | Medizin / Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - Namensnennung 4.0 |
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