Recognising patients who will die in the near future: a nationwide study via the Dutch Sentinel Network of GPs
Source: British Journal of General Practice, Volume 61, Number 587, June 2011 , pp. e371-e378(8)
Publisher: Royal College of General Practitioners
Recognising patients who will die in the near future is important for adequate planning and provision of end-of-life care. GPs can play a key role in this.
To explore the following questions: How long before death do GPs recognise patients likely to die in the near future? Which patient, illness, and care-related characteristics are related to such recognition? How does recognising death in the near future, before the last week of life, relate to care in during this period?
Design and setting:
One-year follow-back study via a surveillance GP network in the Netherlands.
Registration of demographic and care-related characteristics.
Of 252 non-sudden deaths, 70% occurred in the home or care home and 30% in hospital. GP recognition of death in the near future was absent in 30%, and occurred prior to the last month in 15%, within the last month in 19%, and in the last week in 34%. Logistic regression analyses showed cancer and low functional status were positively associated with death in the near future; cancer and discussing palliative care options were positively associated with recognising death in the near future before the last week of life. Recognising death in the near future before patients’ last week of life was associated with fewer hospital deaths, more GP–patient contacts in the last week, more deaths in a preferred place, and more-frequent GP–patient discussions about specific topics in the last 7 days of life.
Recognising death in the near future precedes several aspects of end-of-life care. The proportion in whom death in the near future is never recognised is large, suggesting GPs could be assisted in this process through training and implementation of care protocols that promote timely recognition of the dying phase.
Document Type: Research Article
Affiliations: 1: The EMGO Institute for Health and Care Research (EMGO+), Department of Public and Occupational Health, and Palliative Care Expertise Centre, VU University Medical Centre, Amsterdam, The Netherlands 2: End-of-Life Care Research Group, Ghent University and Vrije Universiteit Brussel, and Department of General Practice, Vrije Universiteit Brussel, Brussels, Belgium 3: Netherlands Institute of Health Services Research, Utrecht, The Netherlands 4: The EMGO Institute for Health and Care Research (EMGO+), Department of Public and Occupational Health, and Palliative Care Expertise Centre, VU University Medical Centre, Amsterdam, The Netherlands and End-of-Life Care Research Group, Ghent University and Vrije Universiteit Brussel, Brussels, Belgium
Publication date: 2011-06-01
- The British Journal of General Practice (BJGP) is an international journal publishing articles of interest to family practitioners and primary care researchers worldwide. The journal's 2012 Impact Factor is 2.034, making it one of the world's most highly cited journals of general practice and primary health care.
Members of the Royal College of General Practitioners receive complementary access to recent issues of the BJGP. Access is via the members' login area using RCGP membership details. All users can find access help for current and archive articles at Accessing BJGP.
- Editorial Board
- Information for Authors
- Submit a Paper
- Subscribe to this Title
- Membership Information
- Information for Advertisers
- BJGP Current Issue
- BJGP Archive
- BJGP Discussion Forum
- ingentaconnect is not responsible for the content or availability of external websites