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A prospective study of patient-physician communication about resuscitation.
J Am Geriatr Soc 2000; 48(S1):S52-60JA

Abstract

OBJECTIVE

To evaluate prospectively seriously ill patients' characteristics, perceptions, and preferences associated with discussing resuscitation (CPR) with their physicians.

DESIGN

Prospective cohort.

SETTING

Five academic medical centers.

PARTICIPANTS

Patients enrolled in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments who had not communicated with their physicians about CPR at admission to a hospital for life-threatening illness (n = 1288).

MEASUREMENTS

Baseline surveys of patients' characteristics, health status, desires for participation in medical decision making, and cardiopulmonary resuscitation. Two month follow-up surveys of patients' communication of resuscitation preference. Chart reviews for clinical indicators.

RESULTS

Thirty percent of patients communicated their resuscitation preference to their physician during a 2 month-period following hospital admission. Patients whose preference was to forego CPR (odds ratio (OR) 2.9;(95% CI, 1.9-4.2)) and whose preference had changed from desiring to foregoing CPR (OR 1.6; (95% CI, 1.1-2.4)) were more likely to communicate their preference than patients who continued to prefer to receive CPR. However, only 50% of patients who maintained a preference to forego CPR communicated this over a 2-month period. Having an advance directive and remaining in the hospital at 2-month follow-up were also independently associated with communication, whereas patients' preference for participation in decision-making, health status, and prognostic estimate were not.

CONCLUSIONS

Communication about resuscitation preferences occurred infrequently after hospital admission for a serious illness, even among patients wishing to forego resuscitation. Factors such as declining quality of life, which were expected to be associated with communication, were not. An invitation to communicate about CPR preference is important after hospital admission for a serious illness. Novel approaches are needed to promote physician-patient discussions about resuscitation.

Authors+Show Affiliations

UCLA Medical Center, Los Angeles, California 90095-1736, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10809457

Citation

Golin, C E., et al. "A Prospective Study of Patient-physician Communication About Resuscitation." Journal of the American Geriatrics Society, vol. 48, no. S1, 2000, pp. S52-60.
Golin CE, Wenger NS, Liu H, et al. A prospective study of patient-physician communication about resuscitation. J Am Geriatr Soc. 2000;48(S1):S52-60.
Golin, C. E., Wenger, N. S., Liu, H., Dawson, N. V., Teno, J. M., Desbiens, N. A., ... Phillips, R. S. (2000). A prospective study of patient-physician communication about resuscitation. Journal of the American Geriatrics Society, 48(S1), pp. S52-60.
Golin CE, et al. A Prospective Study of Patient-physician Communication About Resuscitation. J Am Geriatr Soc. 2000;48(S1):S52-60. PubMed PMID: 10809457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of patient-physician communication about resuscitation. AU - Golin,C E, AU - Wenger,N S, AU - Liu,H, AU - Dawson,N V, AU - Teno,J M, AU - Desbiens,N A, AU - Lynn,J, AU - Oye,R K, AU - Phillips,R S, PY - 2000/5/16/pubmed PY - 2000/6/8/medline PY - 2000/5/16/entrez KW - Death and Euthanasia KW - Empirical Approach KW - Professional Patient Relationship SP - S52 EP - 60 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 48 IS - S1 N2 - OBJECTIVE: To evaluate prospectively seriously ill patients' characteristics, perceptions, and preferences associated with discussing resuscitation (CPR) with their physicians. DESIGN: Prospective cohort. SETTING: Five academic medical centers. PARTICIPANTS: Patients enrolled in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments who had not communicated with their physicians about CPR at admission to a hospital for life-threatening illness (n = 1288). MEASUREMENTS: Baseline surveys of patients' characteristics, health status, desires for participation in medical decision making, and cardiopulmonary resuscitation. Two month follow-up surveys of patients' communication of resuscitation preference. Chart reviews for clinical indicators. RESULTS: Thirty percent of patients communicated their resuscitation preference to their physician during a 2 month-period following hospital admission. Patients whose preference was to forego CPR (odds ratio (OR) 2.9;(95% CI, 1.9-4.2)) and whose preference had changed from desiring to foregoing CPR (OR 1.6; (95% CI, 1.1-2.4)) were more likely to communicate their preference than patients who continued to prefer to receive CPR. However, only 50% of patients who maintained a preference to forego CPR communicated this over a 2-month period. Having an advance directive and remaining in the hospital at 2-month follow-up were also independently associated with communication, whereas patients' preference for participation in decision-making, health status, and prognostic estimate were not. CONCLUSIONS: Communication about resuscitation preferences occurred infrequently after hospital admission for a serious illness, even among patients wishing to forego resuscitation. Factors such as declining quality of life, which were expected to be associated with communication, were not. An invitation to communicate about CPR preference is important after hospital admission for a serious illness. Novel approaches are needed to promote physician-patient discussions about resuscitation. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/10809457/A_prospective_study_of_patient_physician_communication_about_resuscitation_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0002-8614&date=2000&volume=48&issue=S1&spage=S52 DB - PRIME DP - Unbound Medicine ER -