Discussing and documenting preferences for life-sustaining treatment is essential for patient-centered care, yet many patients lack documented plans when a medical crisis occurs. I was excited to contribute to an examination of this: “Documentation of Life-Sustaining Treatment Preferences in a National Cohort of Veteran Decedents” led by Lena Makaroun and recently published in the Journal of General Internal Medicine. We examined patterns and factors associated with life-sustaining treatment (LST) note completion among patients receiving care through the Veterans Health Administration (VHA). We found that greater comorbidity, hospice use, and more primary care visits were associated with higher odds of LST note completion (p < 0.001). Among decedents without high-intensity VHA care, being unmarried with a child as next of kin and receiving more VA financial benefits were also associated with higher odds of completion (p < 0.001). Overall, LST note completion occurred in a minority of decedents, was strongly tied to high-intensity VHA service utilization, and was often completed by a surrogate. These findings highlight an important opportunity to document patient preferences earlier in outpatient settings, ensuring that care aligns with their wishes well before health declines.
Great to work with other co-authors: David Lazris, Carolyn Thorpe, Maria K Mor, Yaming Li, Hongwei Zhang, Ann-Marie Rosland, MD MS, Melissa Dichter, and Ann Kutney-Lee.
Read the full article here.
Linked In post here.