Patient and Family Participation in Medication Decisions on Discharge to Hospice Care

Title

Patient and Family Participation in Medication Decisions on Discharge to Hospice Care

Creator

Noble BN; Izumi S; Tjia J; Ku IY; Kadoyama KL; McPherson ML; Furuno JAO

Publisher

Journal of Palliative Medicine

Date

2022

Subject

Humans; Adolescent; Hospice Care; Cross-Sectional Studies; Family; Decision Making; Shared Oregon PMC; PMC9784578 OTO; NOTNLM

Description

Background: High-quality hospice care is characterized by patient-centered care and shared decision making between patients, families, and health care workers. However, little is known regarding the frequency and characteristics of patient and family participation in medication decisions on transition to hospice care. Objective: To quantify the frequency and characteristics of patient and/or family participation in medication decisions. Subjects: Adult (age ≥18 years) patients discharged from Oregon Health & Science University Hospital (OHSU) to hospice care between January 1, 2010 and December 31, 2016. Design: Cross-sectional study. Measures: The primary outcome was documented patient and/or family participation. Patient or family participation was defined as documentation of patient or family member discussion surrounding medication decisions in the discharge summary. We used logistic regression to identify patient and admission characteristics associated with documentation of patient or family member participation in medication decisions. Results: Among 348 eligible patients, patient and/or family participation was documented in 22% of discharges to hospice care. Higher Charlson comorbidity index (adjusted odds ratio [aOR]: 1.09, 95% confidence interval [CI]: 1.01-1.17) and having a diagnosis of cancer (aOR: 1.99, 95% CI: 1.16-3.43) were associated with an increased documentation of patient or family member participation in medication decisions. Patients admitted to the intensive care unit were less likely to have patient/family member participation (aOR: 0.55, 95% CI: 0.32-0.94). Having a specialty palliative care consultation was not significantly associated with patient or family member participation in medication decisions (aOR: 0.77, 95% CI: 0.40-1.48). Conclusions: Patient or family participation in medication decisions was documented for only 22% patients on discharge to hospice care. Opportunities to improve participation likely include increasing knowledge and capacity regarding primary palliative care for all clinicians and implementation of specialized interventions for patients and families transitioning to hospice care from acute care settings. FAU - Noble, Brie N

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Citation List Month

February List 2023

Collection

Citation

Noble BN; Izumi S; Tjia J; Ku IY; Kadoyama KL; McPherson ML; Furuno JAO, “Patient and Family Participation in Medication Decisions on Discharge to Hospice Care,” Pediatric Palliative Care Library, accessed October 3, 2023, https://pedpalascnetlibrary.omeka.net/items/show/18620.