Your browser doesn't support javascript.
Shared decision-making in advance care planning among hospitalized older COVID-19 patients: a multicenter, retrospective cohort study.
Hendriks, Victoria Johanna Jacoba; Faes, Miriam C; van der Meer, Jop B L; Janse, Emma S; van der Meer, Nardo J M; van der Linden, Carolien M J.
  • Hendriks VJJ; Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands. vicky.hendriks@catharinaziekenhuis.nl.
  • Faes MC; Amphia Hospital, Breda, The Netherlands.
  • van der Meer JBL; Amphia Hospital, Breda, The Netherlands.
  • Janse ES; Erasmus MC, Rotterdam, The Netherlands.
  • van der Meer NJM; Amphia Hospital, Breda, The Netherlands.
  • van der Linden CMJ; Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
Aging Clin Exp Res ; 34(12): 3165-3169, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2104164
ABSTRACT

BACKGROUND:

In the Netherlands, it is customary to discuss directives regarding resuscitation, intubation, and ICU-admission with patients and/or their relatives upon hospital-admission. The outcome of this discussion is documented in a code status. Ideally, these advance care planning (ACP)-related decisions are made by a patient (and/or their relatives) and a professional together in a shared decision-making (SDM) process, to improve patient satisfaction and prevent undesired care. Given the bad outcomes in older COVID-19 patients, it is particularly important to discuss the code status upon admission. This study aims to describe the practice of SDM regarding code status during the COVID-pandemic. Specific aims were to find out to what extend patients took part in this decision-making process and whether all key elements of SDM for a shared decision were documented in medical reports.

METHODS:

In this retrospective cohort study, we included COVID-19 patients aged 70 years and older, admitted to two large teaching hospitals in the Netherlands, during the first months of the COVID-19 pandemic in 2020. Data about code status and the decision-making process were extracted from electronic healthcare records.

RESULTS:

Code status was documented for 274 of 275 included patients. Patient participation in the decision-making process was described in 48%. In 19% all key elements of shared decision-making have been described. Key elements of SDM were defined as the presence of a completed code status form, the presence of clinical notes showing that both patient's wishes and values and the opinion of the healthcare professional about the predicted outcome was taken into consideration and clinical notes of a patient-healthcare professional interaction during the admission.

CONCLUSION:

Our results show that a proper SDM process regarding code status is possible, even in hectic times like the COVID-19-pandemic. However, shared decision-making was not common practice in older patients with COVID-19 regarding code status (an ACP-related decision) in the early phase of the COVID-19 pandemic. Only in 19% of the patients, all key elements of SDM regarding code status were described.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Advance Care Planning / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Humans Language: English Journal: Aging Clin Exp Res Journal subject: Geriatrics Year: 2022 Document Type: Article Affiliation country: S40520-022-02281-y

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Advance Care Planning / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Humans Language: English Journal: Aging Clin Exp Res Journal subject: Geriatrics Year: 2022 Document Type: Article Affiliation country: S40520-022-02281-y