Tuesday, July 12, 2005
This week's JAMA has an interesting article about a simple intervention to increase hospice referrals in NH residents. Basically patients were asked a few screening questions (about desire for CPR/ventilation, preference for a more palliative mode of care, etc.) and for those that seemed amenable to hospice a fax was sent to their PCPs. About 20% of those whose PCP's received the fax were enrolled in hospice at 1 month compared to 1% of those whose PCP's didn't receive the fax. Secondary measures like family satisfaction, total days spent in hospice, & hospital admissions were different between the groups; mortality, place of death, and percentage who died under hospice care did not differ between the groups. Referral of appropriate patients to hospice earlier is a well recognized need in end of life care & it appears this intervention (which the authors noted took 5-10 minutes to complete) would be helpful in the NH population.