Tuesday, July 12, 2005

This week's JAMA: a simple intervention increases hospice referrals in nursing home patients

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.

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