End-of-life care needs improvement for patients with organ failure, study says

End-of-life care, as reported by patient's families, is significantly better for patients with cancer and dementia than those with other serious illness, according to a new study published in JAMA Internal Medicine.

For the study, researchers examined medical records from more than 34,000 patients across 146 Veterans Affairs inpatient facilities who died between 2009 and 2012. Data indicated that patients with conditions like end-stage renal disease, congestive heart failure and chronic lung disease were less likely to be given palliative care consultations than patients with cancer or dementia. Patients who did not receive consultations from a physician regarding symptom management and medical decision-making were more likely to die in the intensive care unit and less likely to have do-not-resuscitate orders than those who did receive such consultations.

"We need to broaden our attention to improve the quality of end-of-life care for all patients, not just those with cancer or dementia," said Melissa Wachterman, MD, a professor of medicine at Harvard Medical School in Boston and lead study author. "Our study shows that while there is room for improvement in the quality of end-of-life care for all patients, this is particularly true for patients dying of heart failure, chronic lung disease and renal failure."

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