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Quality of Life and Cost of Care at the End of Life: The Role of Advance Directives
Open accessAbstract
Context Advance directives (ADs) are expected to improve patients' end-of-life outcomes, but retrospective analyses, surrogate recall of patients' preferences, and selection bias have hampered efforts to determine ADs' effects on patient outcomes.Objectives The aim was to examine associations among ADs, quality of life, and estimated costs of care in the week before death.Methods We used prospective data from interviews of 336 patients with advanced cancer and their caregivers and analyzed patient baseline interview and caregiver and provider post-mortem evaluation data from the Coping with Cancer study. Cost estimates were from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample and published Medicare payment rates and cost estimates. Outcomes were quality of life (range 0-10) and estimated costs of care received in the week before death. Because patient end-of-life care preferences influence both AD completion and care use, analyses were stratified by preferences regarding heroic end-of-life measures (everything possible to remain alive).Results Most patients did not want heroic measures (76%). Do-not-resuscitate (DNR) orders were associated with higher quality of life (β = 0.75, standard error = 0.30, P = 0.01) across the entire sample. There were no statistically significant relationships between DNR orders and outcomes among patients when we stratified by patient preference or between living wills/durable powers of attorney and outcomes in any of the patient groups.Conclusion The associations between DNR orders and better quality of life in the week before death indicate that documenting preferences against resuscitation in medical orders may be beneficial to many patients.
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“Advance care planning has been associated with earlier and increased use of hospice care [12–15], reduced intensive treatment and hospitalizations at the end of life [13, 15–18], and better quality of life in patients with cancer and caregivers [12, 19].”
From Mindfulness to enhance quality of life and support advance care planning: a pilot randomized controlled trial for adults with advanced cancer and their family caregivers. (2024) · cites this paper as [19]
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Cites
Validation of a combined comorbidity index
Charlson, M., Szatrowski, T. P., Peterson, J., & Gold, J. (1994) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(94)90129-5 · Cited by 6,587
Pfeiffer, E. A. (1975) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1975.tb00927.x · Cited by 5,320
Bias and causal associations in observational research
Grimes, D. A., & Schulz, K. F. (2002) · The Lancet · doi:10.1016/s0140-6736(02)07451-2 · Cited by 1,553
Health Care Costs in the Last Week of Life: Associations With End-of-Life Conversations
Zhang, B., Wright, A. A., Huskamp, H. A., Nilsson, M. E., Maciejewski, M. L., Earle, C. C., Block, S. D., Maciejewski, P. K., & Prigerson, H. G. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.587 · Cited by 898
Self-citationDaily cost of an intensive care unit day: The contribution of mechanical ventilation*
Dasta, J. F., McLaughlin, T. P., Mody, S. H., & Piech, C. T. (2005) · Critical Care Medicine · doi:10.1097/01.ccm.0000164543.14619.00 · Cited by 869
Ramsey, S., Blough, D., Kirchhoff, A., Kreizenbeck, K., Fedorenko, C., Snell, K., Newcomb, P., Hollingworth, W., & Overstreet, K. (2013) · Health Affairs · doi:10.1377/hlthaff.2012.1263 · Cited by 699
Association Between Advance Directives and Quality of End‐of‐Life Care: A National Study
Teno, J. M., Gruneir, A., Schwartz, Z., Nanda, A., & Wetle, T. T. (2007) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2007.01045.x · Cited by 551
Advance Care Planning and the Quality of End‐of‐Life Care in Older Adults
Bischoff, K. E., Sudore, R. L., Miao, Y., Boscardin, W. J., & Smith, A. K. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12105 · Cited by 445
The Economics of Dying -- The Illusion of Cost Savings at the End of Life
Emanuel, E. J., & Emanuel, L. L. (1994) · New England Journal of Medicine · doi:10.1056/nejm199402243300806 · Cited by 335
Controlling Death: The False Promise of Advance Directives
Perkins, H. S. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-1-200707030-00008 · Cited by 333
Balboni, T., Balboni, M., Paulk, M. E., Phelps, A., Wright, A., Peteet, J., Block, S., Lathan, C., VanderWeele, T., & Prigerson, H. (2011) · Cancer · doi:10.1002/cncr.26221 · Cited by 330
Self-citationFactors Important to Patients' Quality of Life at the End of Life
Zhang, B., Nilsson, M. E., & Prigerson, H. G. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2012.2364 · Cited by 313
Self-citationNicholas, L. H., Langa, K. M., Iwashyna, T. J., & Weir, D. R. (2011) · JAMA · doi:10.1001/jama.2011.1410 · Cited by 302
Effects of Offering Advance Directives on Medical Treatments and Costs
Schneiderman, L. J., Kronick, R. G., Kaplan, R. M., Anderson, J. P., & Langer, R. D. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-117-7-599 · Cited by 260
Health Care Costs for Patients With Cancer at the End of Life
Chastek, B. J., Harley, C., Kallich, J. D., Newcomer, L. N., Paoli, C. J., & Teitelbaum, A. H. (2012) · Journal of Oncology Practice · doi:10.1200/jop.2011.000469 · Cited by 259
The Frequency and Cost of Treatment Perceived to Be Futile in Critical Care
Huynh, T. N., Kleerup, E. C., Wiley, J. F., Savitsky, T. D., Guse, D., Garber, B. J., & Wenger, N. S. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.10261 · Cited by 247
Advance Directive Completion by Elderly Americans: A Decade of Change
Silveira, M. J., Wiitala, W. L., & Piette, J. D. (2014) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12736 · Cited by 158
Determinants of Medical Expenditures in the Last 6 Months of Life
Kelley, A. S., Ettner, S. L., Morrison, R. S., Du, Q., Wenger, N. S., & Sarkisian, C. A. (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-154-4-201102150-00004 · Cited by 155
Hospital Do-Not-Resuscitate Orders: Why They Have Failed and How to Fix Them
Yuen, J. K. Y., Reid, M. C., & Fetters, M. D. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1632-x · Cited by 136
Does Reimbursement Influence Chemotherapy Treatment For Cancer Patients?
Jacobson, M., O’Malley, A. J., Earle, C. C., Pakes, J., Gaccione, P., & Newhouse, J. P. (2006) · Health Affairs · doi:10.1377/hlthaff.25.2.437 · Cited by 136
The Illusion of End‐of‐Life Resource Savings with Advance Directives
Teno, J. M., Lynn, J., Connors, A. F., Wenger, N. S., Phillips, R. S., Alzola, C., Murphy, D. P., Desbiens, N. A., & Knaus, W. A. (1997) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1997.tb05180.x · Cited by 136
Preferences for cardiopulmonary resuscitation
the SUPPORT Investigators, Teno, J. M., Hakim, R. B., Knaus, W. A., Wenger, N. S., Phillips, R. S., Wu, A. W., Layde, P. M., Connors, A. F., Dawson, N. V., et al. (1995) · Journal of General Internal Medicine · doi:10.1007/bf02600252 · Cited by 135
Influence of patients' preferences and treatment site on cancer patients' end‐of‐life care
Wright, A. A., Mack, J. W., Kritek, P., Balboni, T. A., Massaro, A. F., Matulonis, U. A., Block, S. D., & Prigerson, H. G. (2010) · Cancer · doi:10.1002/cncr.25217 · Cited by 132
Self-citationThe end‐of‐life experience: Modifiable predictors of caregivers' bereavement adjustment
Garrido, M. M., & Prigerson, H. G. (2013) · Cancer · doi:10.1002/cncr.28495 · Cited by 131
Self-citationCosts and trends in pancreatic cancer treatment
O’Neill, C. B., Atoria, C. L., O'Reilly, E. M., LaFemina, J., Henman, M. C., & Elkin, E. B. (2012) · Cancer · doi:10.1002/cncr.27490 · Cited by 97
Levin, T. T., Li, Y., Weiner, J. S., Lewis, F., Bartell, A. S., Piercy, J., & Kissane, D. W. (2008) · Palliative & Supportive Care · doi:10.1017/s1478951508000540 · Cited by 96
Wilson, C. J., Newman, J., Tapper, S., Lai, S., Cheng, P. H., Wu, F. M., & Tai-Seale, M. (2013) · Journal of Palliative Medicine · doi:10.1089/jpm.2012.0472 · Cited by 86
Do Not Resuscitate Orders and the Cost of Death
Maksoud, A. (1993) · Archives of Internal Medicine · doi:10.1001/archinte.1993.00410100075011 · Cited by 75
Garrido, M. M., Idler, E. L., Leventhal, H., & Carr, D. (2012) · The Gerontologist · doi:10.1093/geront/gns128 · Cited by 74
Self-citationThe misleading simplicity of advance directives
Hertogh, C. M. P. M. (2011) · International Psychogeriatrics · doi:10.1017/s1041610211000184 · Cited by 60
Use of advance directives in long-term care populations.
Jones, A., Moss, A. J., & Harris-Kojetin, L. (2011) · PubMed · Cited by 57
Cost of illness in patients with metastatic colorectal cancer
Song, X., Zhao, Z., Barber, B., Gregory, C. W., Cao, Z., & Gao, S. (2010) · Journal of Medical Economics · doi:10.3111/13696998.2010.536870 · Cited by 40
Are Advance Directives Associated with Better Hospice Care?
Ache, K. A., Harrold, J. K., Harris, P. S., Dougherty, M., & Casarett, D. (2014) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12851 · Cited by 32
Advance Directives and Cost Savings
Halpern, S. D. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.1399 · Cited by 21
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Early palliative care consultation in the medical ICU: A cluster randomized crossover trial.
Ma, J., Chi, S., Buettner, B., Pollard, K., Muir, M., Kolekar, C., Al-Hammadi, N., Chen, L., Kollef, M., & Dans, M. (2019) · Critical Care Medicine · doi:10.1097/ccm.0000000000004016 · Cited by 166
Starr, L. T., Ulrich, C. M., Corey, K. L., & Meghani, S. H. (2019) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/1049909119848148 · Cited by 132
“Patients who complete ADs may be more likely to prefer less intensive EOL care,36 but Cappell and colleagues (n ¼ 422) found similar odds: Patients with an AD were similarly less likely to receive ICU care within 30 days of death (25% vs 40%, OR ¼ 0.49, P ¼ .001) than patients without ADs.33 Studies did not consistent…”
InfluentialFrequency and Risk Factors for Live Discharge from Hospice
Russell, D., Diamond, E. L., Lauder, B., Dignam, R. R., Dowding, D. W., Peng, T. R., Prigerson, H. G., & Bowles, K. H. (2017) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14859 · Cited by 66
Self-citationRace Differences in Advance Directive Completion
Koss, C. S., & Baker, T. A. (2016) · Journal of Aging and Health · doi:10.1177/0898264316635568 · Cited by 57
Family Caregiving at the End of Life and Hospice Use: A National Study of Medicare Beneficiaries
Kumar, V., Ankuda, C. K., Aldridge, M. D., Husain, M., & Ornstein, K. A. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16648 · Cited by 54
Metadata
- Authors
- Garrido, M. M., Balboni, T. A., Maciejewski, P. K., Bao, Y., & Prigerson, H. G.
- Affiliations
- James J. Peters VA Medical Center (US)
- Harvard University (US)
- Weill Cornell Medicine (US)
- Corresponding author
- Prigerson, Holly G.
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 49
- Issue
- 5
- Pages
- 828-835
- ISSN
- 0885-3924 (ISSN-L)
- PMC
- PMC4441858
- OpenAlex
- W2007677818
- Cited by
- 126
- References
- 35
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 11 · 2023: 14 · 2022: 11 · 2021: 11 · 2020: 14 · 2019: 15 · 2018: 14 · 2017: 12 · 2016: 11 · 2015: 5
- FWCI
- 9.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH63892, K01 MH090087)
- National Cancer Institute (CA 106370)
- Center for Research on End of Life Care (CA 156732)
- Department of Veterans Affairs (CDA 11-201, CDP 12-255)
- Icahn School of Medicine
- NIA (P30 AG028741-01A2)
- Translational Research Institute on Pain in Late Life (5P30AG022845)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- advance directives, do-not-resuscitate orders, end-of-life care, quality of life, cost of care, advanced cancer, living wills, durable power of attorney, resuscitation preferences, postmortem care, caregiver perspectives, Medicare spending
- MeSH terms
- Female, Humans, Male, Neoplasms, Quality of Life, Right to Die, Risk Factors, Terminal Care, United States, Prevalence, Advance Directives, Resuscitation Orders, Health Care Costs
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