JAMA Internal Medicine · 9 authors, 3 centres
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This survey study of 933 patients on maintenance dialysis found that while most valued comfort-focused care if seriously ill, their expressed values did not lead to significant differences in their engagement in advance care planning or the intensity of end-of-life care they received.
The study analyzed survey data from 933 patients receiving maintenance dialysis to assess how their expressed values regarding comfort versus life prolongation related to advance care planning and end-of-life care. The most common value preference was for comfort-focused care (48.4%). However, regardless of their stated values, most patients had not engaged in advance care planning, such as completing an advance directive. The study suggests a disconnect between patient values and actual care, potentially due to challenges in advance care planning and health system defaults favoring aggressive care.
