Important treatment aims at the end of life: a nationwide study among GPs

Little is known about treatment aims during the last 3 months of life.

To investigate important treatment aims in the last 3 months of patients' lives in cases of non-sudden death.

Mortality follow-back study in The Netherlands.

Data were collected retrospectively in 2009 within the representative Sentinel Network of GPs in The Netherlands. GPs completed a standardised registration form.

Data for 279 patients were studied. Of these, 55% died of cancer and 45% of another disease. Treatment was aimed at palliation for 73% of the patients in months 2 and 3 before death, and for 95% of the patients in the last week of life. Seven per cent received treatment aimed at cure in the last week of life. In a minority of patients, cure/life prolongation and palliation were simultaneously important treatment aims. In the last week of life and in the 2-4 weeks before death, cure was more frequently reported as an important treatment aim in patients with a non-cancer disease than in patients with cancer. In the 2-4 weeks before death, palliation was an important treatment aim for a larger proportion of patients with cancer than patients with other diseases.

Registration by GPs show that, in the last weeks and days of life, cure was more frequently reported as an important treatment aim in patients with a non-cancer disease than in patients with cancer. For a small number of patients, palliation and cure/life prolongation were simultaneously important treatment aims.