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Doctors' reports about palliative systemic treatment: A medical record study
Hilde M Buiting1,2, Mirian Brink1, Marleen N Wijnhoven1,3
11 Department of Registry and Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
Palliative Medicine
|August 6, 2016
Summary
Doctors
Area of Science:
- Oncology
- Palliative Care
- Medical Informatics
Background:
- Palliative systemic treatment decisions are crucial in end-of-life cancer care.
- These decisions are often complex and require careful consideration.
Purpose of the Study:
- To analyze the documentation of palliative systemic treatment decisions in medical records.
- Focus on advanced non-small cell lung and pancreatic cancer patients.
Main Methods:
- Retrospective review of 147 cancer patient medical records (2009-2012).
- Analysis of 276 doctor's notes concerning palliative systemic treatment.
- Utilized nationwide Netherlands Cancer Registry for patient selection.
Main Results:
- 75% of notes mentioned considerations for starting/continuing treatment.
- Prognosis (47%) and patient wishes (33%) were key documented factors.
- Comorbidity (82%) and smoking status (78%) were frequently recorded, unlike performance status (16%).
- Patient/family discussions documented in 49% of notes.
- Treatment response and dose adaptations recorded in 75% and 71% of treated patients, respectively.
Conclusions:
- Medical records offer insights into palliative treatment decision-making.
- Significant variability exists in the detail of doctors' notes regarding treatment considerations.
- Future research should focus on optimizing medical records for evaluating end-of-life care quality.
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