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Patient Preferences for Discussing Life Expectancy: a Systematic Review
Emma Bjørk1, Wade Thompson2,3,4, Jesper Ryg4,5,6,7
1Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark. embjorkol@gmail.com.
Journal of General Internal Medicine
|August 2, 2021
Summary
Most patients are willing to discuss life expectancy, but preferences vary significantly. Identifying predictors is challenging due to heterogeneity across age, disease, and cultural factors, emphasizing personalized clinical communication.
Area of Science:
- Medical Communication
- Patient Preferences
- Health Outcomes Research
Background:
- Discussing life expectancy is crucial for informed decisions on preventive care, screening, and personal planning.
- Patient preferences regarding life expectancy discussions are not well understood.
- This study systematically reviewed literature to understand patient willingness to discuss life expectancy and identify predictors.
Approach:
- A comprehensive literature search was conducted across multiple databases (PubMed, Cochrane Library, Embase, MEDLINE, PsycInfo) and gray literature.
- Data from 41 studies (27 quantitative, 14 qualitative) involving 27,570 participants were synthesized.
- Willingness to discuss life expectancy was analyzed, with a focus on heterogeneity and potential predictors based on patient characteristics.
Key Points:
- Willingness to discuss life expectancy varied widely (19-100%), with a median of 61%.
- A majority of studies (77%) reported over half of participants were willing to discuss life expectancy.
- Significant heterogeneity was observed, particularly among cancer patients and those aged 50-64, hindering predictor identification.
Conclusions:
- While most patients are open to discussing life expectancy, a notable proportion is not.
- Heterogeneity in patient preferences complicates the identification of clear predictors.
- Clinicians should prioritize eliciting individual patient preferences when initiating discussions about life expectancy, acknowledging the topic's complexity.
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