寿命を延ばす治療の選択と,高齢者の医療利用と終末期の経験との関連
Lesli E Skolarus1, Chun Chieh Lin2, Sara Hassani1
1Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Journal of the American Geriatrics Society
|August 29, 2025
まとめ
高齢者の寿命延長治療 (LPT) の好みは,医療の使用や終末期の経験に有意な影響を及ぼさなかった. これらの偏好が 介護の決定にどのように役立つかを理解するには さらに研究が必要である.
科学分野:
- ゲロントロジー
- 医療サービス研究
- 緩和ケア
背景:
- 寿命延長治療 (LPT) に関する個人の好みは大きく異なります.
- LPTの好みとヘルスケアの利用の関係を理解することは,終末期ケア (EOL) にとって極めて重要です.
研究 の 目的:
- LPTの好みと医療利用と高齢者のEOL経験との関連を調査する.
主な方法:
- 5373人の高齢者を対象にMedicare/Medicaidに関連したNHATSデータを用いた遡及コホート研究.
- 重度の障害や痛みのシナリオにおけるLPT偏好の分類 (受け入れ/拒否)
- 医療利用,費用,自宅から離れている日,死亡場所,EOLの経験の評価
主要な成果:
- 高齢者の69%は全てのLPTを拒否する. 偏好は障害や痛みのシナリオによって異なります.
- LPTの好みと入院,ICUの訪問,LPTの受付,またはコストとの間には関連性はありません.
- 痛みを治療するためにLPTを服用すると,外出日数が増加し,重度の障害/痛みを治療するためにLPTを服用すると,病院での死亡率が増加しました.
結論:
- 仮説的なLPTの好みは,医療利用,費用,またはEOLの医療品質と関連していなかった.
- 偏好の測定,現実世界の変化,そして介護に影響を与える研究も必要である.
- EOLのケアには 患者の好みを理解し 組み込むことが不可欠です
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