Early discussions about desired end-of-life care, among patients with incurable cancer, were associated with less aggressive treatment in the last month of life, according to a study published this week in the Journal of Clinical Oncology (Nov. 13 online ahead of print).

The American Society of Clinical Oncology (ASCO) highlighted this study for providing “the first-of-its-kind scientific evidence that timing of end-of-life discussions affects decisions” and actual treatment given at the end of a patient’s life.

The study found that nearly 40% of end-of-life discussions with cancer patients happened in the last 30 days of life. Among patients who had such discussions earlier, they were much more likely to receive hospice care and less likely to be treated aggressively at the end of life. Read the rest of this entry »

This week brings some excellent reading about why and how to educate patients so they can help make better decisions about their own care.

What happens when patients get to read their own medical records? The Oct. 2^nd  Annals of Internal Medicine published two editorials and results of a quasi-experimental trial of 100 primary care doctors who voluntarily provided 13,500 patient volunteers with access to their doctors’ notes for a year. To read details, read further, but some results in brief :

• patients loved being able to read their visit report, and 75% said they were more likely to take medicines as directed;
• doctors didn’t see increased patient anxiety, visits, or time demands.

Meanwhile, an expert panel of “thought leaders” gathered by the Institute of Medicine released an in-depth report about helping patients make better care decisions by giving them the best available medical evidence. The results, summarized in an online JAMA article  and discussed by Dr. Robert Miller for ASCO Connections, included:

• 8 in 10 patients want their provider to listen, but only 6 in 10 say it happens;
• 8 in 10 want to hear the full truth about their diagnosis;
• fewer than half of patients say their provider asks about their goals and concerns. Read the rest of this entry »

Patients who go to the doctor prepared with the questions they want answered get better care, according to the federal government’s Agency for Healthcare Research and Quality (AHRQ).

They have a new website that can help you start the communication with your doctor, even before you get to your appointment.

AHRQ says,

Asking questions and providing information to your doctor and other care providers can improve your care. Talking with your doctor builds trust and leads to better results, quality, safety, and satisfaction.

Read the rest of this entry »