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

Claessen, S.J.J., Echteld, M.A., Francke, A.L., Block, L. van den, Donker, G.A., Deliens, L. Important treatment aims at the end of life: a nationwide study among GPs. British Journal of General Practice: 2012, 62(595), e121-e126
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Background: Little is known about treatment aims during the last 3 months of life. Aim: To investigate important treatment aims in the last 3 months of patients' lives in cases of on-sudden death. Design and setting: Mortality follow-back study in the Netherlands. Method: data were collected retrospectively in 2009 within the representative Sentinel Network of GPs in the Netherlands. GPs completed a standardised registration form. Results: 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. Conclusion: 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. (aut. ref.)
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