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

Abstract

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 non-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.