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Quality of end-of-life care for dementia patients during acute hospital admission: a retrospective study in Ireland
Afzal N, Buhagiar K, Flood J, Cosgrave M.. General hospital psychiatry, 2009-11-12
Topic: Risk, prevention and care in population studies
Objectives To examine the quality of end-of-life care received by patients with and without dementia on acute medical wards during their final hospitalization. Methods A retrospective clinical case note review of patients aged over 65 who had died on acute medical wards within a 6-month period in a general hospital in Dublin was conducted. Seventy-five multidisciplinary clinical notes were available for scrutiny in order to identify cognitive status, measure the frequency of invasive procedures undertaken and examine the quality of palliative care as benchmarked with the Liverpool Care Pathway for the Dying Patient (LCP) program. Comparison between patients with and without dementia was made. Results Eighteen (24.0%) subjects had dementia, 32 (42.7%) subjects were described as "cognitively intact" and 25 subjects did not have reference to cognitive status. Of the 50 patients with known cognitive status, 27 (54.0%) had had a Mini Mental State Examination (MMSE) conducted (10 dementia vs. 17 nondementia). Patients were equally subjected to invasive interventions regardless of their cognitive status. However, dementia patients were significantly less likely to be referred to palliative care interventions (P=.007), to be prescribed palliative drugs (P=.017) and to have carers involved in decision making (P=.006). Conclusion Individuals with dementia may be receiving different end-of-life care from those without. The effective delivery of robust multidisciplinary frameworks for the palliation of symptoms of hospitalized dementia patients remains an important clinical goal.
Key findings
- Results Eighteen (24.0%) subjects had dementia, 32 (42.7%) subjects were described as "cognitively intact" and 25 subjects did not have reference to cognitive status.
- However, dementia patients were significantly less likely to be referred to palliative care interventions (P=.007), to be prescribed palliative drugs (P=.017) and to have carers involved in decision making (P=.006).
Study details
- Participants25
- Effect size24.0%; 42.7%; 54.0%
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 27 of the 58 points we could judge it on, which is 47 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (General hospital psychiatry) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 25 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 20302987) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 27 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 27 of the 58 points we could judge it on is 47 out of 100. |
| Total | 47 / 100 | — |
What each of these 20 components measures, and what this score is not →
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APA 7th
Afzal, N., Buhagiar, K., Flood, J., & Cosgrave, M. (2010). Quality of end-of-life care for dementia patients during acute hospital admission: a retrospective study in Ireland. General hospital psychiatry. https://doi.org/10.1016/j.genhosppsych.2009.10.003
Vancouver
Afzal N, Buhagiar K, Flood J, Cosgrave M. Quality of end-of-life care for dementia patients during acute hospital admission: a retrospective study in Ireland. General hospital psychiatry. 2010. doi:10.1016/j.genhosppsych.2009.10.003. PMID: 20302987.
BibTeX
@article{afzal2010-20302987,
author = {Afzal, N. and Buhagiar, K. and Flood, J. and Cosgrave, M.},
title = {{Quality of end-of-life care for dementia patients during acute hospital admission: a retrospective study in Ireland}},
journal = {General hospital psychiatry},
year = {2010},
doi = {10.1016/j.genhosppsych.2009.10.003},
pmid = {20302987},
url = {https://doi.org/10.1016/j.genhosppsych.2009.10.003}
}
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