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Care for older patients with co-morbidity

 

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Care for older patients with co-morbidity

The management of end of life care, particularly for patients suffering from more than one medical condition (co-morbidity), could be addressed by GPs having anticipatory care plan (ACP) discussions with patients, suggests a study in this month’s British Journal of General Practice (BJGP).

These discussions between patients, professional carers and sometimes family and friends, help ensure patients’ wishes regarding their final stages of care are widely known.  An advanced directive, or living will can then be drawn up, setting out patients’ wishes in the event of a sudden deterioration in health, which may include decisions such as “do not resuscitate”.

The authors of the study found that more use of ACPs in primary care helped reduce unplanned hospitalisation by 52 per cent as more was understood regarding patients wishes surrounding medical interventions. ACPs did not affect the number of deaths of patients who took part in the study, compared to the control group, but  the number of patients who died in hospital and the hospital bed days used in the last three months of life were significantly lower for decedents with an ACP, saving those patients from medical procedures they may not have wished to endure.