Gadoud, Amy, Kane, Eleanor Victoria orcid.org/0000-0002-7438-9982, Oliver, Steven Edward orcid.org/0000-0002-1637-7692 et al. (3 more authors) (2020) Palliative care for non-cancer conditions in primary care:a time trend analysis in the UK (2009-2014). BMJ Supportive & Palliative Care. ISSN 2045-4368
Abstract
Objectives Whilst guidelines recommend palliative care in non-cancer conditions, this has not been widely implemented. We examined whether the recording of a palliative care approach and the numbers of hospital deaths for deceased patients with heart failure, dementia, chronic obstructive pulmonary disease (COPD) and cancer have changed since the UK End of Life Care Strategy was introduced. Methods We conducted sequential cross-sectional studies of decedents within the UK’s Clinical Practice Research Datalink and Hospital Episode Statistics. All adults with a primary care record of COPD (N=5,426), dementia (N=7,339), heart failure (N=6,409) or cancer (N=18,668) who died during three one-year periods (April 2009-March 2014) were included. Evidence of a palliative care approach was identified from primary care records, and death in hospital from secondary care data. Results From 2009 to 2014, proportions with a primary care record of palliative care increased for COPD from 13.6% to 21.2%; dementia from 20.9% to 40.7%; and heart failure from 12.6% to 21.2%; but remained substantially lower than for cancer (57.6% to 61.9%). Median days before death of recording improved for COPD (145 to 224) and dementia (44 to 209); but not for heart failure (168.5 to 153) and cancer (123 to 114). Trends in hospital deaths were not consistently downward, although the proportions of patients dying in hospital were lower in the last period compared to the first. Conclusions Recording of a palliative care approach for non-cancer conditions has increased since the introduction of the UK End of Life Care Strategy, but remains inadequate.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2020. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details. |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) The University of York > Faculty of Sciences (York) > Hull York Medical School (York) |
Depositing User: | Pure (York) |
Date Deposited: | 17 Dec 2019 13:20 |
Last Modified: | 03 Dec 2024 11:00 |
Published Version: | https://doi.org/10.1136/bmjspcare-2019-001833 |
Status: | Published online |
Refereed: | Yes |
Identification Number: | 10.1136/bmjspcare-2019-001833 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:154722 |
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