Acceptance of Advance Directives and Palliative Care Referral for Veterans With Advanced Cancer: A Retrospective Analysis

Am J Hosp Palliat Care. 2016 Sep;33(8):742-7. doi: 10.1177/1049909115595216. Epub 2015 Jul 12.

Abstract

Objectives: To evaluate the documentation of advance directive (ADs) and physician orders for life-sustaining treatment (POLST) with acceptance of palliative care (PC) services referral among patients with cancer.

Methods: We retrospectively reviewed veterans with advanced cancers at the Veterans Administration Palo Alto Health Care System. Chi-square tests estimated AD and POLST documentation and referral to PC. Logistic regression models estimated the odds of AD and POLST documentation and PC referral.

Results: Two hundred and forty-six veterans were diagnosed with cancer. In all, 53% had a documented AD, 5% had a POLST, and 47% accepted referral to PC. The AD documentation was not associated with acceptance of PC.

Discussion: We found no association of AD documentation and PC referral. Future studies should evaluate other factors that influence referral to these services.

Keywords: advance directives; advanced cancer; end of life; hospice; palliative care; veterans administration.

MeSH terms

  • Adult
  • Advance Directives / statistics & numerical data*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Documentation
  • Female
  • Humans
  • Life Support Care / statistics & numerical data*
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Palliative Care / statistics & numerical data*
  • Racial Groups
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • Veterans / statistics & numerical data*