Findings from SUPPORT and HELP: an introduction

Article Abstract:

An introduction to the findings of the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) and the Hospitalized Elderly Longitudinal Project (HELP), a companion study, is presented. Questions about the appropriate use of life-extending technology when the remaining life of the patient was likely to be short and the cost and technological complexity of the care were likely to be high inspired the studies.

Health aspects, Aging, Practice, Geriatrics, Robert Wood Johnson Foundation

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Age-related differences in care preferences, treatment decisions, and clinical outcomes of seriously ill hospitalized adults: lessons from SUPPORT

Article Abstract:

Age-related differences in treatment decisions, care preferences, and clinical outcomes of seriously ill hospitalized adults as seen from the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) are discussed. It was found that seriously ill hospitalized older patients were treated less aggressively than younger patients. This was true even after adjustment for prognoses and care preferences of patients. It may be that excessive provision of ineffective treatment to younger patients was more responsible than was less aggressive treatment of the older patients. It was seen that less aggressive treatment of older patients does not contribute to the modest survival disadvantage for the elderly.

Demographic aspects, Description and travel

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Communication and decision-making in seriously ill patients: findings of the SUPPORT project

Article Abstract:

Communication and decision-making in seriously ill patients as seen from findings of the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) project are discussed. It was found by study of published reports of the study that physicians and surrogates are often not aware of the preferences of seriously ill patients relative to care. The care given those patients is often not in line with their preferences. It is often not associated with factors other than preferences or prognoses. Simple interventions may not be enough to improve end-of-life care deficiencies. Systematic change may be required.

Standards, Research, Prevention, Medical care, Terminally ill persons, Terminally ill, Physician and patient, Physician-patient relations, Physicians, Medical professions, Prognosis, Training, Beliefs, opinions and attitudes, Ethical aspects, Death, Advance directives (Medicine), Nursing home patients, Bioethics, Durable power of attorney

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