TY - JOUR
T1 - The Oncology Specialist’s Role in POLST Form Completion
AU - Lammers, Austin J.
AU - Zive, Dana
AU - Tolle, Susan W.
AU - Fromme, Erik
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Susan W. Tolle received salary support from The Retirement Research Foundation and the California HealthCare Foundation. Dana M. Zive receives salary support from the Oregon POLST Registry and has received POLST-related funding from the California HealthCare Foundation.
Publisher Copyright:
© 2017, © The Author(s) 2017.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Introduction: Patients with cancer and oncology professional societies believe that advance care planning is important, but we know little of who actually has this conversation. Physician Orders for Life-Sustaining Treatment (POLST) forms can help to document these important conversations to ensure patients receive the level of treatment they want. We therefore sought to determine the specialty of those signing POLST forms for patients who died of cancer to better understand who is having this discussion with patients. Methods: Retrospective cohort study including all deaths due to cancer in Oregon between January 1, 2010, and December 31, 2011. Death certificates were matched to POLST forms in the Oregon POLST Registry, and the signing physician’s specialty was determined using the Oregon Medical Board’s database. Results: A total of 14 979 people died of cancer in Oregon in 2010 to 2011. Of which, 6145 (41.0%) had at least 1 POLST form in the Registry. Oncology specialists signed 14.9% of POLST forms, compared to 53.7% by primary care, 15.3% by hospice/palliative care, 12.8% by advanced practice providers, and 2.7% by other specialists; 51.8% of oncology specialists did not sign a POLST form, whereas 12.5% completed 10 or more. Conclusion: Oncology specialists play a central role in caring for patients with cancer through the end of their lives, but not in POLST completion. Whether or not they actually sign their patients’ POLST forms, oncology specialists in the growing number of POLST states should integrate POLST into their goals of care conversations with patients nearing the end of life.
AB - Introduction: Patients with cancer and oncology professional societies believe that advance care planning is important, but we know little of who actually has this conversation. Physician Orders for Life-Sustaining Treatment (POLST) forms can help to document these important conversations to ensure patients receive the level of treatment they want. We therefore sought to determine the specialty of those signing POLST forms for patients who died of cancer to better understand who is having this discussion with patients. Methods: Retrospective cohort study including all deaths due to cancer in Oregon between January 1, 2010, and December 31, 2011. Death certificates were matched to POLST forms in the Oregon POLST Registry, and the signing physician’s specialty was determined using the Oregon Medical Board’s database. Results: A total of 14 979 people died of cancer in Oregon in 2010 to 2011. Of which, 6145 (41.0%) had at least 1 POLST form in the Registry. Oncology specialists signed 14.9% of POLST forms, compared to 53.7% by primary care, 15.3% by hospice/palliative care, 12.8% by advanced practice providers, and 2.7% by other specialists; 51.8% of oncology specialists did not sign a POLST form, whereas 12.5% completed 10 or more. Conclusion: Oncology specialists play a central role in caring for patients with cancer through the end of their lives, but not in POLST completion. Whether or not they actually sign their patients’ POLST forms, oncology specialists in the growing number of POLST states should integrate POLST into their goals of care conversations with patients nearing the end of life.
KW - POLST
KW - advance care planning
KW - cancer
KW - end of life
KW - oncologist
KW - oncology
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U2 - 10.1177/1049909117702873
DO - 10.1177/1049909117702873
M3 - Article
C2 - 28413928
AN - SCOPUS:85040324932
VL - 35
SP - 297
EP - 303
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
SN - 1049-9091
IS - 2
ER -