12 / 14
allied
academies
Page 26
International Journal of Respiratory Medicine
|
Volume 3
LUNG CANCER AND COPD
5
th
International Congress on
J u n e 2 5 - 2 6 , 2 0 1 8 | A m s t e r d a m , N e t h e r l a n d s
Lynn F Reinke et al., Int J Respir Med 2018, Volume 3
ONE CONVERSATION IS NOT ENOUGH:
THE LONG-TERM IMPACT OF AN
END-OF-LIFE COMMUNICATION
INTERVENTION AMONG PATIENTS
WITH COPD
Lynn F Reinke, Laura C Feemster, Jennifer McDowell, Eric
Gunnick, Erica V Tartaglione, Edmund Udris, J Randall Curtis
and
David H Au
University of Washington, USA
Aim:
The aim of the project is to assess if an end-of-life communication
intervention with patients with COPD led to higher long-term
documentation of advance care planning discussions at the end-of-life.
Background:
We previously demonstrated that providing clinicians a
patient-specificfeedbackformaboutpatients’communicationpreferences
improved the occurrence and quality of clinician communication about
end-of-life care.
Methods:
Among those individuals enrolled in the intervention study
(2004-2007) who had died during the follow-up period (up to 2013),
we assessed if patients in the intervention arm had more goals of care
discussions and formal advance directives completed as compared to
controls. We conducted logistic models accounting for provider level
clustering, adjusting for age, FEV1 and race.
Results:
Among the 376 patients, 157 died (76 in the intervention arm, 81
controls). Over an average duration of 3.6 years (time of the first study
appointment to death), 73% patients engaged in 451 unique end-of-life
care discussions. The intervention was not associated with a higher
percentage of patients with documented end-of-life conversations (I:C
75% vs. 72%, p=0.63) or completion of advance care directives (26% vs.
29%, p=0.55).
Conclusions:
Despite initially improving the occurrence of end-of-life
conversations, the intervention did not increase documentation of
subsequent conversations about end-of-life care, nor did it improve
documentation of advance directives. Future research should focus on
testing multi-faceted, longitudinal, system-level interventions to enhance
conversations about goals of care that promote goal-concurrent care.
Lynn F Reinke has completed her PhD in Biobe-
havioral Science at the University of Washing-
ton, School of Nursing and a post-doctoral fel-
lowship at the Department of Veterans Affairs.
Her program of research focuses on improving
the delivery of palliative care for patients with
advanced, serious illnesses specifically COPD,
lung cancer and multi-morbidities. She has
conducted several studies testing methods to
improve clinicians end-of-life communication
skills for patients with advanced illnesses. She
is sought out for her clinical expertise in manag-
ing patients with severe dyspnea and dyspnea
crisis episodes. She has over 40 publications in
peer-reviewed journals and has presented her
research nationally and internationally. She is
an elected member of the National Academy of
Nursing and serves in leadership roles for the
American Thoracic Society. She has completed
her Health and Aging Policy Fellowship in 2017.
reinkl@uw.eduBIOGRAPHY