Is annual income a predictor of completion of advance directives (ADs) in patients with cancer

Article indépendant

SAEED, Fahad | XING, Guibo | TANCREDI, Daniel J. | EPSTEIN, Ronald M. | FISCELLA, Kevin A. | NORTON, Sally A. | DUBERSTEIN, Paul R.

CONTEXT: Completion of advance directives (ADs) enhances the likelihood of receiving goal-concordant treatments near the end of life. Previous research on community samples have shown that completion of ADs is less common in lower socioeconomic status demographic group; there is a paucity of such research in patients with cancer. OBJECTIVES: To study the effect of income and education on the completion of ADs. HYPOTHESIS: Patients with cancer having lower incomes and education levels would be less likely to report completing ADs. METHODS: We conducted cross-sectional analyses of data provided by patients (n = 265) enrolled in the Values and Options in Cancer Care clinical trial. Patients with advanced cancer reported whether they had (1) completed a living will or (2) designated a health-care proxy. Response options for both questions were yes (scored 1), no (scored 0), and unsure (scored 0). We studied the association of lower household income (=US$20 000) and education level (never attended college) with AD scores. RESULTS: Patients with lower annual incomes had lower AD scores (estimate -0.44; confidence intervals [CI]: -0.71 to -0.16, P = .001); the association between higher educational attainment (some college or more) and completion of ADs was not statistically significant (estimate 0.04, CI: -0.16 to 0.24, P = .70). CONCLUSION: Interventions to promote completion of ADs among lower income patients with serious illnesses are needed.

http://dx.doi.org/10.1177/1049909118813973

Voir la revue «The American journal of hospice and palliative care, 36»

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