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  1. Can clinical Interventions change care at the end of life ?

    Article - En anglais


    To review clinical interventions designed to change care at the end of life.

    Data Sources 

    Published results of clinical trials identified by MEDLINE searches, review of abstracts from meetings, and selected bibliographies.

    Study Selection 

    Studies were included if data were presented on a clinical intervention designed to change medical care at the end of life.

    Studies done in nonclinical settings or outside the United States were excluded.

    Data Extraction 

    Interventions were classified as targeting patients, physicians, or both and were analyzed by their effect on four common clinical goals : increasing use of patient preferences, decreasing pain and suffering, reducing use of life-sustaining treatments, and reducing costs.

    Positive and negative trial results were compared for differences in intervention, target group, and strength of study methods.

    Data Synthesis 

    Educational interventions usually increased expression of patient treatment preferences.

    Success rates were higher when more severely ill patients were targeted and when written materials were combined with repeated discussions in clinical encounters.

    Educational interventions with physicians led to increased use of patient preferences, but sophisticated educational techniques were needed to motivate physicians to change their behavior.

    Three studies provided limited evidence that physician education reduced the use of life-sustaining treatments. (...)

    Mots-clés Pascal : Intervention, Soin, Modification, Extrémité, Vie physiologique, Malade, Synthèse bibliographique, Ethique, Homme

    Mots-clés Pascal anglais : Operation, Care, Modification, End, Life (physiology), Patient, Bibliographic survey, Ethics, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0196982

    Code Inist : 002B30A09. Création : 21/05/1997.