Missed opportunities! End of life decision making and discussions in implantable cardioverter defibrillator recipients Academic Article uri icon

abstract

  • BACKGROUND:Recent guidelines highlight the need for clinician-patient discussions regarding end-of-life (EOL) choices prior to implantable cardioverter defibrillator (ICD) implantation. Health literacy could affect the quality and quantity of such discussions. OBJECTIVE:Our objective was to determine the association of health literacy with experiences, attitudes, and knowledge of the ICD at EOL. METHODS:In this cross-sectional study, we used validated instruments to measure health literacy and patient experiences, attitudes, and knowledge of the ICD at EOL. RESULTS:Of the 240 ICD recipients, 76% of participants reported never having discussed the implications of a future withdrawal of defibrillation therapy with their healthcare provider. Increased odds of choosing to maintain defibrillation therapy were associated with female gender and lower ICD knowledge. CONCLUSIONS:From patients' perspectives, EOL discussions with providers were minimal. Most patients hold misperceptions about ICD function that could interfere with optimal EOL care, particularly for those with inadequate health literacy.

authors

  • Miller, Jennifer L
  • Chung, Misook L
  • Etaee, Farshid
  • Hammash, Muna
  • Thylén, Ingela
  • Biddle, Martha J
  • Elayi, Samy C
  • Czarapata, Mary M
  • McEvedy, Samantha
  • Cameron, Jan
  • Haedtke, Christine A
  • Ski, Chantal F
  • Thompson, David R
  • Moser, Debra K

publication date

  • 2019

has subject area