Missed opportunities! End of life decision making and discussions in implantable cardioverter defibrillator recipients

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

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)313-319
Number of pages7
JournalHeart and Lung
Volume48
Issue number4
DOIs
StatePublished - Jul 1 2019

Keywords

  • End of life
  • End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire
  • Hospital Anxiety and Depression Scale
  • Implantable cardioverter defibrillator
  • Newest Vital Sign

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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    Miller, J. L., Chung, M. L., Etaee, F., Hammash, M., Thylén, I., Biddle, M. J., Elayi, S. C., Czarapata, M. M., McEvedy, S., Cameron, J., Haedtke, C. A., Ski, C. F., Thompson, D. R., & Moser, D. K. (2019). Missed opportunities! End of life decision making and discussions in implantable cardioverter defibrillator recipients. Heart and Lung, 48(4), 313-319. https://doi.org/10.1016/j.hrtlng.2019.04.006