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Patients with advanced cancer who spoke with a trained nonclinical worker about personal goals for care were more likely to talk with doctors about their preferences, report higher satisfaction with their care and incur lower health costs in their final month of life, Stanford University School of Medicine researchers report.

The findings, from a pilot study of 213 patients, suggest that patients with a serious illness are more at ease with decisions about their care and more likely to mention their care preferences to health care providers when they discuss those preferences soon after their diagnosis, and on an ongoing basis, with someone outside the medical context, said Manali Patel, MD, assistant professor of medicine at Stanford and the study’s lead author.

She and her colleagues employed a lay health worker to conduct conversations with patients about their personal desires for their care and to encourage them to share this information with providers. The intervention was based on prior research conducted by Patel when she was a fellow at Stanford’s Clinical Excellence Research Center in which patients expressed a preference for having these discussions with nonclinical workers. Though more research is needed, the new study suggests it is a promising approach for

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