• J Palliat Med · May 2023

    Elements of Potentially Inappropriate Interventions and Patient Prognostic Profiles at the End of Life in Cardiology: A Qualitative Analysis.

    • Jamie J Lo, Sungwon Yoon, NeoShirlyn Hui ShanSHS0000-0003-2811-1661Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore., SimDavid Kheng LengDKLNational Heart Centre Singapore, Singapore, Singapore., and Nicholas Graves.
    • Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
    • J Palliat Med. 2023 May 1; 26 (5): 700703700-703.

    AbstractBackground: The determination of what makes a medical treatment inappropriate is unclear with a small likelihood of consensus. Objectives: This study aimed to explore how clinicians in cardiology perceive "inappropriate treatment" and to collate the common profiles of cardiology patients receiving likely "inappropriate treatment" as perceived by clinicians in a multiethnic Asian context. Methods: A qualitative study was conducted using semistructured in-depth interviews with 32 clinicians involved in the care for cardiology patients at a large national cardiology center in Singapore. Results: Clinicians' accounts indicated that elements of potentially inappropriate treatment encompass patient-related treatment elements as well as quantitative and probability-based elements such as resource use and probability of treatment benefit. Patient prognostic profiles, characterized as likely to have received inappropriate treatment by clinicians, were organized into six categories according to demographic, clinical, and functional factors. Conclusions: The perception of inappropriateness of treatments among clinicians in cardiology was primarily focused on patient-related outcomes. Collated patient profiles may serve as meaningful indicators of patient cases receiving potentially inappropriate treatment for further research and intervention.

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