Clinicians’ and public acceptability of universal risk-of-death screening for older people in routine clinical practice in Australia: cross-sectional surveys

Background Clinicians’ delays to identify risk of death and communicate it to patients nearing the end of life contribute to health-related harm in health services worldwide. This study sought to ascertain doctors, nurses and senior members of the public’s perceptions of the routine use of a screeni...

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Bibliographic Details
Published in:Aging clinical and experimental research 2021-04, Vol.33 (4), p.1063-1070
Main Authors: Lewis, Ebony T., Harrison, Reema, Nicholson, Margaret, Hillman, Ken, Trankle, Steven, Rangel, Shirley, Stokes, Claire, Cardona, Magnolia
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Australia
Clinical medicine
Cross-Sectional Studies
Decision making
Elder care
Geriatrics/Gerontology
Humans
Intensive care
Male
Mass Screening
Medical prognosis
Medicine
Medicine & Public Health
Nurses
Older people
Original Article
Palliative care
Patients
Physicians
Polls & surveys
Surveys and Questionnaires
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Summary:Background Clinicians’ delays to identify risk of death and communicate it to patients nearing the end of life contribute to health-related harm in health services worldwide. This study sought to ascertain doctors, nurses and senior members of the public’s perceptions of the routine use of a screening tool to predict risk of death for older people. Methods Cross-sectional online, face-to-face and postal survey of 360 clinicians and 497 members of the public. Results Most (65.9%) of the members of the public welcomed (and 12.3% were indifferent to) the use of a screening tool as a decision guide to minimise overtreatment and errors from clinician assumptions. Supporters of the use of a prognostic tool were likely to be males with high social capital, chronically ill and who did not have an advance health directive. The majority of c linicians (75.6%) reported they were likely or very likely to use the tool, or might consider using it if convinced of its accuracy. A minority (13.3%) stated they preferred to rely on their clinical judgement and would be unlikely to use it. Differentials in support for tools by seniority were observed, with more support expressed by nurses, interns and registrars than medical specialists ( χ 2  = 12.95, p  = 0.044) and by younger (
ISSN:1720-8319
1594-0667
1720-8319
DOI:10.1007/s40520-020-01598-w