Patient-clinician communication about end-of-life care for Dutch and US patients with COPD

Abstract

Improving patient-clinician communication about end-of-life care is important to enhance quality of care for patients with COPD. Our objective was to compare quality of patient-clinician communication about end-of-life care and endorsement of barriers and facilitators to this communication in the Netherlands and US.

The present study is an analysis of survey data from 122 Dutch and 391 US outpatients with COPD. We compared quality of patient-clinician communication about end-of-life care (Quality of Communication questionnaire) and barriers and facilitators to communication about end-of-life care (Barriers and Facilitators questionnaire) between the Netherlands and the US controlling for patients' demographic and illness characteristics.

Although Dutch patients in this study had worse lung function and disease-specific health status than US patients, Dutch patients reported lower quality of communication about end-of-life care (median score (inter-quartile range): 0.0 (0.0–2.0) vs. 1.4 (0.0–3.6), adjusted p<0.005). Clinicians in both countries rarely discussed life-sustaining treatment preferences, prognoses, dying processes, and spiritual issues.

Quality of communication about end-of-life care needs to improve in the Netherlands and the US. Future studies to improve this communication should be designed to take into account international differences and patient-specific barriers and facilitators to communication about end-of-life care.