Table 2.
Life-ending drug use in general practice without patient's explicit request - aggregated (n = 13)
| Sociodemographic characteristics * | n | |
|---|---|---|
| Age at death | 1-64 years | 3 |
| 65-79 years | 6 | |
| ≥ 80 years | 4 | |
| Sex | Male | 8 |
| Female | 5 | |
| Educational level* | Elementary or lower | 2 |
| Lower secondary | 6 | |
| Higher secondary or more | 4 | |
| Community of Belgium | Dutch community | 6 |
| French community | 7 | |
| Fixed partner at time of death | Yes | 6 |
| No | 7 | |
| Place of death | Home | 8 |
| Care home | 5 | |
| Symptom burden in the last week of life (MSAS-GDI) † | ||
| Physical symptoms | Lack of energy | 12 (6) |
| Pain | 9 (5) | |
| Dry mouth | 8 (5) | |
| Difficulty breathing | 8 (4) | |
| Feeling drowsy | 10 (3) | |
| Constipation | 7 (2) | |
| Lack of appetite | 11 (1) | |
| Psychological symptoms | Feeling sad | 7 (5) |
| Feeling nervous | 9 (4) | |
| Worrying | 6 (4) | |
| Feeling irritable | 5 (3) | |
| End-of-life care provision | ||
| Patient-GP encounters | In last week of life (range) | 1-15 |
| In last 3 months of life (range) | 6-42 | |
| Clinical specialist involved in care in last 3 months of life | None | 4 |
| Sometimes or often | 9 | |
| Informal care over last 3 months of life | None | 1 |
| Sometimes or often | 12 | |
| Treatment goal over last 3 months of life | Comfort/palliation | 5 |
| Transition to comfort/palliation | 8 | |
| Consideration of curative or life-prolonging treatments by GP ‡ | Not possible anymore | 7 |
| Still possible but not applied | 6 | |
| Reasons why not applied § | Physician deemed chance for improvement too small | 4 |
| Physician wanted to end further suffering | 4 | |
| Patient refused treatment (verbally or non-verbally) | 2 | |
| Proxies wanted to end further suffering | 1 | |
| Proxies were psychologically and physically exhausted | 1 | |
| Consideration of alternative palliative treatments by GP ‡ | Not possible anymore | 10 |
| Still possible but not applied | 3 | |
| Reasons why not applied § | Physician did not want to prolong patient's life | 1 |
| Physician wanted to end further suffering | 2 | |
| Patient refused treatment | 1 | |
| Multidisciplinary palliative home care team involved in last three months of life | Yes | 4 |
| No | 9 | |
* Missing values for level of education n = 1;
† Symptoms that were present during the last week before death, despite possible treatment. Between brackets: symptoms that distressed the patient, if present. Distress levels were measured for all but one case (patient comatose during last week) using the MSAS-GDI. Psychological symptoms were considered to have caused distress if patient did appear to feel this way "frequently" or "almost constantly". Physical symptoms were considered to have caused distress if symptom distressed the patient "quite a bit" or "very much"
‡ At the time of the decision making
§Multiple answers were possible;