People aged 65–84 years (n=1126) | People aged 85 years and older (n=1203) | |||||||||
Belgium (n=718) | Italy (n=254) | Spain (n=154) | Belgium (n=690) | Italy (n=342) | Spain (n=171) | |||||
n (%) | n (%) | OR (95% CI) | n (%) | OR (95% CI) | n (%) | n (%) | OR (95% CI) | n (%) | OR (95% CI) | |
1. Pain measured often or very often in last 3 months of life | 318 (46.2) | 58 (23.2) | 0.25 (0.14 to 0.43) | 87 (64.9) | 2.75 (1.41 to 5.37) | 303 (45.1) | 50 (14.8) | 0.20 (0.11 to 0.39) | 75 (46.6) | 1.94 (1.00 to 3.77) |
2. GP thinks that patient was able to accept their approaching end completely or for the most part* | 393 (55.4) | 98 (39.2) | 0.33 (0.20 to 0.52) | 69 (49.6) | 0.70 (0.40 to 1.22) | 423 (62.8) | 167 (49.1) | 0.44 (0.25 to 0.76) | 64 (38.8) | 0.27 (0.15 to 0.49) |
3.1. GP discussed at least three illness-related topics† with patient | 381 (60.8) | 50 (19.7) | 0.12 (0.07 to 0.20) | 44 (44.0) | 0.28 (0.16 to 0.48) | 254 (46.9) | 32 (9.4) | 0.09 (0.05 to 0.16) | 21 (32.8) | 0.49 (0.25 to 0.96) |
3.2. GP was aware of patient preferences about medical treatments | 309 (43.5) | 37 (14.6) | 0.16 (0.10 to 0.27) | 28 (18.4) | 0.18 (0.11 to 0.31) | 235 (34.3) | 39 (11.6) | 0.21 (0.12 to 0.35) | 19 (11.2) | 0.20 (0.11 to 0.37) |
4. GP discussed at least three illness-related topics† with family | 492 (76.4) | 209 (82.3) | 1.50 (0.90 to 2.49) | 114 (86.4) | 1.92 (1.03 to 3.57) | 514 (81.2) | 282 (82.5) | 1.17 (0.72 to 1.90) | 127 (82.5) | 1.19 (0.67 to 2.10) |
5. Multidisciplinary consultation at least once a week during the last month of life | 246 (35.2) | 46 (18.5) | 0.38 (0.23 to 0.63) | 35 (25.9) | 0.44 (0.26 to 0.74) | 259 (38.4) | 44 (13.1) | 0.29 (0.17 to 0.52) | 16 (10.0) | 0.15 (0.08 to 0.30) |
6. Palliative care services involved in last 3 months of life | 407 (62.3) | 113 (48.1) | 0.56 (0.35 to 0.88) | 112 (88.9) | 4.81 (2.41 to 9.61) | 376 (60.5) | 57 (18.3) | 0.18 (0.11 to 0.30) | 102 (77.3) | 3.1 (1.71 to 5.53) |
7. Patient did not die in hospital‡ | 468 (66.5) | 162 (63.8) | 1.05 (0.70 to 1.58) | 88 (61.1) | 0.94 (0.59 to 1.48) | 507 (74.9) | 246 (72.4) | 1.71 (1.18 to 2.48) | 109 (67.3) | 1.02 (0.66 to 1.57) |
8. GP contacted or plans to contact relatives about bereavement counselling | 482 (68.2) | 170 (67.7) | 1.29 (0.73 to 2.29) | 109 (72.7) | 1.20 (0.67 to 2.14) | 436 (64.1) | 229 (68.6) | 0.93 (0.54 to 1.63) | 112 (67.1) | 0.97 (0.55 to 1.73) |
Reference group=Belgium.
Tested for the differences between countries using generalised linear mixed models to account for clustering at general practitioner level and to adjust for patient characteristics that differed between the countries.
People aged 65–84 years: Missing data, n (%): Pain measured, 53 (4.7), accepted death, 27 (2.4), discussion with patient,145 (12.9), preference medical treatments,10 (0.9), discussion with family, 96 (8.5), multidisciplinary consultation, 44 (3.9), palliative care services involved, 112 (9.9), place of death, 24 (2.1), bereavement counselling, 18 (1.6).
People aged 85 years and older: Missing data, n (%): Pain measured, 32 (2.7), accepted death, 24 (2.0), discussion with patient, 255 (21.2), preference medical treatments, 11 (0.9), discussion with family, 74 (6.2), multidisciplinary consultation, 31 (2.6), palliative care services involved, 138 (11.5), place of death, 24 (2.0), bereavement counselling, 22 (1.8).
*Excluded ‘don’t know’ (people aged 65–84 years, 293, people aged 85 years and older, 387).
†The topics discussed were diagnosis, course of the disease/prognosis, the approaching end of life, advantages and disadvantages of the treatments, options in terms of end-of-life care.
‡Regular hospital wards excluding palliative care units.
CI, confidence interval; GP, general practitioner; OR, odds ratio.