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Trends in medical end-of-life practices in Belgium, 1998-2001-2007

(2010) PALLIATIVE MEDICINE. 24(4, suppl.). p.S154-S155
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Abstract
Aim: After two large scale studies on medical end-of-life practices in Belgium in 1998 and 2001, we conducted a follow-up study in 2007 to investigate trends in frequency and characteristics of these practices and differences before and after the enactment of the laws on palliative care and on euthanasia in 2002. Methods: We drew a stratified at random sample of 6927 cases from all deaths that occurred between June and November 2007 in Flanders, Belgium and mailed questionnaires about medical end-of-life practices to the certifying physicians. Results: Response rate was 58.4%. In 2007, the rate of intensified pain alleviation in Flanders increased from 18.4% of all deaths in 1998 and 22.0% in 2001 to 26.7% in 2007, and that of non-treatment decisions from 14.6 % in 2001 to 17.4% in 2007. In 1.9% of all deaths physicians reported euthanasia, a rate that was higher than that in 1998 (1.1%) and 2001 (0.3%). The rate of lethal drug use without the patient’s explicit request was lower in 2007 (1.8% of all deaths) than that in 1998 (3.2%), but similar to that in 2001 (1.5%). No shift in characteristics of patients whose death was the result of using these drugs was found. In 14.5% of all deaths in 2007, physicians reported continuous and deep sedation until death, which was substantially more often than in 2001 (8.2%). In 2007, physicians discussed medical end-of-life practices more often with competent patients, relatives and colleagues than in 1998. Conclusion: The enactment of the Belgian laws on palliative care and on euthanasia was followed by an increase in all types of medical end-of-life practices, with the exception of the use of lethal drugs without patient’s explicit request. No shift toward the use of life-ending drugs in vulnerable patient groups was observed. The substantial increase in the frequency of deep sedation demands more in-depth research. Funding: Institute for the Promotion of Innovation by Science and Technology - Flanders.

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Chicago
Bilsen, Johan, Joachim Cohen, Kenneth Chambaere, Geert Pousset, BD Onwuteaka-Philipsen, Freddy Mortier, and Luc Deliens. 2010. “Trends in Medical End-of-life Practices in Belgium, 1998-2001-2007.” In Palliative Medicine, 24:S154–S155.
APA
Bilsen, J., Cohen, J., Chambaere, K., Pousset, G., Onwuteaka-Philipsen, B., Mortier, F., & Deliens, L. (2010). Trends in medical end-of-life practices in Belgium, 1998-2001-2007. PALLIATIVE MEDICINE (Vol. 24, pp. S154–S155). Presented at the 6th Research congress of the European Association for Palliative Care (EAPC 2010).
Vancouver
1.
Bilsen J, Cohen J, Chambaere K, Pousset G, Onwuteaka-Philipsen B, Mortier F, et al. Trends in medical end-of-life practices in Belgium, 1998-2001-2007. PALLIATIVE MEDICINE. 2010. p. S154–S155.
MLA
Bilsen, Johan, Joachim Cohen, Kenneth Chambaere, et al. “Trends in Medical End-of-life Practices in Belgium, 1998-2001-2007.” Palliative Medicine. Vol. 24. 2010. S154–S155. Print.
@inproceedings{1002193,
  abstract     = {Aim: After two large scale studies on medical end-of-life practices in Belgium in 1998 and 2001, we conducted a follow-up study in 2007 to investigate trends in frequency and characteristics of these practices and differences before and after the enactment of the laws on palliative care and on euthanasia in 2002. Methods: We drew a stratified at random sample of 6927 cases from all deaths that occurred between June and November 2007 in Flanders, Belgium and mailed questionnaires about medical end-of-life practices to the certifying physicians.
Results: Response rate was 58.4\%. In 2007, the rate of intensified pain alleviation in Flanders increased from 18.4\% of all deaths in 1998 and 22.0\% in 2001 to 26.7\% in 2007, and that of non-treatment decisions from 14.6 \% in 2001 to 17.4\% in 2007. In 1.9\% of all deaths physicians reported euthanasia, a rate that was higher than that in 1998 (1.1\%) and 2001 (0.3\%). The rate of lethal drug use without the patient{\textquoteright}s explicit request was lower in 2007 (1.8\% of all deaths) than that in 1998 (3.2\%), but similar to that in 2001 (1.5\%). No shift in characteristics of patients whose death was the result of using these drugs was found. In 14.5\% of all deaths in 2007, physicians reported continuous and deep sedation until death, which was substantially more often than in 2001 (8.2\%). In 2007, physicians discussed medical end-of-life practices more often with competent patients, relatives and colleagues than in 1998.
Conclusion: The enactment of the Belgian laws on palliative care and on euthanasia was followed by an increase in all types of medical end-of-life practices, with the exception of the use of lethal drugs without patient{\textquoteright}s explicit request. No shift toward the use of life-ending drugs in vulnerable patient groups was observed. The substantial increase in the frequency of deep sedation demands more in-depth research.
Funding: Institute for the Promotion of Innovation by Science and Technology - Flanders.},
  articleno    = {abstract 473},
  author       = {Bilsen, Johan and Cohen, Joachim and Chambaere, Kenneth and Pousset, Geert and Onwuteaka-Philipsen, BD and Mortier, Freddy and Deliens, Luc},
  booktitle    = {PALLIATIVE MEDICINE},
  issn         = {0269-2163},
  language     = {eng},
  location     = {Glasgow, Scotland, UK},
  number       = {4, suppl.},
  pages        = {abstract 473:S154--abstract 473:S155},
  title        = {Trends in medical end-of-life practices in Belgium, 1998-2001-2007},
  url          = {http://dx.doi.org/10.1177/0269216310366390},
  volume       = {24},
  year         = {2010},
}

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