The POLST Program: A Retrospective Review of the Demographics of Use and Outcomes in One Community Where Advance Directives Are Prevalent
Hammes, B.J., Rooney, B.L., Gundrum, J.D., Hickman, S.E., & Hager, N. (2012). The POLST program: A retrospective review of the demographics of use and outcomes in one community where advance directives are prevalent. Journal of Palliative Medicine, 15(1), 77-85. doi:10.1089/jpm.2011.0178. Epub 2012 Jan 10.
A retrospective review of medical record and death certificate data of 400 adults who died in 2007/08 in the La Crosse County, Wisconsin, community. Information about POAHC, POLST forms, and medical treatments provided in the last 30 days of life were abstracted from decedents’ medical records;67% of decedents had a POLST form, whereas 22% had POAHC alone. In comparison with decedents with POAHC alone, decedents with a POLST form were significantly older (83 versus 77 years, p<0.001), more likely to die in a nursing home than in a hospital (p<0.001), and more likely to die from a terminal or chronic illnesses (97%). Decedents with POLST orders for higher levels of medical treatment received more treatment, and in only 2 cases was there evidence that treatment was discrepant with POLST orders. In 31% of all POLST forms, the person appointed in the POAHC consented to the POLST orders. POLST can be a highly effective program to ensure that patient preferences are known and honored in all settings.
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