ICD Knowledge and Attitudes at End of Life in a Diverse and Vulnerable Patient Population

Background. Studies thus far lacking diversity show many patients with implantable cardioverter defibrillators (ICDs) have poor understanding of ICD functioning, preventing informed decision-making near end of life (EOL). Objective. To describe knowledge, perceptions, and preferences regarding ICDs...

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Published inJournal of health care for the poor and underserved Vol. 33; no. 4; pp. 1793 - 1808
Main Authors Berlacher, Mark, Abousaab, Carol, Chen, Christine, Suarez, Arlen, Garrett, Brenden E, Badia, Rohit R, Newcomer, Kelley, Lee, Simon, Ayers, Colby, Sulistio, Melanie S
Format Journal Article
LanguageEnglish
Published Baltimore Johns Hopkins University Press 01.11.2022
Subjects
Clinical decision making
Deactivation
Decision making
End of life
End of life decisions
Health care access
Health care delivery
Heart
Hispanic Americans
Hospital systems
Hospitals
Interpreters
Knowledge
Medicaid
Medicare
Minority & ethnic groups
Palliative care
Patient communication
Patients
Perceptions
Polls & surveys
Population studies
Quality improvement
Safety
Surgery
Surveys
Telephone surveys
Uninsured people
Vulnerability
Australia
United States > US
Kentucky
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Summary:Background. Studies thus far lacking diversity show many patients with implantable cardioverter defibrillators (ICDs) have poor understanding of ICD functioning, preventing informed decision-making near end of life (EOL). Objective. To describe knowledge, perceptions, and preferences regarding ICDs among patients nearing EOL in a diverse, safety-net hospital population. Methods. A cross sectional phone survey of patients with ICDs nearing EOL from a safety-net hospital was performed. The survey assessed knowledge, perceptions, and preferences regarding their ICD. Results. Nearly half (46%) of patients falsely believed turning off shocking function would stop the heart, 69% were unaware that disabling ICDs does not require surgery, and 88% said no doctor had ever discussed the option of deactivation of shocking therapy with them. Conclusion. Challenges in health care delivery in a safety-net hospital patient population may result in patients being poorly equipped to align ICD settings with goals of care when nearing EOL.
Bibliography:ObjectType-Article-1
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ISSN:1049-2089
1548-6869
1548-6869
DOI:10.1353/hpu.2022.0138