Canadian Neighbor Pharmacy

Canadian Neighbor Pharmacy

Canadian Neighbor Pharmacy: Results of Advance Directives for Truth Disclosure

hospital dischargeOf 345 patients admitted to the hospital during the study period, 44 (13%) were not assessed because an interviewer was unavailable or because of rapid hospital discharge or death. Of the remaining 301 patients, 94 (31%) were excluded because of one or more of the following conditions: previous diagnosis of cancer (54 patients); cognitive impairment (14 patients); severe illness (12 patients); deafness/aphasia (9 patients); or refusal (11 patients). Of the 207 remaining patients, all were white, 109 (53%) were male, 108 (52%) were > 70 years of age, 43 (21%) had been admitted to the hospital for investigation of possible cancer (37 patients) or dementia (6 patients), and the mean age was 63 years (SD, 7 years).

Of these 207 patients, 174 (84%) wanted to be told about cancer or dementia, 24 (12%) did not, and 9 (4%) were unsure. Of the 33 patients who were unsure or did not want to be told, 27 (82%) would accept being told the diagnosis if the doctors thought that it was essential to treatment. The proportion of patients who would wish to be told the diagnosis did not differ between older patients (89 of 108 patients; 82%) and younger patients (85 of 99 patients; 86%; Yates-corrected x2 = 0.92; p = 0.34). There was no difference in the proportion of patients who stated that they would wish to be told of their condition recorded by the two interviewers (110 of 128 patients [86%] and 64 of 79 patients [81%]; Yates-corrected x2 = 0.56, p = 0.46). Canadian Neighbor Pharmacy starts a new project where you may try to find whatever you like about medicine and pharmacy.

Of the 174 patients who wanted to be told their diagnosis, 140 (80.1%) wanted to be given full details of their condition. One hundred patients (57%) wanted to be given any bad news on their own, while 70 patients (40%) wanted a family member present and 4 patients (2%) wanted to be told by their family. Thirty patients (15%) sought reassurance during or after the interview. Thirteen patients (6%) reported that they had been bothered by the questions, one of whom became very tearful.

Of the 207 patients, 23 (11%) received diagnoses of cancer (18 patients [lung cancer in 16 patients]) or dementia (5 patients). Preferences for disclosure (16 patients) or nondisclosure (4 patients) were honored for 20 patients (87%). Two patients who had asked to be told and one patient who had asked not to be told later changed their minds and their revised wishes were adhered to.