Recruitment, follow-up and survival in an 11-country cohort study of patients at the end of life and their relatives.

<h4>Background</h4>Large, international cohort studies generate high-level evidence, but are resource intense. In end-of-life care such studies are scarce. Hence, planning for future studies in terms of data on screening, recruitment, retention and survival remains a challenge.<h4>...

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Main Authors: Maria E C Schelin, Christel Hedman, Pilar Barnestein-Fonseca, Martina Egloff, John Ellershaw, Dagny Faksvåg Haugen, Claudia Fischer, Melanie Joshi, Ida J Korfage, Urška Lunder, Stephen Mason, Judit Simon, Vilma A Tripodoro, Berivan Yildiz, Sofia C Zambrano, Steffen Eychmueller, Lia van Zuylen, Agnes van der Heide, Carl Johan Fürst, iLIVE Consortium
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0317002
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Summary:<h4>Background</h4>Large, international cohort studies generate high-level evidence, but are resource intense. In end-of-life care such studies are scarce. Hence, planning for future studies in terms of data on screening, recruitment, retention and survival remains a challenge.<h4>Objectives</h4>The aim was to describe recruitment, follow-up and survival in a multinational study of patients' and relatives' expectations, concerns and preferences at the end of life.<h4>Methods</h4>In this 11-country cohort study with six months follow-up patients, >18 years old, were included on the basis of an adapted "surprise question" to assess patients´ end of life status. Patients were required to be aware of their limited life expectancy. We collected patient questionnaires (baseline and 1 month), and searched medical records for the date of death. One relative per patient was invited to participate.<h4>Results</h4>26735 patients were screened for inclusion, 3065 (11%) were found eligible and were invited to participate, 1509 chose to participate, i.e. 6% of those initially screened. A total of 699 patients (49%) participated in the 1-month follow-up, with proportions varying according to survival time, from 20% if the patient died at month 2, to 75% if the patient died at month 6. Survival time was not associated with patient gender or age, but with diagnosis, country of residence and healthcare setting.<h4>Conclusion</h4>Approximately 20 times the desired cohort size had to be screened for eligibility. Prognostication was difficult, we noted a wide distribution of survival after inclusion. Patients' ability to complete follow-up questionnaires declined well before death.
ISSN:1932-6203