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Summaries for Patients |3 February 2015

Symptoms During the Last Year of Life Free

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information

  • The full report is titled “Symptom Trends in the Last Year of Life From 1998 to 2010. A Cohort Study.” It is in the 3 February 2015 issue of Annals of Internal Medicine (volume 162, pages 175-183). The authors are A.E. Singer, D. Meeker, J.M. Teno, J. Lynn, J.R. Lunney, and K.A. Lorenz.


Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
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What is the problem and what is known about it so far?

Patients with terminal diseases may experience painful and other troubling symptoms. Despite efforts by the medical community to focus on these symptoms, some patients may continue to have them. How often this occurs is not known.

Why did the researchers do this particular study?

To find out whether the symptoms that patients experience toward the end of life have changed over the past few years.

Who was studied?

7204 participants in a long-term study of community-dwelling adults who died between 1998 and 2010.

How was the study done?

After a patient died, researchers contacted proxy informants, such as family members or friends who might have been involved in the patient's care before death, and asked what symptoms the patient had experienced.

What did the researchers find?

During the 12 years of the study, the proxies reported that more than half of the patients had some pain for at least 1 month during the last year of their lives. The number increased from about 54% at the beginning of the study to about 61% by the end. Reports of patients having some depression or periodic episodes of confusion also increased. Reports of moderate or severe pain did not change over the time studied when the researchers evaluated groups of patients with specific diagnoses, such as cancer or heart failure.

What were the limitations of the study?

The researchers did not have information about the proxies, such as whether and how they might have been involved in the patients' care. They also did not know if the patients had been enrolled in programs, such as hospice, that are aimed at relieving troubling symptoms. It is not known if changes in the types of patients, their treatments, or the proxies who provided the information might have influenced differences over time in the reports of these troubling symptoms.

What are the implications of the study?

More studies are needed to assess the situations in which patients continue to have troubling symptoms toward the end of life so that they can be effectively addressed.

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Symptoms During the Last Year of Life. Ann Intern Med. 2015;162:I–28. doi: https://doi.org/10.7326/P15-9003

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Published: Ann Intern Med. 2015;162(3):I-28.

DOI: 10.7326/P15-9003

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