Percutaneous Feeding Tubes in Individuals with Advanced Dementia: Are Physicians “Choosing Wisely”?

摘要: Objectives To evaluate physician knowledge and perceptions about the American Board of Internal Medicine/American Geriatrics Society (ABIM/AGS) Choosing Wisely recommendations regarding percutaneous endoscopic gastrostomy (PEG) in individuals with advanced dementia. Design Multicenter, mixed-mode, anonymous questionnaire. Setting Three tertiary four community hospitals New York. Participants Internal medicine physicians (N = 168). Measurements Physician PEG tubes dementia. Results Ninety-nine percent reported having cared for someone dementia; 95% had been involved decision-making process; 38% were unsure whether ABIM/AGSChoosing advise or against dementia. Physicians who agreed that there is enough evidence to recommend placement dementia more likely know (71% vs 28%, P < .001). Fifty-two felt control decision, 27% expressed concerns potential litigation. The most common factor influencing was patient decision-maker request (70%); 63% stated families even when would not it. Only 4% choose have a tube if they dementia. Conclusion Despite scientific supporting use dementia, numerous incentives complicate decision placement. In today's healthcare environment, it incumbent upon practitioners be aware available provide leadership guide this complex process promote true person-centered care.