Article Addresses Cardioverter-Defibrillators in Hospices

Most hospices admit patients with ICDs; researchers recommend deactivation policies
By Jane Parry
HealthDay Reporter

THURSDAY, March 4 (HealthDay News) -- Hospices should have formalized policies in place regarding the deactivation of the shocking function of implantable cardioverter-defibrillators (ICDs) during end-of-life care, according to an article published in the March 2 issue of the Annals of Internal Medicine.

Nathan Goldstein, M.D., of the Mount Sinai School of Medicine in New York City, and colleagues analyzed data from 414 hospices that responded to a survey regarding their management of patients with ICDs.

Patients with ICDs were admitted by 97 percent of the hospices surveyed, and 58 percent of respondents reported patients with ICDs having undergone shock treatment within the past year, the investigators discovered. However, a policy addressing deactivation of ICDs was in place in only 10 percent of hospices, with an average of 42 percent of patients with ICDs having the shocking function deactivated. The authors created a sample policy for use by hospices, based on those submitted by respondents.

"Hospices enroll patients with active ICDs, and patients are shocked near the end of life. These data show an association between having a deactivation policy and a higher percentage of patients with deactivated ICDs," the authors conclude. "We hope that by providing a sample policy, hospices will engage in quality improvement activities to improve outcomes for patients with ICDs and their families."

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