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ICD Knowledge and Attitudes at End of Life in a Diverse and Vulnerable Patient Population
- Journal of Health Care for the Poor and Underserved
- Johns Hopkins University Press
- Volume 33, Number 4, November 2022
- pp. 1793-1808
- 10.1353/hpu.2022.0138
- Article
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Abstract:
Background. Studies thus far lacking diversity show many patients with implantable cardioverter defibrillators (ICDs) have poor understanding of ICD functioning, preventing informed decision-making near end of life (EOL). Objective. To describe knowledge, perceptions, and preferences regarding ICDs among patients nearing EOL in a diverse, safety-net hospital population. Methods. A cross sectional phone survey of patients with ICDs nearing EOL from a safety-net hospital was performed. The survey assessed knowledge, perceptions, and preferences regarding their ICD. Results. Nearly half (46%) of patients falsely believed turning off shocking function would stop the heart, 69% were unaware that disabling ICDs does not require surgery, and 88% said no doctor had ever discussed the option of deactivation of shocking therapy with them. Conclusion. Challenges in health care delivery in a safety-net hospital patient population may result in patients being poorly equipped to align ICD settings with goals of care when nearing EOL.