Overtreatment of Older People Near End of Life: A Qualitative Scoping Review of Modalities, Drivers, and Solutions

Samantha Fien; Emily Plunkett; Daniel Wadsworth; Magnolia Cardona

doi:10.1177/00302228251334280

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Overtreatment of Older People Near End of Life: A Qualitative Scoping Review of Modalities, Drivers, and Solutions

Journal article

Open access

Peer reviewed

Overtreatment of Older People Near End of Life: A Qualitative Scoping Review of Modalities, Drivers, and Solutions

Samantha Fien, Emily Plunkett, Daniel Wadsworth and Magnolia Cardona

Omega: Journal of Death and Dying, Vol.Advanced access

2025

DOI: https://doi.org/10.1177/00302228251334280

PMID: 40245932

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Abstract

health care

dysthenasia

overtreatment

aged

end of life

non-beneficial

Review

This study aimed to understand the drivers better to help minimise further risks of overtreatment for older people near the end of life (dysthanasia). A systematic scoping review of any publication types released in Medline, Embase, and Cochrane databases from January 2002 to January 2023 were used. Deductive thematic analysis was conducted independently and concurrently by paired reviewers. Risk of bias assessed for primary studies only using a modified version of the COREQ checklist. Twenty-one studies met the inclusion criteria. Determinants included healthcare system factors, patient-centered care, family and caregiver, and clinician perspectives. This review confirms that despite almost two decades of recognition of the potential harms of overtreatment near the end of life, society, patients, and health systems have a role to play in reducing and addressing the determinants. We offer a range of solutions for clinicians, health service managers, and members of the public to consider.

Details

Title: Overtreatment of Older People Near End of Life: A Qualitative Scoping Review of Modalities, Drivers, and Solutions
Authors: Samantha Fien (Corresponding Author) - Central Queensland University
Emily Plunkett (Author) - Toowoomba Hospital
Daniel Wadsworth (Author) - University of the Sunshine Coast, Queensland, School of Health - Nursing
Magnolia Cardona (Author) - UNSW Sydney
Publication details: Omega: Journal of Death and Dying, Vol.Advanced access
Publisher: Sage Publications, Inc.
DOI: 10.1177/00302228251334280
ISSN: 1541-3764
PMID: 40245932
Copyright note: © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Grant note: Dr Wadsworth is supported by a Postdoctoral Research Fellowship from Manna Institute, a Commonwealth-funded institute.
Organisation Unit: Healthy Ageing Research Cluster; School of Health - Nursing
Language: English
Record Identifier: 991125705802621
Output Type: Journal article

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Web Of Science research areas: Psychology, Multidisciplinary; Social Sciences, Biomedical

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