Timing of POLST Form Completion by Cause of Death

Abstract Context The physician orders for life-sustaining treatment (POLST) paradigm allows health care professionals to document the treatment preferences of patients with advanced illness or frailty as portable and actionable medical orders. National standards encourage offering POLST orders to patients for whom clinicians would not be surprised if they died in the next year. Objectives To determine the influence of cause of death on the timing of POLST form completion and on changes to POLST orders as death approaches. Methods This was a cohort study of 18,285 Oregon POLST Registry decedents who died in 2010–2011 matched to Oregon death certificates. Results The median interval between POLST completion and death was 6.4 weeks. Those dying of cancer had forms completed nearer death (median 5.1 weeks) than those with organ failure (10.6 weeks) or dementia (14.5 weeks; P