European Geriatric Medicine - Supplement 1 - Volume 6

Oral presentations / European Geriatric Medicine 6S1 (2015) S5

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rehabilitation unit or hospice. Half (51) occurred in people admitted

from care homes who returned there within 10 days. The remainder

were in people admitted from home but discharged to care homes.

Conclusions:

Patients discharged to care homes before 10 days

were at increased risk, but this is a complex group of individuals.

The small absolute numbers of deaths do not justify cautioning

against allowing people to return to their care home when the

patient, their family and the multidisciplinary team agree this is

appropriate.

Ethics and end of life care

O-083

Euthanasia and physician assisted suicide

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a survey among

Danish geriatricians

J. Ilvemark

, B. Dahle

, L.-E. Matzen

University of Southern Denmark, Odense C, Denmark;

Odense

University Hospital, Odense C, Denmark

Objective:

Euthanasia (EU) and/or physician assisted suicide (PAS)

is legal in some countries and discussed in others. The aim of

this survey was to study the attitudes to EU/PAS among Danish

geriatricians.

Method:

An online questionnaire with 22 questions was mailed to

all members of the Danish Geriatric Society. The answers where

anonymised.

Results:

46% (120/259) responded. 23% agreed and 56% disagreed

that euthanasia is ethically defendable if a suffering patient

explicitly and repeatedly express a wish to die, for PAS responses

were 19% and 64% respectively. 13% agreed and 74% disagreed

that euthanasia should be offered as an alternative to palliative

care, for PAS responses were 15% and 77% respectively. 68% of

respondents have received explicit requests to end a patient’s life.

Twenty physicians (20%) had complied on one or more of these

request, and of these 7 reported they were aware of acting outside

the Danish laws, 5 were unsure. That a legalization of EU and PAS

would have a positive effect on the physician/patient relationship

was the opinion of 13% while 62% found the effect to be negative,

for PAS opinions were 11% and 64% respectively.

Conclusion:

The majority of Danish geriatricians are against EU

and PAS. Many have experienced patients asking for EU/PAS, but

only a few have complied with the request.

O-084

Evaluating the policy of prescribing and deprescribing during

the last 48 hours on acute geriatric wards in Flanders

N. Van Den Noortgate

, R. Verhofstede

, T. Smets

, J. Cohen

R. Piers

, L. Deliens

4,1

Ghent University Hospital, Ghent, Belgium;

Belgium;

Vrije

Universiteit Brussel, Elsenen, Belgium;

Vrije Universiteit Brussel,

Belgium

Objectives:

Pharmacological management is considered as a quality

indicator during end of life care. This study wants to describe the

pharmacological management the last 48 hours of life on acute

geriatric wards.

Methods:

A retrospective cross-sectional descriptive study in

23 acute geriatric wards in 13 hospitals in Flanders (Belgium)

based on a structured after death questionnaire, filled in by the

treating geriatrician. Following data were collected: demographic

characteristics, underlying diseases, cause of death, ability to

communicate, expected death by the physician, anticipatory

prescription and deprescription of potentially inappropriate

medication during the last 48 hours of life.

Results:

Two hundred ninety patients (mean age 85.7 years

old) were included. There was an anticipatory prescription

of medication in 65.4%, more specifically morphine in 45.5%,

benzodiazepines in 15.5% and scopolamine in 13.8% of the dying

patients. The likelihood of having anticipatory prescription was

significantly higher in patients where death was expected by

the physician (OR 19.2; CI 9.4–39.8; p

0.0001) and significantly

lower in patients with dementia (OR 0.3; CI 0.2–0.7; p

0.006). A

deprescription of medication was noted in 67.9% of the patients. The

likelihood of having medication stopped is higher in patients where

death is expected (OR 20.7;CI10.0–42.9;p

0.0001) and in patients

dying from an oncological disease (OR 7.0; CI 1.1–45.6;p = 0.042).

Conclusions:

Anticipatory prescription and deprescription of

potentially inappropriate medication at the end of life in older

inpatients can be improved. A well-developed intervention to guide

the care during the terminal phase can be a first step to improve

quality of care.

O-085

Conceptualising the participation of older people in clinical

research

N. Parekh

, K. Ali

Lewisham and Greenwich NHS Trust, London, England;

United

Kingdom

Objectives:

The inclusion of older people in research can be

enhanced by engaging older people in a ‘patient and public

involvement’ (PPI). This work reviews the literature on the exclusion

of older people from clinical research. We apply a novel conceptu-

alisation of PPI to clinical research with stroke patients in one UK

hospital, using the four principles approach to medical ethics.

Methods:

(1)We conducted a systematic literature search in

EMBASE, MEDLINE, CINAHL, Cochrane Database of Systematic

Reviews. Key search terms around ‘older people’, ‘clinical trials’

and ‘exclusion’ were used. (2) We applied the four principles of

Respect for Autonomy, Beneficence, Non-Maleficence and Justice

to explore the impact of PPI in a study conducted in 2013 of art

therapy in stroke rehabilitation.

Results:

The literature search yielded a variety of articles. The

predominant reasons cited for the exclusion of older people were

upper age limit, performance status, and stringent organ function

restrictions. Several recommendations to reduce non-recruitment

bias have been proposed.

Using the four principles as a conceptual framework can demon-

strate both moral and practical value to improve research outcomes.

PPI in our study of art therapy in stroke rehabilitation enabled us to

implement a study that respected the participants autonomy, opti-

mised benefit and minimised the risk of harm during the research.

Conclusion:

There is a need for greater involvement of older people

in clinical research. The Four Principles approach can form an

acceptable conceptual framework to consider both the moral and

practical impact of PPI in research involving older people.

Longevity and prevention

O-086

A cross-sectional study of physical activity correlates in older

adults (70

–

77 yrs): The Generation 100 study

H. Viken

, N.P. Aspvik

, J.E. Ingebrigtsen

, N. Zisko

, U. Wisløff

D. Stensvold

The Norwegian University of Science and Technology (NTNU),

Trondheim, Norway;

NTNU, Trondheim, Norway;

Norwegian

University of Science and Technology Trondheim, Norway (NTNU),

Trondheim, Norway;

CERG, NTNU, Trondheim, Norway

Objectives:

Physical activity (PA) is an important factor for

improved and sustained health in older adults, but few meet

current PA recommendations. Therefore, knowledge about factors