PATH Outcomes

Results from the first 150 patients completing the PATH program are published in the Journal of the American Geriatric Society and show that:

  • Forty-seven per cent of PATH referrals were requests to assist with a specific decision, such as whether to pursue surgery.
  • Ninety-two per cent of participants were able to make, on average, three new decisions about their medical care, most often with the help of a substitute-decision-maker.
  • Those with more advanced frailty or dementia were less likely to choose aggressive treatments. Controlling for age, those with higher baseline frailty and more advanced dementia were more likely to decline scheduled interventions (odds ratio (OR) = 3.41, 95% confidence interval (CI) = 1.39–8.38) and OR = 1.66, 95% CI = 1.05–2.65, respectively) compared to those with less frailty or without dementia.
  • At the time of PATH assessment, 71 patients were scheduled to have a total of 77 procedures or treatments. There was a 75% reduction in the demand for offered interventions upon completion of PATH.
  • Ten per cent of patients with multiple pre-PATH hospitalizations and who would have conventionally been treated in the hospital were cared for from home.

Bars indicate:
red = declined intervention;
blue = proceed with intervention;
yellow = unsure

Moorhouse P, Mallery L.  Palliative and Therapeutic Harmonization: A Model forAppropriate Decision-Making in Frail Older Adults. J Am Geriatr Soc. 2012 Dec; 60(12):2326-32.