{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:30:43Z","timestamp":1790739043355,"version":"4.1.0"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"unspecified","delay-in-days":137,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X24000615_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>Antimicrobials are frequently used for palliation during end-of-life care, but adverse effects, such as antimicrobial resistance, are a concern. Shared decision-making is beneficial in end-of-life care conversations to help align antimicrobial-prescribing with patient preferences. However, there is limited data regarding optimal incorporation of antimicrobial-prescribing discussions into shared decision-making conversations. We explored healthcare provider, patient, and support caregiver (eg, family member\/friend) perceptions of barriers and facilitators to discussing antimicrobial-prescribing during the end-of-life period.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24000615_as2\">\n\t    <jats:title>Design:<\/jats:title>\n\t    <jats:p>Qualitative study.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24000615_as3\">\n\t    <jats:title>Participants:<\/jats:title>\n\t    <jats:p>Healthcare providers; palliative care\/hospice care patients\/caregivers.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24000615_as4\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We conducted semi-structured interviews on shared attitudes\/beliefs about antimicrobial-prescribing during end-of-life patient care at one acute-care and one long-term-care facility. Interviews were analyzed for thematic content.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24000615_as5\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Fifteen providers and 13 patients\/caregivers completed interviews. Providers recognized the potential benefit of leveraging shared decision-making to guide antimicrobial-prescribing decisions. Barriers included limited face-to-face time with the patient and uncertainty of end-of-life prognosis. Patients\/caregivers cited trust, comprehension, and feeling heard as important characteristics which act as facilitators in fostering effective shared decision-making around antimicrobial use. Communication in which providers ensure patients are involved in shared decision-making discussions could be increased to ensure patients and their providers develop a mutually agreeable care plan.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24000615_as6\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Shared decision-making is a practice that can guide antimicrobial-prescribing decisions during end-of-life care, thus potentially minimizing antimicrobial-related adverse effects. Our findings highlight opportunities for increased shared decision-making around antimicrobial use during end-of-life care. Interventions designed to address the identified barriers to shared decision-making have the potential to improve antimicrobial-prescribing practices at end-of-life.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2024.61","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T08:24:38Z","timestamp":1715934278000},"source":"Crossref","is-referenced-by-count":5,"title":["Improving shared decision-making around antimicrobial-prescribing during the end-of-life period: a qualitative study of Veterans, their support caregivers and their providers"],"prefix":"10.1017","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0990-1799","authenticated-orcid":false,"given":"Cassie Cunningham","family":"Goedken","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Balkenende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8523-214X","authenticated-orcid":false,"given":"Daniel","family":"Livorsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karleen","family":"Giannitrapani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"McCaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gosia","family":"Clore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6612-5613","authenticated-orcid":false,"given":"Michihiko","family":"Goto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre R.","family":"Marra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli N.","family":"Perencevich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,5,17]]},"reference":[{"key":"S2732494X24000615_ref15","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X05279903"},{"key":"S2732494X24000615_ref17","volume-title":"The Professional Stranger: An Informational Introduction to Ethnography,","author":"Agar","year":"1996"},{"key":"S2732494X24000615_ref19","first-page":"47","article-title":"A comprehensive approach to eliciting, documenting, and honoring patient wishes for care near the end of life: the Veterans health Administration\u2019s Life-Sustaining Treatment decisions initiative","volume":"45","author":"Foglia","year":"2019","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"S2732494X24000615_ref20","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.5271"},{"key":"S2732494X24000615_ref21","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.8970"},{"key":"S2732494X24000615_ref18","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X02239569"},{"key":"S2732494X24000615_ref3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.13080"},{"key":"S2732494X24000615_ref22","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2009.0262"},{"key":"S2732494X24000615_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2022.07.018"},{"key":"S2732494X24000615_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.6"},{"key":"S2732494X24000615_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.167"},{"key":"S2732494X24000615_ref8","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120951748"},{"key":"S2732494X24000615_ref10","first-page":"1","article-title":"Antibiotic use towards the end of life: development of good practice recommendations","author":"Seaton","year":"2021","journal-title":"BMJ Support Palliat Care"},{"key":"S2732494X24000615_ref5","doi-asserted-by":"publisher","DOI":"10.1177\/10499091211027806"},{"key":"S2732494X24000615_ref16","volume-title":"Qualitative Research in Health Care,","author":"Pope","year":"2003"},{"key":"S2732494X24000615_ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2016-005325"},{"key":"S2732494X24000615_ref1","doi-asserted-by":"publisher","DOI":"10.14475\/jhpc.2022.25.1.50"},{"key":"S2732494X24000615_ref9","unstructured":"9. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2019. https:\/\/ndc.services.cdc.gov\/wp-content\/uploads\/Antibiotic-Resistance-Threats-in-the-United-States-2019.pdf. Accessed January 10, 2023."},{"key":"S2732494X24000615_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2012.09.010"},{"key":"S2732494X24000615_ref11","unstructured":"11. Healthcare Improvement Scotland, SAPG safeguarding antibiotics. Good practice recommendations for use of antibiotics towards the end of life, 2020. https:\/\/www.sapg.scot\/media\/5446\/gprs-for-use-of-antibiotic-towards-eol.pdf. Accessed May 10, 2023."},{"key":"S2732494X24000615_ref14","unstructured":"14. US Department of Veterans Health. Veterans Health Administration, 2023. https:\/\/www.va.gov\/health\/. Accessed June 10, 2023."},{"key":"S2732494X24000615_ref12","volume-title":"Essential Ethnographic Methods: Observations, Interviews, and Questionnaires","author":"Schensul","year":"1999"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X24000615","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T08:24:48Z","timestamp":1715934288000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X24000615\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024]]}},"alternative-id":["S2732494X24000615"],"URL":"https:\/\/doi.org\/10.1017\/ash.2024.61","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]},"article-number":"e89"}}