The Medical Orders for Scope of Treatment (MOST) form completion: A retrospective study

dc.contributor.authorMallidou, Anastasia
dc.contributor.authorTschanz, Coby
dc.contributor.authorAntifeau, Elisabeth
dc.contributor.authorLee, Kyoung Young
dc.contributor.authorKayuni-Mtambo, Jenipher
dc.contributor.authorHeckl, Holly
dc.date.accessioned2025-02-18T22:40:37Z
dc.date.available2025-02-18T22:40:37Z
dc.date.issued2022
dc.description.abstractBackground: Advance care planning (ACP) involves discussions about patient and families’ wishes and preferences for future healthcare respecting autonomy, improving quality of care, and reducing overtreatment. The Medical Orders for Scope of Treatment (MOST) form records person preferred level and types of treatment and intervention. Purpose: To examine the MOST form use in inpatient units within a British Columbia (Canada) hospital, estimate and compare its completion rate, and inform health policies for continuous, quality and individualized patient care. Methods: About 5,000 patients admitted to the participating tertiary acute care hospital during October 2020. Data from 780 eligible participants in medical, surgical, or psychiatry unit were analyzed with descriptive statistics, the chi-square test for group comparisons, and logistic regression to assess predictors of the MOST form completion. Results: Participants’ (54% men) age ranged from 20–97 years (mean = 59.53, SD = 19.54). Mainly physicians (99.1%) completed the MOST form for about 60% of them. A statistically significant difference of MOST completion found among the units [Pearson χ2 (df=2, n=780) = 79.53, p < .001, φ = .319]. Multivariate logistic regression analysis demonstrated that age (OR = 1.05, 95% CI 1.04 to 1.06) and unit admission (OR = .60, 95% CI 0.36 to 0.99 in psychiatry; and OR = .21, 95% CI 0.14 to 0.31 in surgery) were independently associated with the MOST form completion. Conclusion: Our findings demonstrate a need for consistent and broad completion of the MOST form across all jurisdictions using, desirably, advanced electronic systems. Healthcare providers need to raise awareness of the MOST completion benefits and be prepared to discuss topics relevant to end-of-life. Further research is required on the MOST form completion.
dc.description.reviewstatusReviewed
dc.description.scholarlevelFaculty
dc.description.sponsorshipThis study was financially supported by the Faculty of Human and Social Development (HSD), University of Victoria (2020–2021 HSD Internal Research Grant). However, the funding body did not involved in any way in the design of the study, data collection and analysis, interpretation of findings, or in writing this manuscript.
dc.identifier.citationMallidou, A. A., Tschanz, C., Antifeau, E., Lee, K. Y., Mtambo, J. K., & Heckl, H. (2022). The Medical Orders for Scope of Treatment (MOST) form completion: A retrospective study. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08542-w
dc.identifier.urihttps://doi.org/10.1186/s12913-022-08542-w
dc.identifier.urihttps://hdl.handle.net/1828/21210
dc.language.isoen
dc.publisherBMC Health Services Research
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectadvance care planning
dc.subjectMedical Orders for Scope of Treatment (MOST) form
dc.subjecthospital
dc.subjectnurse practitioner
dc.subjectretrospective study
dc.subjectMOST form completion
dc.subjecthealth system quality and safety
dc.subject.departmentSchool of Nursing
dc.titleThe Medical Orders for Scope of Treatment (MOST) form completion: A retrospective study
dc.typeArticle

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