Systematic Review of the Literature for the Physician Orders for Life-Sustaining Treatment (POLST) Program

Abstract

The Physician Orders for Life-Sustaining Treatment (POLST) program was developed in 1994 in order to translate patient treatment preferences regarding end-of-life care into immediately actionable physician’s orders, and can follow a patient through multiple care settings. A number of studies have been done on the POLST program to evaluate its efficacy and usefulness to residents and health care providers who deal with chronic illness and end-of-life care. However, because the program is relatively young, there is opportunity for more thorough research of the program and its impact on the field of end-of-life care. A systematic review of the literature was performed to summarize what is known about the POLST Program and identify areas for future research. The review of the literature yielded 12 studies focused on the POLST program: A majority (8 out of 12) studies were conducted in the long-term care setting; three were conducted in the community setting; and the remaining study focused on POLST’s use in the emergency response setting. Findings suggest that the kinds of orders documented on POLST differ depending on patient demographics and that providers’ overall opinion reflects that the program is both useful and beneficial. Several areas for future research were identified, including the program’s use in more diverse settings across the nation, barriers to POLST use, the quality of conversations regarding POLST, and patient and family experiences with the program.