Beyond light-touch nudges: rethinking interventions to reduce low-value care at the end of life.

The article focuses on the challenges of reducing low-value care for older adults at the end of life (EOL) in hospital settings, highlighting findings from the InterACT trial, which tested behavioural nudges to improve care for seriously ill patients aged 75 and older. The trial showed that low-cost...

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Publicado en:Age & Ageing Vol. 55; no. 1; pp. 1 - 4
Autores principales: Malhotra, Chetna, Andres, Ellie B, Poco, Louisa
Formato: Artículo
Publicado: Oxford University Press / USA Jan2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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        10.1093/ageing/afaf377
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        atl: Beyond light-touch nudges: rethinking interventions to reduce low-value care at the end of life.
      aug:
        au:
          Malhotra, Chetna
          Andres, Ellie B
          Poco, Louisa
        affil: Duke-NUS Medical School, Lien Centre for Palliative Care, 169857, Singapore
      su:
        Australia
        Palliative treatment
        Medical care
        Patient-centered care
        Health behavior
        Medical research
        Terminal care
        Patients' attitudes
        Cost analysis
        Value-based healthcare
        Quality assurance
      sug:
        subj:
          Palliative treatment
          Medical care
          Patient-centered care
          Health behavior
          Medical research
          Terminal care
          Patients' attitudes
          Australia
          Research and Development in the Physical, Engineering, and Life Sciences (except Biotechnology)
          Cost analysis
          Value-based healthcare
          Quality assurance
      keyword:
        behavioural nudges
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        de-implementation
        end-of-life care
        https://dx.doi.org/10.1093/ageing/afaf377
        inLanguage:en
        low-value care
        older people
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41563341/
        value-based care
        behavioural nudges
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        de-implementation
        end-of-life care
        https://dx.doi.org/10.1093/ageing/afaf377
        inLanguage:en
        low-value care
        older people
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41563341/
        value-based care
      ab: The article focuses on the challenges of reducing low-value care for older adults at the end of life (EOL) in hospital settings, highlighting findings from the InterACT trial, which tested behavioural nudges to improve care for seriously ill patients aged 75 and older. The trial showed that low-cost nudges alone were insufficient to change entrenched clinical practices or increase palliative care referrals, due to systemic incentives, hospital culture, and workflow integration barriers. The authors propose a five-step roadmap for de-implementing low-value EOL care, emphasizing comprehensive assessment, embedding palliative care, aligning financial and organizational incentives, engaging stakeholders including patients and families, and rigorous evaluation. Sustainable improvement in EOL care requires multi-level strategies beyond behavioural nudges, incorporating systemic reforms and collaborative decision-making to enhance patient quality of life.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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