Recognising end of life in older people

Identification of end of life can be challenging for clinicians, particularly in older people living with frailty. In this study, fewer than half of people aged ≥75 years who died had a code in their electronic health record (EHR) to suggest that their death was anticipated by their GP. End-of-life codes in EHRs were entered near to death (median 4 months prior). In the minority of older decedents (aged ≥75 years) for whom end of life was recognised, only a small proportion were on the palliative care register or had their preferences for place of care or death recorded.

Mortality in the first COVID-19 pandemic peak

The COVID-19 pandemic has passed its first peak in many countries in Europe. A study from the University of Oxford examined the characteristics associated with excess deaths in the first COVID-19 pandemic peak. Findings were that male sex, population density, black ethnicity, and people with long-term conditions, including learning disability, had higher odds of mortality. Planning for subsequent peaks should take account of these findings. Listen to the podcast interview with Professor Simon de Lusignan.

Pregnancy abnormalities from ACE inhibitors and ARBs 

The adverse effects of ACE inhibitors and ARBs for pregnant women and their babies are known, but the recording of pre-pregnancy advice when prescribing these drugs is suboptimal, according to a new study from Queen Mary University of London. The study was conducted across 140 general practices in East London in women aged 15-45 years who were issued a prescription for an ACE inhibitor or ARB. Of over 300,000 women, 2651 were prescribed an ACE inhibitor or an ARB; and of these, 81.4% had no record of contraception prescription. Dr Elizabeth Lovegrove discusses the findings and their clinical relevance in a podcast interview.