# Comparison of Palliative Care Models in Idiopathic Pulmonary Fibrosis
## 3 Results
### Improved EOL Care  
One hundred and twenty two patients died during the study giving a mortality rate of 41% (122; consisting of 45 EC (47%), 51 BC (61%), and 26 QC (22%)) (\(p<0.001\)). Median (IQR) follow-up time was 16 (5-28) months (Table 3; Supplement Table S3). Overall, 76% of decedents had received PC at some point during their illness trajectory: 91% (41) in EC and 92% (47) in BC. QC EOL data is available only for 27% (7/26) decedents who were seen in the specialist PC clinic. There were significant differences across models (Table 3 and Figure 1B). At EOL, overall 66% (81) were on oxygen and 35% (43) were on opioids for dyspnea, initiated 15 and 5 (median) months before death, respectively. Significantly more decedents in EC and BC were on supplemental oxygen and opioids than QC (Oxygen: \(p=0.04\); Opioids: \(p<0.001\)) (Table 3). Ninety-one percent EC and 92% BC decedents were taught non-pharmacologic dyspnea strategies (pacing, energy conservation); there were no data recorded in QC (\(p<0.001\)). Supplement Figure S1 displays a timeline of the PC therapies decedents received across all cohorts. Amongst the QC patients who were referred to specialist PC clinic (21%), only seven died, and most of them received symptom management (Supplement Table S4). Figure 1: (**A–D**) panel plots: (**A**) dyspnea management in all patients; (**B**): dyspnea management in decedents; (**C**): ACP documentation in all patients; and (**D**): ACP documentation in decedents. Overall, 80% had ACP discussions, with 69% patient preferences recorded and 64% with documented do not resuscitate/intubate (DNR/DNI) orders; 59% had preferred location of death recorded, and 54% had end of life discussions (Table 3 and Figure 1D). While 93% and 100% of EC and BC decedents, respectively, had ACP discussions, 81% of QC did not (Figure 1D). Home or hospice was the preferred location of death in 53% (65) of patients, when documented (Table 3). Overall, 59% died at home or hospice and 38% in hospitals (1 in intensive care) (Table 4). Fifty-nine% in EC and 58% in BC models died at their preferred location of home or hospice. In the two sites that recorded preference for location of death (EC and BC), there was \"fair\" agreement between the patient preference and location of death in the EC cohort (k = 0.29) and no agreement at the BC site (k = \(-\)0.11). Respiratory cause of death was reported in 95% EC, 80% BC, and 46% of QC decedents (not reported in 50% of QC). \begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Location of Death** & **All Cohorts** & **EC** & **BC** & **_p-Value_** \\ \hline Home & 47.9\% (46/96) & 42.2\% (19/45) & 52.9\% (27/51) & 0.05 \\ Hospice & 11.5\% (11/96) & 20\% (9/45) & 3.92\% (2/51) & 0.05 \\ \hline Home \& Hospice concordance rate & & & & \\ (actual: preferred) & 57:98 & 28:48 & 29:50 & \\ (actual & 1.04\% (1/96) & 2.22\% (1/45) & 0\% (0/51) & 0.82 \\ \hline Hospital concordance rate & & & & \\ (actual/preferred) & 36:10 & 17:7 & 19:3 & \\ (1.04\% (1/96) & 0.29 (\(-\)0.02-0.51) & \(-\)0.11 (\(-\)0.20-0.15) & \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Location of Death and concordance (actual/preferred location).