Advanced care planning benefits patients and families

January 01, 0001

Advanced care planning benefits patients and families

Advance care planning involves patients reflecting on their possible future medical treatment choices, to document their wishes, and potentially to appoint a surrogate. Yet, advanced care planning can be a challenging subject to broach with patients. These Australian researchers examined the impact of advance care planning on end of life care in elderly patients using a prospective randomized controlled trial at a university hospital in Melbourne, Australia. They enrolled competent medical inpatients aged 80 or more and followed them for six months. Enrollees were randomized to receive either usual care or usual care plus facilitated advance care planning.

The researchers report: "154 of the 309 patients were randomised to advance care planning, 125 (81%) received advance care planning, and 108 (84%) expressed wishes or appointed a surrogate, or both. Of the 56 patients who died by six months, end of life wishes were much more likely to be known and followed in the intervention group (25/29, 86%) compared with the control group (8/27, 30%). In the intervention group, family members of patients who died had significantly less stress (intervention 5, control 15), anxiety (intervention 0, control 3), and depression (intervention 0, control 5) than those of the control patients. Patient and family satisfaction was higher in the intervention group."

The authors concluded: "Advance care planning improves end of life care and patient and family satisfaction and reduces stress, anxiety, and depression in surviving relatives."

Facilitated advanced care planning both helps to ensure a patients wishes are known, and has benefits to the surviving family members.

For the full abstract, click here.

BMJ 340:c1345, 23 March 2010 © 2010 Detering et al.
The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. Karen M Detering, Andrew D Hancock, Michael C Reade, William Silvester. Correspondence to K M Detering: [email protected]

Category: A. General/Unspecified. Keywords: advanced care planning, end of life, stress, anxiety, depression, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 16 April 2010

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