RT Journal Article
SR Electronic
T1 Older patient engagement in advance care planning in Canadian primary care practices
JF Canadian Family Physician
JO Can Fam Physician
FD The College of Family Physicians of Canada
SP 371
OP 377
VO 64
IS 5
A1 Howard, Michelle
A1 Bernard, Carrie
A1 Klein, Doug
A1 Tan, Amy
A1 Slaven, Marissa
A1 Barwich, Doris
A1 You, John J.
A1 Asselin, Gabriel
A1 Simon, Jessica
A1 Heyland, Daren K.
YR 2018
UL http://www.cfp.ca/content/64/5/371.abstract
AB Objective To assess primary care patients’ engagement in advance care planning (ACP) and predictors of engagement.Design Cross-sectional survey using a revised version of a validated questionnaire.Setting Alberta, Ontario, and British Columbia.Participants Convenience sample of 20 family practices that provided a consecutive sample of 810 patients aged 50 years and older.Main outcome measures Engagement in ACP activities, and sociodemographic and health-related predictors of having engaged in ACP activities.Results Patients had a mean age of 66 years (55.6% women). Two-thirds of patients (68.5%; 555) had thought about the kinds of medical treatments they would want or not want if they were sick and in hospital, 52.8% (n = 428) had talked with someone about what they would want, 32.0% (n = 259) had written down their wishes, 50.4% (n = 408) had named someone to be their substitute decision maker, and 23.0% (n = 186) had engaged in all 4 key ACP activities. Of those patients who had talked to someone about medical treatments wanted or not, 17.5% (n = 75) had talked to their family doctors. Age (adjusted odds ratio per 10-year category of 1.55; 95% CI 1.26 to 1.90; P < .001) was significantly associated with having engaged in all ACP activities.Conclusion Many patients have engaged in some ACP activities, but few have discussed ACP with their family physicians. Strategies should be implemented in primary care to reduce the barriers to discussing ACP.