PMID: 29760260May 16, 2018Paper

Older patient engagement in advance care planning in Canadian primary care practices: Results of a multisite survey

Canadian Family Physician Médecin De Famille Canadien
Michelle HowardD Heyland

Abstract

To assess primary care patients' engagement in advance care planning (ACP) and predictors of engagement. Cross-sectional survey using a revised version of a validated questionnaire. Alberta, Ontario, and British Columbia. Convenience sample of 20 family practices that provided a consecutive sample of 810 patients aged 50 years and older. Engagement in ACP activities, and sociodemographic and health-related predictors of having engaged in ACP activities. 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. Many patients have engaged in some ACP activiti...Continue Reading

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