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Advance Care Planning

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1. Advance care planning and palliative care

Advance care planning and palliative care Advance care planning and palliative care | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword (...) Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Advance care planning and palliative care Article Text This article has a correction. Please see: EBN perspective Advance care planning and palliative care Roberta Heale 1 , Helen Noble 2 Statistics from Altmetric.com EBN Perspectives brings together key issues from the commentaries in one of our nursing

2017 Evidence-Based Nursing

2. Does advance care planning alter management decisions made by healthcare professionals?

Does advance care planning alter management decisions made by healthcare professionals? Review Methods Search Strategy: A systematic search was conducted across a wide-ranging set of data- bases: Ovid Medline, including In-Process & Other Non-Indexed Citations, Ovid Embase, Ovid PsycINFO, Ebsco CINAHL and Cochrane Library. The preliminary search strategy was developed on Ovid Medline using both text words and Medical subject headings from January 2006 to August 2016 restricted to English (...) influenced by the presence of an advanced care plan in making management decision. Studies published in English from 2006 to current. Exclusion: Studies where physicians experiences were not explored, advance directives only referring to do-not-resuscitate (DNR) orders, studies set in non Organization for Economic Cooperation and Development (OECD) coun- tries. Study selection/Quality Assessment/Data Extraction: Study selection was based upon review of the abstract by two independent reviewers. The full

2017 Palliative Care Evidence Review Service (PaCERS)

3. Costs and outcomes of advance care planning and end-of-life care for older adults with end-stage kidney disease: A person-centred decision analysis. Full Text available with Trip Pro

Costs and outcomes of advance care planning and end-of-life care for older adults with end-stage kidney disease: A person-centred decision analysis. Economic evaluations of advance care planning (ACP) in people with chronic kidney disease are scarce. However, past studies suggest ACP may reduce healthcare costs in other settings. We aimed to examine hospital costs and outcomes of a nurse-led ACP intervention compared with usual care in the last 12 months of life for older people with end-stage (...) kidney disease managed with haemodialysis.We simulated the natural history of decedents on dialysis, using hospital data, and modelled the effect of nurse-led ACP on end-of-life care. Outcomes were assessed in terms of patients' end-of-life treatment preferences being met or not, and costs included all hospital-based care. Model inputs were obtained from a prospective ACP cohort study among dialysis patients; renal registries and the published literature. Cost-effectiveness of ACP was assessed

2019 PLoS ONE

4. The Impact of Advance Care Planning on End-of-Life Care: Do the Type and Timing Make a Difference for Patients With Advanced Cancer Referred to Hospice? (Abstract)

The Impact of Advance Care Planning on End-of-Life Care: Do the Type and Timing Make a Difference for Patients With Advanced Cancer Referred to Hospice? This study aimed to determine the impact of advanced care planning (ACP) on potentially avoidable hospital admissions at the end of life (EOL) among a sample of hospice-referred patients with cancer, in order to present actionable considerations for the practicing clinician.This study was designed as a retrospective cohort using electronic (...) documentation is associated with fewer admissions in the last 30 days of life for patients with advanced cancer referred to hospice. Improving ACP processes prior to hospice referral holds promise for reducing EOL admissions.

2019 American Journal of Hospice and Palliative Medicine

5. Understanding Underuse of Advance Care Planning Among a Cohort of African American Patients With Advanced Cancer: Formative Research That Examines Gaps in Intent to Discuss Options for Care. (Abstract)

Understanding Underuse of Advance Care Planning Among a Cohort of African American Patients With Advanced Cancer: Formative Research That Examines Gaps in Intent to Discuss Options for Care. Advance care planning (ACP), palliative care (PC), and hospice are often underutilized by African Americans (AAs). This study assessed the impact of stage of intent to discuss ACP options as key potential barriers.We examined intent to discuss completion of ACP, PC, and hospice among 22 AA patients (...) with cancer admitted to a local safety net hospital. Participants were asked about intent to discuss an advanced directive or living will (AD/LW), medical power of attorney (MPOA), PC, and hospice with their doctors. Intent to discuss these ACP components was based on the transtheoretical model. Electronic health records were reviewed at various intervals to assess completion of ACP behaviors and survival.Participants had colorectal (33%), breast (44%), and lung (23%) cancer, and 82% had stage III/IV

2019 American Journal of Hospice and Palliative Medicine

6. What influences patients' decisions regarding palliative care in advance care planning discussions? Perspectives from a qualitative study conducted with advanced cancer patients, families and healthcare professionals. (Abstract)

What influences patients' decisions regarding palliative care in advance care planning discussions? Perspectives from a qualitative study conducted with advanced cancer patients, families and healthcare professionals. The concept of advance care planning is largely derived from Western countries. However, the decision-making process and drivers for choosing palliative care in non-Western cultures have received little attention.To explore the decision-making processes and drivers of receiving (...) palliative care in advance care planning discussions from perspectives of advanced cancer patients, families and healthcare professionals in northern Taiwan.Semi-structured qualitative interviews with advanced cancer patients, their families and healthcare professionals independently from inpatient oncology and hospice units. Thematic analysis with analytical rigour enhanced by dual coding and exploration of divergent views.Forty-five participants were interviewed (n = 15 from each group). Three main

2019 Palliative Medicine

7. Randomised controlled trial: Family-centred advanced care planning with adolescents living with HIV is perceived as important, helpful and meaningful

Randomised controlled trial: Family-centred advanced care planning with adolescents living with HIV is perceived as important, helpful and meaningful Family-centred advanced care planning with adolescents living with HIV is perceived as important, helpful and meaningful | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please (...) see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Family-centred advanced care planning with adolescents living with HIV is perceived as important, helpful and meaningful

2017 Evidence-Based Nursing

8. Advance care planning for haemodialysis patients. Full Text available with Trip Pro

Advance care planning for haemodialysis patients. End-stage kidney disease (ESKD) is a chronic, debilitative and progressive illness that may need interventions such as dialysis, transplantation, dietary and fluid restrictions. Most patients with ESKD will require renal replacement therapy, such as kidney transplantation or maintenance dialysis. Advance care planning traditionally encompass instructions via living wills, and concern patient preferences about interventions (...) such as cardiopulmonary resuscitation and feeding tubes, or circumstances around assigning surrogate decision makers. Most people undergoing haemodialysis are not aware of advance care planning and few patients formalise their wishes as advance directives and of those who do, many do not discuss their decisions with a physician. Advance care planning involves planning for future healthcare decisions and preferences of the patient in advance while comprehension is intact. It is an essential part of good palliative

2016 Cochrane

9. Clinician-targeted interventions to improve advance care planning in heart failure: a systematic review and meta-analysis (Abstract)

Clinician-targeted interventions to improve advance care planning in heart failure: a systematic review and meta-analysis Advance care planning (ACP) is widely advocated to contribute to better outcomes for patients suffering from heart failure. But clinicians appear hesitant to engage with ACP. Our aim was to identify interventions with the greatest potential to engage clinicians with ACP in heart failure.A systematic review and meta-analysis. We searched CINAHL, Cochrane Central Register

2019 EvidenceUpdates

10. Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones Full Text available with Trip Pro

Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones Advance care planning (ACP) is uncommon in patients with chronic obstructive pulmonary disease (COPD).To assess whether a nurse-led ACP-intervention can improve quality of patient-physician end-of-life care communication in patients with COPD. Furthermore, the influence of an ACP-intervention on symptoms of anxiety and depression in patients and loved ones was studied. Finally (...) , quality of death and dying was assessed in patients who died during 2-year follow-up.A multicentre cluster randomised-controlled trial in patients with advanced COPD was performed. The intervention group received an 1.5 hours structured nurse-led ACP-session. Outcomes were: quality of patient-physician end-of-life care communication, prevalence of ACP-discussions 6 months after baseline, symptoms of anxiety and depression in patients and loved ones and quality of death and dying.165 patients were

2019 EvidenceUpdates

11. An Employer Health Incentive Plan for Advance Care Planning and Goal-Aligned Care Full Text available with Trip Pro

An Employer Health Incentive Plan for Advance Care Planning and Goal-Aligned Care One strategy to promote workforce well-being has been health incentive plans, in which a company's insured employees are offered compensation for completing a particular health-related activity. In 2015, Providence Health & Services adopted an Advance Care Planning (ACP) activity as a 2015-2016 health incentive option. More than 51,000 employees and their insured relatives chose the ACP incentive option. More than (...) 80% rated the experience as helpful or very helpful. A high proportion (95%) of employees responded that they had someone they trusted who could make medical care decisions for them, yet only 23% had completed an advance directive, and even fewer (11%) had shared the document with their health care provider. The most common reason given for not completing an advance directive was that health care providers had never asked about it. These findings suggest that an insured employee incentive plan

2018 Population health management

12. Advanced care planning: the impact of Ceiling of Treatment plans in patients with Coordinate My Care. (Abstract)

Advanced care planning: the impact of Ceiling of Treatment plans in patients with Coordinate My Care. The aim of this evaluation is to describe the components and results of urgent care planning in Coordinate My Care (CMC), a digital clinical service for patients with life-limiting illness, for use if a patient is unable to make or express choices. Ceiling of treatment (CoT) plans were created detailing where the patient would like to receive their care and how aggressive medical interventions (...) of which CoT option was chosen, for most patients, PPD was home or care home. Patients with a CoT plan were more likely to have a documented resuscitation status.Patients with a CoT were more likely to die in their PPD (82%vs71%, OR 1.79, p<0.0001). A higher proportion of patients with a CoT decision died outside hospital.This analysis demonstrates that a substantial proportion of patients are willing to engage in urgent care planning. Three facets of urgent care planning identified include PPD, CoT

2018 BMJ Supportive & Palliative Care

13. Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan. Full Text available with Trip Pro

Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan. Although advance directives (AD) have been implemented for years in western countries, the concept of AD is not promoted extensively in eastern countries. In this study we evaluate a program to systematically conduct advance care planning (ACP) communication for hospitalized patients in Taiwan and identify the factors associated with AD completion.In (...) this retrospective evaluation of a clinical ACP program, we identified adult patients with chronic life-limiting illness admitted to Taipei City Hospital between April 2015 and January 2016. Trained healthcare providers held an ACP meeting to discuss patients' preference regarding end-of-life care and AD completion. A multiple logistic regression was performed to determine the factors associated with the AD completion.A total of 2878 patients were determined to be eligible for ACP during the study, among which

2018 PLoS ONE

14. Decision support intervention (Plan Well Guide) for patients and their substitute decision-makers to improve engagement in advance care planning: protocol for a randomised trial. Full Text available with Trip Pro

Decision support intervention (Plan Well Guide) for patients and their substitute decision-makers to improve engagement in advance care planning: protocol for a randomised trial. The purpose of this randomised trial is to evaluate the efficacy of a decision support intervention for serious illness decisions (the Plan Well Guide decision aid; www.PlanWellguide.com) in increasing the engagement of substitute decision-makers (SDMs) in the patient's advance care planning process (ie, 'ACP (...) engagement'), specifically the SDM's confidence and readiness for the role in the future.This study is a parallel group randomised controlled trial. We aim to enrol 90 participant dyads: patients aged 65 years and older attending outpatient healthcare settings and with indicators they would be at high risk of needing future medical decisions and their SDM. The intervention is the Plan Well Guide decision aid, administered to the patient by a facilitator, with the SDM present. The primary endpoint

2019 BMJ open

15. Advance care planning in life-threatening pulmonary disease: a focus group study Full Text available with Trip Pro

Advance care planning in life-threatening pulmonary disease: a focus group study Advance care planning (ACP) is a communication process for mapping a patient's wishes and priorities for end-of-life care. In preparation for the introduction of ACP in Norway, we wanted to explore the views of Norwegian pulmonary patients on ACP. We conducted four focus group interviews in a Norwegian teaching hospital, with a sample of 13 patients suffering from chronic obstructive pulmonary disease, lung cancer (...) at the time of diagnosis and at different "turning points" in the disease trajectory and being asked carefully about their needs for communication and planning. Transparency was important, but difficult to balance. ACP for patients with life-threatening pulmonary disease should rest upon an established patient-doctor/nurse relationship and awareness of turning points in the patient's disease progression. Individually requested and tailored information can support and empower patients and their relatives.

2018 ERJ open research

16. Do-not-resuscitate orders as part of advance care planning in patients with COPD Full Text available with Trip Pro

Do-not-resuscitate orders as part of advance care planning in patients with COPD There is growing awareness of the need for advance care planning in patients with chronic obstructive pulmonary disease (COPD). However, do-not-resuscitate (DNR) order implementation remains a challenge in clinical practice. We retrospectively analysed an observational cohort of 569 COPD patients with 2.5-8 years of follow-up in secondary care, to evaluate potential determinants and the prognostic significance

2018 ERJ open research

17. Advance care planning in severe COPD: it is time to engage with the future Full Text available with Trip Pro

Advance care planning in severe COPD: it is time to engage with the future Advance care planning should be part of our clinical routine in severe COPD http://ow.ly/Cshs30i8FS9.

2018 ERJ open research

18. Does advance care planning in addition to usual care reduce hospitalisation for patients with advanced heart failure: A systematic review and narrative synthesis. (Abstract)

Does advance care planning in addition to usual care reduce hospitalisation for patients with advanced heart failure: A systematic review and narrative synthesis. People with advanced heart failure have repeated hospital admissions. Advance care planning can support patient preferences, but studies in people with heart failure have not been assessed.To evaluate the literature regarding advance care planning in heart failure.Systematic review and narrative analysis (PROSPERO CRD42017059190 (...) randomised controlled trials and one observational study assessed planning as part of a specialist palliative care intervention; one randomised controlled trial assessed planning in addition to usual cardiology care; one randomised controlled trial and one observational study assessed planning in an integrated cardiology-palliative care model; one observational study assessed evidence of planning (advance directive) as part of usual care and one observational study was a secondary analysis of trial

2018 Palliative medicine

19. Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs Full Text available with Trip Pro

Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options.To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care.This was a case-control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath (...) . We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs.Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases.The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed

2018 Journal of palliative medicine

20. Effects of a Structured Advance Care Planning Guide Among Patients With Advanced Illness in Hospital Care Settings

Effects of a Structured Advance Care Planning Guide Among Patients With Advanced Illness in Hospital Care Settings Effects of a Structured Advance Care Planning Guide Among Patients With Advanced Illness in Hospital Care Settings - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number (...) of saved studies (100). Please remove one or more studies before adding more. Effects of a Structured Advance Care Planning Guide Among Patients With Advanced Illness in Hospital Care Settings The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details

2018 Clinical Trials

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