Effect of a Disease-Specific Advance Care Planning Intervention on End-of-Life Care
Kirchhoff, K., Hammes, B., Kehl, K., Briggs, L., & Brown, R. (2012). Effect of a disease-specific advance care planning intervention on end-of-life care. Journal of American Geriatrics Society, 60(5), 946-950. doi: 10.1111/j.1532-5415.2012.03917.x
A randomized controlled trial was conductedwith 313 individuals from two centers in Wisconsin with congestive heart failure or end-stage renal disease and their surrogates who were randomized to receive patient-centered advance care planning (PC-ACP) or usual care (standard AD counseling). PC-ACP interviews were conducted by trained facilitators. 110 individuals died before the end of the study. Days from entry into the study until death ranged from 19 to 997 (control) and 5 to 1,010 (intervention). Concordance of documented patient preferences and care received at the end of life was evaluated through surrogate interviews or medical charts. 74% of patients continued to make their own decisions about care to the end. Care received matched initial choices for 46 of the 62 intervention patients (74.1%) and for 30 of 48 control patients (62%). This study demonstrated that when disease-specific planning is done, the patient and surrogate are being helped to face future decisions in a more informed and prepared way.
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