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Evidence of increasing public participation in advance care planning: a comparison of polls in Alberta between 2007 and 2013.
BMJ Support Palliat Care. 2019 Jun; 9(2):189-196.BS

Abstract

BACKGROUND

Advance care planning (ACP) encompasses both verbal and written communications expressing preferences for future health and personal care and helps prepare people for healthcare decision-making in times of medical crisis. Healthcare systems are increasingly promoting ACP as a way to inform medical decision-making, but it is not clear how public engagement in ACP activities is changing over time.

METHODS

Raw data from 3 independently conducted public polls on ACP engagement, in the same Canadian province, were analysed to assess whether participation in ACP activities changed over 6 years.

RESULTS

Statistically significant increases were observed between 2007 and 2013 in: recognising the definition of ACP (54.8% to 80.3%, OR 3.37 (95% CI 2.68 to 4.24)), discussions about healthcare preferences with family (48.4% to 59.8%, OR 1.41 (95% CI 1.17 to 1.69)) and with healthcare providers (9.1% to 17.4%, OR 1.98 (95% CI 1.51 to 2.59)), written ACP plans (21% to 34.6%, OR 1.77 (95% CI 1.45 to 2.17)) and legal documentation (23.4% to 42.7%, OR 2.13 (95% CI 1.75 to 2.59)). These remained significant after adjusting for age, education and self-rated health status.

CONCLUSIONS

ACP engagement increased over time, although the overall frequency remains low in certain elements such as discussing ACP with healthcare providers. We discuss factors that may be responsible for the increase and provide suggestions for healthcare systems or other public bodies seeking to stimulate engagement in ACP.

Authors+Show Affiliations

Division of Palliative Medicine, Department of Oncology, University of Calgary, Calgary, Alberta, Canada. Department of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.Department of Medical Oncology, Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada. Alberta Health Services-Cancer Control.Clinical Evaluation Research Unit, Department of Medicine, Kingston General Hospital, Kingston, Ontario, Canada. Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada.Health Quality Council of Alberta, Calgary, Alberta, Canada.Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.Department of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.Division of Palliative Medicine, Department of Oncology, University of Calgary, Calgary, Alberta, Canada. John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada.Department of Cardiac Sciences, University of Calgary, and Libin Cardiovascular Institute, Calgary, Alberta, Canada.Covenant Health Palliative Institute, Edmonton, Alberta, Canada. Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26817793

Citation

Simon, J E., et al. "Evidence of Increasing Public Participation in Advance Care Planning: a Comparison of Polls in Alberta Between 2007 and 2013." BMJ Supportive & Palliative Care, vol. 9, no. 2, 2019, pp. 189-196.
Simon JE, Ghosh S, Heyland D, et al. Evidence of increasing public participation in advance care planning: a comparison of polls in Alberta between 2007 and 2013. BMJ Support Palliat Care. 2019;9(2):189-196.
Simon, J. E., Ghosh, S., Heyland, D., Cooke, T., Davison, S., Holroyd-Leduc, J., Wasylenko, E., Howlett, J., & Fassbender, K. (2019). Evidence of increasing public participation in advance care planning: a comparison of polls in Alberta between 2007 and 2013. BMJ Supportive & Palliative Care, 9(2), 189-196. https://doi.org/10.1136/bmjspcare-2015-000919
Simon JE, et al. Evidence of Increasing Public Participation in Advance Care Planning: a Comparison of Polls in Alberta Between 2007 and 2013. BMJ Support Palliat Care. 2019;9(2):189-196. PubMed PMID: 26817793.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence of increasing public participation in advance care planning: a comparison of polls in Alberta between 2007 and 2013. AU - Simon,J E, AU - Ghosh,S, AU - Heyland,D, AU - Cooke,T, AU - Davison,S, AU - Holroyd-Leduc,J, AU - Wasylenko,E, AU - Howlett,J, AU - Fassbender,K, AU - ,, Y1 - 2016/01/27/ PY - 2015/05/05/received PY - 2015/10/14/revised PY - 2016/01/05/accepted PY - 2016/1/29/pubmed PY - 2019/7/30/medline PY - 2016/1/29/entrez KW - Communication KW - Service evaluation SP - 189 EP - 196 JF - BMJ supportive & palliative care JO - BMJ Support Palliat Care VL - 9 IS - 2 N2 - BACKGROUND: Advance care planning (ACP) encompasses both verbal and written communications expressing preferences for future health and personal care and helps prepare people for healthcare decision-making in times of medical crisis. Healthcare systems are increasingly promoting ACP as a way to inform medical decision-making, but it is not clear how public engagement in ACP activities is changing over time. METHODS: Raw data from 3 independently conducted public polls on ACP engagement, in the same Canadian province, were analysed to assess whether participation in ACP activities changed over 6 years. RESULTS: Statistically significant increases were observed between 2007 and 2013 in: recognising the definition of ACP (54.8% to 80.3%, OR 3.37 (95% CI 2.68 to 4.24)), discussions about healthcare preferences with family (48.4% to 59.8%, OR 1.41 (95% CI 1.17 to 1.69)) and with healthcare providers (9.1% to 17.4%, OR 1.98 (95% CI 1.51 to 2.59)), written ACP plans (21% to 34.6%, OR 1.77 (95% CI 1.45 to 2.17)) and legal documentation (23.4% to 42.7%, OR 2.13 (95% CI 1.75 to 2.59)). These remained significant after adjusting for age, education and self-rated health status. CONCLUSIONS: ACP engagement increased over time, although the overall frequency remains low in certain elements such as discussing ACP with healthcare providers. We discuss factors that may be responsible for the increase and provide suggestions for healthcare systems or other public bodies seeking to stimulate engagement in ACP. SN - 2045-4368 UR - https://www.unboundmedicine.com/medline/citation/26817793/Evidence_of_increasing_public_participation_in_advance_care_planning:_a_comparison_of_polls_in_Alberta_between_2007_and_2013_ L2 - http://spcare.bmj.com/cgi/pmidlookup?view=long&pmid=26817793 DB - PRIME DP - Unbound Medicine ER -