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Prevalence of advance care planning documentation and self-reported uptake in older Australians with a cancer diagnosis.
J Geriatr Oncol. 2021 Mar; 12(2):274-281.JG

Abstract

BACKGROUND

Advance care planning (ACP) and completion advance care directives (ACDs) is recommended for patients with cancer. Documentation needs to be available at the point of care.

OBJECTIVE(S)

To describe the prevalence of ACDs in health records and the self-reported awareness of and engagement in ACP as reported by older Australians with cancer, and to examine the concordance between self-reported completion of and presence of documentation in participants' health records.

DESIGN/SETTING/PARTICIPANTS

Prospective multi-center audit of health records, and a self-report survey of eligible participants in 51 Australian health and residential aged care services. The audit included 458 people aged ≥65 years with cancer.

RESULTS

30% had ≥ ACD located in their record. 218 people were eligible for survey completion; 97 (44% response rate) completed it. Of these, 81% had a preference to limit some/all treatments, 10% wanted to defer decision-making to someone else, and 9% wanted all treatments. Fifty-eight percent of survey completers reported having completed an ACP document. Concordance between documentation in the participant's record and self-report of completion was 61% (k = 0.269), which is only fair agreement.

CONCLUSION(S)

Whilst 30% of participants had at least one ACD in their record, 58% self-reported document completion, and concordance between self-reported completion and presence in records was only fair. This is significant given most people had a preference for some/all limitation of treatment. Further ACP implementation strategies are required. These include a systematic approach to embedding ACP into routine care, workforce education, increasing community awareness, and looking at e-health solutions to improve accessibility at the point of care.

Authors+Show Affiliations

Advance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, Melbourne University, Melbourne, Victoria, Australia; Faculty of Health, Arts and Innovation, Swinburne University, Australia. Electronic address: kdetering@swin.edu.au.Advance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia.Advance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia.Centre for Learning & Research in Palliative Care, HammondCare, Greenwich Hospital, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, Australia.Advance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia.Advance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32739354

Citation

Detering, Karen M., et al. "Prevalence of Advance Care Planning Documentation and Self-reported Uptake in Older Australians With a Cancer Diagnosis." Journal of Geriatric Oncology, vol. 12, no. 2, 2021, pp. 274-281.
Detering KM, Sellars M, Kelly H, et al. Prevalence of advance care planning documentation and self-reported uptake in older Australians with a cancer diagnosis. J Geriatr Oncol. 2021;12(2):274-281.
Detering, K. M., Sellars, M., Kelly, H., Clayton, J. M., Buck, K., & Nolte, L. (2021). Prevalence of advance care planning documentation and self-reported uptake in older Australians with a cancer diagnosis. Journal of Geriatric Oncology, 12(2), 274-281. https://doi.org/10.1016/j.jgo.2020.07.012
Detering KM, et al. Prevalence of Advance Care Planning Documentation and Self-reported Uptake in Older Australians With a Cancer Diagnosis. J Geriatr Oncol. 2021;12(2):274-281. PubMed PMID: 32739354.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of advance care planning documentation and self-reported uptake in older Australians with a cancer diagnosis. AU - Detering,Karen M, AU - Sellars,Marcus, AU - Kelly,Helana, AU - Clayton,Josephine M, AU - Buck,Kim, AU - Nolte,Linda, Y1 - 2020/07/29/ PY - 2020/04/08/received PY - 2020/05/26/revised PY - 2020/07/18/accepted PY - 2020/8/3/pubmed PY - 2020/8/3/medline PY - 2020/8/3/entrez KW - Advance care directives KW - Advance care planning KW - Cancer KW - End of life care KW - Geriatric oncology KW - Oncology SP - 274 EP - 281 JF - Journal of geriatric oncology JO - J Geriatr Oncol VL - 12 IS - 2 N2 - BACKGROUND: Advance care planning (ACP) and completion advance care directives (ACDs) is recommended for patients with cancer. Documentation needs to be available at the point of care. OBJECTIVE(S): To describe the prevalence of ACDs in health records and the self-reported awareness of and engagement in ACP as reported by older Australians with cancer, and to examine the concordance between self-reported completion of and presence of documentation in participants' health records. DESIGN/SETTING/PARTICIPANTS: Prospective multi-center audit of health records, and a self-report survey of eligible participants in 51 Australian health and residential aged care services. The audit included 458 people aged ≥65 years with cancer. RESULTS: 30% had ≥ ACD located in their record. 218 people were eligible for survey completion; 97 (44% response rate) completed it. Of these, 81% had a preference to limit some/all treatments, 10% wanted to defer decision-making to someone else, and 9% wanted all treatments. Fifty-eight percent of survey completers reported having completed an ACP document. Concordance between documentation in the participant's record and self-report of completion was 61% (k = 0.269), which is only fair agreement. CONCLUSION(S): Whilst 30% of participants had at least one ACD in their record, 58% self-reported document completion, and concordance between self-reported completion and presence in records was only fair. This is significant given most people had a preference for some/all limitation of treatment. Further ACP implementation strategies are required. These include a systematic approach to embedding ACP into routine care, workforce education, increasing community awareness, and looking at e-health solutions to improve accessibility at the point of care. SN - 1879-4076 UR - https://www.unboundmedicine.com/medline/citation/32739354/Prevalence_of_advance_care_planning_documentation_and_self_reported_uptake_in_older_Australians_with_a_cancer_diagnosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1879-4068(20)30174-0 DB - PRIME DP - Unbound Medicine ER -
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