People who plan their end of life care in advance can enjoyed improved survival and care quality, according to Danish doctors.
Advance Care Planning involves a discussion of a person’s wishes and priorities for their care, including when stopping treatment that prolongs life.
The work was done by Professor Mette Neergaard of Aarhus University Hospital, Denmark, and colleagues. They investigated the effect of Advance Care Planning in a trial of terminally ill patients who had various conditions including cancer, lung and cardiac diseases.
They found that while Advance Care Planning did not affect “fulfilment of preferences concerning place of death and hospitalisation”, it did increase survival and the rate of patients dying at home.
Information was used on 205 patients, from national registers between November 2013 and November 2016. Analysis showed a significant improvement in the one-year survival rate in the Advance Care Planning group (57% versus 73%).
In BMJ Supportive & Palliative Care today (11 December), the team writes: “To our knowledge, this study is the first randomised controlled trial indicating that Advance Care Planning alone may potentially improve survival. Interestingly, the effect was most pronounced among patients with non-malignant diagnoses, who also benefited from Advance Care Planning in other studies with respect to knowledge and fulfilment of end-of-life preferences.”
They conclude: “Advance Care Planning can be a way to meet patients’ end-of-life preferences and increase awareness and quality of end-of-life care.
“Advance Care Planning was associated with a significantly improved survival among terminally ill patients, primarily patients with non-cancer diseases. However, the analysis was explorative, and the association must be investigated further before drawing any firm conclusions.”
Neergaard, M. A. et al. Advance care planning and longer survival in the terminally ill: a randomised controlled trial unexpected finding. BMJ Supportive & Palliative Care 11 December 2019 doi: 10.1136/bmjspcare-2019-001906
https://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2019-001906
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