Reimagining and rebranding advance care planning

被引:1
作者
Malhotra, Chetna [1 ]
机构
[1] Duke NUS Med Sch, Lien Ctr Palliat Care, Program Hlth Serv & Syst Res, 8 Coll Rd, Singapore 169857, Singapore
关键词
advance care planning; care planning; care preparation; end of life; serious illness; goal concordant care; older people;
D O I
10.1093/ageing/afae233
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Advance care planning (ACP) has traditionally aimed at ensuring that patients' end-of-life (EOL) wishes are understood and respected. However, recent literature raises concerns about its effectiveness, with many trials indicating that ACP does not significantly improve goal-concordant care, enhance quality of life or reduce healthcare costs. This is because patients' future decisions are influenced by their transient preferences due to projection bias. To remain relevant, ACP requires a radical shift in perspective, implementation and branding. First, ACP's mission must be redefined with a focus on: Educate, Share and Prepare. This perspective emphasises ongoing conversations about patient health and illness, sharing of patients' current values and goals of care and preparation for the future, rather than making definitive future decisions. Second, ACP should be integrated into routine care, normalising these discussions. Simplifying ACP processes and shifting incentives to support shared responsibility among stakeholders can enhance integration. Last, rebranding ACP as 'Advance Care Preparation' can clarify its purpose, distinguishing it from EOL planning and increasing its uptake. This rebranding ensures that ACP meets the evolving needs of patients and their families, ultimately enhancing the quality of care and patient satisfaction. These changes in perspective, implementation and branding can transform ACP into a valuable tool for delivering compassionate,-centred healthcare, it relevant to all individuals.
引用
收藏
页数:3
相关论文
共 15 条
[1]   Association Between a Name Change from Palliative to Supportive Care and the Timing of Patient Referrals at a Comprehensive Cancer Center [J].
Dalal, Shalini ;
Palla, Shana ;
Hui, David ;
Nguyen, Linh ;
Chacko, Ray ;
Li, Zhijun ;
Fadul, Nada ;
Scott, Cheryl ;
Thornton, Veatra ;
Coldman, Brenda ;
Amin, Yazan ;
Bruera, Eduardo .
ONCOLOGIST, 2011, 16 (01) :105-111
[2]   The economic evidence for advance care planning: Systematic review of evidence [J].
Dixon, Josie ;
Matosevic, Tihana ;
Knapp, Martin .
PALLIATIVE MEDICINE, 2015, 29 (10) :869-884
[3]   Advance care planning: It is time to rethink our goals [J].
Malhotra, Chetna .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2023, 71 (12) :3963-3966
[4]   Caregivers' End-of-Life Care Goals for Persons with Severe Dementia Change Over Time [J].
Malhotra, Chetna ;
Balasubramanian, Ishwarya .
JOURNAL OF ALZHEIMERS DISEASE, 2023, 93 (03) :967-975
[5]   Barriers to advance care planning among patients with advanced serious illnesses: A national survey of health-care professionals in Singapore [J].
Malhotra, Chetna ;
Chaudhry, Isha .
PALLIATIVE & SUPPORTIVE CARE, 2024, 22 (05) :978-985
[6]   Complexity of implementing a nationwide advance care planning program: results from a qualitative evaluation [J].
Malhotra, Chetna ;
Ramakrishnan, Chandrika .
AGE AND AGEING, 2022, 51 (10)
[7]   What is the evidence for efficacy of advance care planning in improving patient outcomes? A systematic review of randomised controlled trials [J].
Malhotra, Chetna ;
Shafiq, Mahham ;
Batcagan-Abueg, Ada Portia Macarubbo .
BMJ OPEN, 2022, 12 (07)
[8]   A Prospective Cohort Study of Stability Preferred Place of Death Among Patients With Stage IV Cancer in Singapore [J].
Malhotra, Chetna ;
Koh, Ling En ;
Teo, Irene ;
Ozdemir, Semra ;
Chaudhry, Isha ;
Finkelstein, Eric .
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK, 2022, 20 (01) :20-+
[9]   Instability in Preference for Place of Death Among Patients With Symptoms of Advanced Heart Failure [J].
Malhotra, Chetna ;
Bundoc, Filipinas G. ;
Sim, David ;
Jaufeerally, Fazlur Rehman ;
Finkelstein, Eric A. .
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2021, 22 (02) :349.e29-349.e34
[10]   Instability in End-of-Life Care Preference Among Heart Failure Patients: Secondary Analysis of a Randomized Controlled Trial in Singapore [J].
Malhotra, Chetna ;
Hu, Meibo ;
Malhotra, Rahul ;
Sim, David ;
Jaufeerally, Fazlur Rehman ;
Bundoc, Filipinas G. ;
Finkelstein, Eric A. .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2020, 35 (07) :2010-2016