What do doctors know about Advance Care Planning?

Advanced care planning and end-of-life discussions in the perioperative period: a review of healthcare professionals’ knowledge, attitudes and training. Blackwood et al

Background

  • There are 20–25, 000 post-operative deaths in the UK each year
  • High risk surgical patients (12.5% of surgical patients) account for more than 80% of perioperative deaths
  • There is a move towards greater patient involvement in the own care (e.g. Advanced Care Planning – ‘ACP’)

Aims

  • This is a systematic review with the intention to identify the knowledge and attitudes of health care professionals towards ACPs prior to surgery, and also to identify examples of current practice and barriers to delivery

Methods

  • A review of peer reviewed journal articles in variety of databases and the grey literature  
  • PICOS framework informed the search strategy
  • They also screened articles for references
  • There were four main search questions: themes – attitudes if health care professionals (‘HCP’s) to ACPs; level of knowledge of HCPs around ACPs; barriers to ACP discussions and presence of interventions aimed to improve ACP discussions

Results

  • Of 1566 papers, only 7 met the criteria for inclusion and therefore there is very limited data on which to make conclusions regarding the search questions

Discussion

  • There is a lack of evidence in this area
  • Health care professionals are positive about Advanced Care Planning
  • There is currently a lack of training and resources to improve the delivery of ACP discussions

Summary by Dr Nisha Sriram

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