Feasibility and Acceptability of Facilitated Advance Care Planning in Outpatient Clinics: A Qualitative Study of Patient and Caregivers Experiences.
Kate H MarshallDiane L Riddiford-HarlandAnne E MellerGideon A CaplanVasi NaganathanJohn CullenPeter GonskiNicholas A ZwarJulie-Ann O'KeeffeKarolina KrysinskaJoel J RheePublished in: Journal of applied gerontology : the official journal of the Southern Gerontological Society (2023)
Guidelines recommend advance care planning (ACP) for people with advanced illness; however, evidence supporting ACP as a component of outpatient care is lacking. We sought to establish the feasibility and acceptability of a facilitated ACP intervention for people attending tertiary outpatient clinics. Data from 20 semi-structured interviews with patient ( M = 79.3 ± 7.7, 60% male) and caregiver ( M = 68.1 ± 11.0, 60% female) participants recruited as part of a pragmatic, randomized controlled trial (RCT) were analyzed using qualitative descriptive methodology. Patients were randomized to intervention (e.g., facilitated support) or control (e.g., standard care). Intervention patients expressed high satisfaction, reporting the facilitated ACP session was clear, straightforward, and suited to their needs. Intervention caregivers did not report any significant concerns with the facilitated ACP process. Control participants reported greater difficulty completing ACP compared to intervention participants. Embedding facilitated ACP into tertiary outpatient care appears feasible and acceptable for people with advanced illnesses.
Keyphrases
- randomized controlled trial
- palliative care
- advance care planning
- end stage renal disease
- healthcare
- study protocol
- ejection fraction
- newly diagnosed
- chronic kidney disease
- primary care
- prognostic factors
- systematic review
- mental health
- clinical trial
- pain management
- machine learning
- open label
- cross sectional
- placebo controlled
- deep learning
- working memory
- patient reported
- artificial intelligence
- tertiary care