Patient-directed Advance Care Planning

dodson%20headshotSeveral weeks ago, the American Geriatrics Society (AGS) held its annual scientific sessions in San Antonio, TX. This meeting attracts geriatricians and other professionals dedicated to caring for older adults. As a geriatric cardiologist I attend AGS regularly, and in recent years I have seen interest from other subspecialists continue to grow.

One of the most interesting abstracts presented at AGS this year was by Dr. Rebecca Sudore (UCSF), who discussed a randomized clinical trial aimed at improving advance care planning (ACP). Essentially, Dr. Sudore and colleagues created an interactive, patient-centered advance care planning website. They then assigned half of participants to review this website, and the other half to receive usual care. After 9 months, documentation of ACP improved significantly in the group assigned to the website. They published these findings concurrently in JAMA Internal Medicine.

One of the true innovations of this study is that they targeted patients without requiring intervention on part of the clinical team or health system. This helped to overcome some of the barriers we face in our busy practices with regards to ACP; we all know it’s important, but are often busy with more acute medical issues and long-term planning is therefore overlooked. I am interested in seeing whether Dr. Sudore’s work can be scaled to other healthcare settings in the coming years.

 

By: John Dodson, MD