The Effect of Discussions About Advance Directives on Patients' Satisfaction with Primary Care

Tierney, William M.; Dexter, Paul; Gramelspacher, Gregory P.; Perkins, Anthony J.; Zhou, Xiao‐Hua; Wolinsky, Fredric D.

doi:10.1111/j.1525-1497.2001.00215.x

Cited by 100 publications

(86 citation statements)

References 24 publications

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“…Such discussions may have the added potential benefit of long-term improvement in patient satisfaction. 24 The rates of consent for organ donation in the intervention and control arms compared favorably to that of other studies, 2 but were lower than those seen when the same video was shown to individuals applying for their first driver's license at the bureau of motor vehicles. 1 One potential reason for the difference was the disparate study populations.…”

Section: Discussionmentioning

confidence: 55%

Effects of a Video on Organ Donation Consent Among Primary Care Patients: A Randomized Controlled Trial

et al. 2016

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Section: Discussionmentioning

confidence: 55%

Effects of a Video on Organ Donation Consent Among Primary Care Patients: A Randomized Controlled Trial

et al. 2016

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“…49e51 Previous studies have shown that patients are more satisfied with their GP when advance directives are discussed. 49 Moreover, it could be a satisfactory experience for the physician as well. 52 Altogether, the extent to which ACP truly occurs in advance of future medical decision making is questionable.…”

Section: Discussionmentioning

confidence: 99%

Advance Care Planning in Belgium and The Netherlands: A Nationwide Retrospective Study Via Sentinel Networks of General Practitioners

Meeussen

Block

Echteld

et al. 2011

Journal of Pain and Symptom Management

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Context. Advance care planning (ACP) is an important part of patient-centered palliative care. There have been few nationwide studies of ACP, especially in Europe.Objectives. To investigate the prevalence and characteristics of ACP in two European countries and identify the associated factors.Methods. A mortality follow-back study was undertaken in 2007 via representative nationwide Sentinel Networks of general practitioners (GPs) in Belgium and The Netherlands using similar standardized procedures. All GPs reported on each non-suddenly deceased patient in their practice. Our main outcome measure was whether or not ACP, that is, an agreement for medical treatment and/or medical decisions in the last phase of life in the case of the patient losing competence, was present.Results. Among 1072 non-sudden deaths, ACP was done with 34% of patients and most often related to the forgoing of potential life-prolonging treatments in general (24%). In 8% of cases, ACP was made in consultation with the patient and in writing. In 23% of cases, care was planned with the patient's family only. Multivariate analysis revealed that ACP was more often made with patients if they were capable of decision making during the last three days of life (odds ratio [OR] 3.86; 95% confidence interval [CI] 2.4e6.1), received treatment aimed at palliation in the last week (OR 2.57; 95% CI 1.6e4.2), had contact with a GP in the last week (OR 2.71; 95% CI 1.7e4.1), died of cancer (OR 1.46; 95% CI 1.1e2.0), or died at home (OR 2.16; 95% CI 1.5e3.0).

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“…A critical tool to achieving this is adequate documentation of patient preferences within the medical record, which helps to ensure that patient wishes are communicated and acted on across care settings and providers, and has been shown to increase patient autonomy in decision making and to decrease resource use. 1 Unfortunately, evidence suggests that documentation of preferences among patients with cancer is suboptimal, [2][3][4] and as a result, providers are often unaware of their patients' preferences regarding treatment. [5][6][7][8] In addition to adequate documentation of preferences, a growing body of literature has highlighted the relevance of having early and regular discussions about patient preferences to improving the quality of cancer care.…”

Section: Introductionmentioning

confidence: 99%

Documentation and Discussion of Preferences for Care Among Patients With Advanced Cancer

Ahluwalia

Chuang

Antonio

et al. 2011

JOP

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9. Wright AA, Zhang B, Ray A, et al: Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA 300: [1665][1666][1667][1668][1669][1670][1671][1672][1673] 2008 10. Temel JS, Greer JA, Admane S, et al: Longitudinal perceptions of prognosis and goals of therapy in patients with metastatic non-small cell lung cancer: Results of a randomized study of early palliative care. J Clin Methods:We prospectively abstracted the medical records of 118 patients receiving care at a Veterans Administration (VA) facility from diagnosis of stage IV disease to 12 months postdiagnosis or death. We used univariate statistics to describe the type and frequency of documentation of patient preferences and palliative care/hospice referral. We calculated the time from diagnosis to the first documentation of preferences and the time from first documentation to death. We compared documentation of patient preferences between decedents and nondecedents using 2 tests. Results:The majority of patients (81%) had some documentation of their care preferences recorded, although decedents were significantly more likely to have had their preferences documented than nondecedents (96% v 60%; P Ͻ .000). Most (53%) patients did not have a formal advance directive documented in the medical record. The mean time from diagnosis to the first documentation of preferences was approximately 2 months. More than half of all patients (53%) and almost threequarters of decedents (73%) had a palliative care consultation. Conclusion:Despite high rates of preference documentation, there remains room for improvement. Providers may need to be helped to identify patients earlier in their trajectory for appropriate palliative care services, and future work should focus on developing useful alternatives to advance directives for adequately documenting patient preferences.

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The Effect of Discussions About Advance Directives on Patients' Satisfaction with Primary Care

Cited by 100 publications

References 24 publications

Effects of a Video on Organ Donation Consent Among Primary Care Patients: A Randomized Controlled Trial

Effects of a Video on Organ Donation Consent Among Primary Care Patients: A Randomized Controlled Trial

Advance Care Planning in Belgium and The Netherlands: A Nationwide Retrospective Study Via Sentinel Networks of General Practitioners

Documentation and Discussion of Preferences for Care Among Patients With Advanced Cancer

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