Feasibility and Acceptability of Facilitated Advance Care Planning in Outpatient Clinics: A Qualitative Study of Patient and Caregivers Experiences

• Published in: Journal of applied gerontology 2024-04, Vol.43 (4), p.339-348
• Main Authors: Marshall, Kate H., Riddiford-Harland, Diane L., Meller, Anne E., Caplan, Gideon A., Naganathan, Vasi, Cullen, John, Gonski, Peter, Zwar, Nicholas A., O’Keeffe, Julie-Ann, Krysinska, Karolina, Rhee, Joel J.
• Format: Article
• Language: English
• Subjects: Advance Care Planning; Advance directives; Ambulatory Care Facilities; Caregivers; Clinics; Feasibility Studies; Female; Humans; Illnesses; Intervention; Male; Outpatient care facilities; Patient satisfaction; Patients; Qualitative Research
• ISSN: 0733-4648; 1552-4523; 1552-4523
• DOI: 10.1177/07334648231206742

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.