Implementation of advance care planning for patients with advanced illnesses attending hospital outpatient clinics

P. Gonski, J. Rhee, A. Meller, K. Krysinska, V. Naganathan, N. Zwar, A. Hayen, J. Cullen, J. A. O'Keefe, J. McDonald, B. Harris-Roxas, G. Caplan

Research output: Contribution to journalMeeting AbstractResearchpeer-review


Aim: The uptake of older people completing advance care directives needs to be improved if this can improve patient care and avoid unwanted interventions and hospitalisation. Advance care directives can be completed in various health settings. However, this requires staff that are well educated themselves in this area and time with patients and carers to educate them. The aim of this study was to increase uptake of advance care directives in outpatient clinics and determine if there was an improvement in these domains.

Methods: The study was undertaken in 5 metropolitan hospitals in Sydney in various hospital outpatient clinics (aged care, respiratory, cardiology etc).Patients were initially screened via the SPICT tool. This screens potential death within 6–12 months. If positive they were asked if they wanted to participate in the study. Patients were assigned to a control group or intervention group. Intervention group had nurses see them at home to educate and complete advance care directives.

Results: 197 patients were randomised. Similar age and gender distribution. Similar number withdrew/died. Quality of life measures showed similar outcomes apart from health perception and physical functioning were worse for intervention group. Patient perception of chronic illness care was better in intervention group.

Conclusions: The study confirmed that the outpatient settings was an effective way to screen patients and subsequently educate and help them complete advance care directives. The feedback from patients was excellent. Results show benefit in patients’ understanding of their illnesses. However, there needs to be a well-informed driver (nurse, doctor etc) to make sure patients and carers are well educated and forms are completed.
Original languageEnglish
Article numberP57
Pages (from-to)61-61
Number of pages1
JournalAustralasian Journal on Ageing
Issue numberS1
Publication statusPublished - May 2019


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