Increasing advance personal planning: the need for action at the community level

Advance personal planning is the process by which people consider, document and communicate their preferences for personal, financial and health matters in case they lose the ability to make decisions or express their wishes in the future.

There is a need for rigorous evidence to demonstrate wheter a community action approach is effective in estabilishing whole community adoption of advance personal planning. 

Patient experience of primary care and advance care planning: a multicentre cross-sectional study in Japan.

Advance care planning (ACP) is a process whereby a patient, in consultation with health care providers, family members, and important others, makes decisions about his or her future health care. ACP process includes discussions regarding goals of care, resuscitation and life support, palliative care options, surrogate decision-making and advance directives (AD). Previous studies have shown positive impact of ACP on end-of-life care, including less aggressive medical care and better quality of life; decreased rates of hospital admission, especially of nursing home residents; and increased rates of hospice admission. So the aim of this study was to investigate the relationship between patient experience of primary care and ACP.

Exploring Patient-Reported Barriers to Advance Care Planning in Family Practice

Although patient-centred care has become increasingly important across all medical specialties, when it comes to end of life care, research has shown that treatments ordered are not often concordant with people's expressed preferences. Patient and family engagement in Advance Care Planning (ACP) in the primary care setting could improve the concordance between patients' wishes and the healthcare received when patients cannot speak for themselves. 

Managing clinical uncertainty in older people towards the end of life: a systematic review of person-centred tools

Older people with multi-morbidities commonly experience an uncertain illness trajectory. Clinical uncertainty is challenging to manage, with risk of poor outcomes. Person-centred care is essential to align care and treatment with patient priorities and wishes. Use of evidence-based tools may support person-centred management of clinical uncertainty. We aimed to develop a logic model of person-centred evidence-based tools to manage clinical uncertainty in older people.