Advance Care Planning? Meh. - Part 2

by Drew Rosielle (@drosielle)This is Part 2/2 of a couple posts about advance care planning (ACP).The last post outlined why there are really good reasons to believe that ACP (completion of health care directives and the healthcare conversations that occur around healthcare directive (HCD) completion, implemented on a broad scale) does not lead to any better, patient-centered outcomes, particularly when evaluated as a health intervention to be applied across a population (which is how ACP is typically conceptualized and researched).In the prior post, I perhaps obnoxiously promised that I thought one of the most important ACP research studies to occur has just been published, although I think it ' s important for reasons that weren ' t necessarily intended by its investigators.Thestudy is in JAMA Internal Medicine and was published a couple months ago.If you recall from my first post on ACP, one of the challenges with ACP research has been confounding in observational studies. Take an observational study showing that people with HCDs are more likely to have a longer than average hospice length of stay -- that may be true but we don ' t know why it ' s true. It could be true because completion of the ACP casually lead to the longer hospice LOS. It could also be true because patients who are inclined towards ACP completion are also inclined towards wanting less ' invasive ' EOL care; both of those measurable phenomena stem from underlying personal/social characteristics which pr...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Source Type: blogs