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O-31 Impact of an advance care planning program on the conformity of medical treatment at the end of life with nursing home residents’ preferences: A controlled interview survey of bereaved family members
  1. Thomas Otten1,
  2. Christiane Woopen2,
  3. H Christ3 and
  4. Jürgen in der Schmitten4
  1. 1Departement for Pastoral Care in Health and Social Services, Archdiocese of Cologne, Germany
  2. 2Research Unit Ethics, University Hospital Cologne, Germany
  3. 3Institute for Medical Statistics, Informatics and Epidemiology, University Hospital Cologne, Germany
  4. 4Institute of General Practice, Medical Faculty, Heinrich Heine University Düsseldorf, Germany

Abstract

Background In Germany, beizeiten begleiten (bb) was the first Advance Care Planning (ACP) program to be regionally implemented and evaluated. While the ACP program resulted in a much higher proportion of residents with meaningful and valid advance directives (ADs) in the intervention nursing homes  (n/hs), its effect on the dying process has not yet been evaluated.

Aim To study whether bb has improved conformity of end-of-life (EOL) care with the respective person’s treatment preferences.

Methods Prospective controlled survey of bereaved family members in two intervention n/hs compared with two matched controls. Using the After-death Bereaved Family Member Interview, we conducted telephone-interviews with next of kin of recently deceased residents.

Results 45 interviews in the intervention group (IG) were compared with 61 in the control group (CG; response rate 56.3% vs. 82.4%, p = 0.165). Conformity of EOL medical treatment with residents’ preferences (primary endpoint), measured on a 10-point Likert scale, was significantly higher in the IG (8.67) than in the CG (7.93, p = 0.026), and relatives were more comfortable that the resident could die the way he or she wanted (9.20 vs. 8.36, p = 0.037). Advance directives were more frequent in the IG (84.4% vs. 47.5%, p < 0.001). Of the remaining 52 survey items, 7 vs. 0 showed a significant and 38 vs. 7 a numeric advantage for the IG.

Discussion This comparison indicates better conformity of EOL care with patient and family wishes in 2 n/hs practising the ACP program beizeiten begleiten versus 2 matched control n/hs.

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