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O-77 Effects of advance care planning in patients with cancer. results from a systematic review
  1. Jan Schildmann1,
  2. C Bausewein2,
  3. Tanja Krones3,
  4. A Simon4,
  5. ST Simon5,
  6. R Voltz5,
  7. M Weber6,
  8. J Weis7 and
  9. Jürgen in der Schmitten8
  1. 1Institute of Medical Ethics and History of Medicine, Ruhr University Bochum, Germany
  2. 2Hospital of the University Munich, Campus Großhadern, Germany
  3. 3Clinical Ethics University Hospital Zurich, Zurich, Switzerland
  4. 4Academy for Ethics in Medicine, Göttingen, Germany
  5. 5Centre of Palliative Medicine, University Hospital Cologne, Cologne, Germany
  6. 6Interdisciplinary Institution for Palliative Care, University Hospital Mainz
  7. 7Hospital for Tumorbiology at University Freiburg
  8. 8Institute of General Practice, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Germany
  9. *on Behalf of the German Guideline Group S3-Palliativmedizin

Abstract

Background Advance Care Planning (ACP) is a systematic and interprofessional approach of communicating and implementing advance health care planning between patients, relatives and persons involved in the healthcare of a particular patient.

Aim The aim of this contribution is to assess the effectiveness of ACP in patients with cancer.

Methods Search in MEDLINE, EMBASE, PsycINFO and Cochrane Library. Criteria for inclusion were patients with cancer, ACP defined as communication about advance healthcare planning facilitated by healthcare professionals, a control group without ACP and measurement of patient oriented outcomes. All abstracts and selected publications were evaluated by two researchers independently.

Results Out of 572 hits we included 11 relevant studies with a total of 4060 patients. ACP often was part of a complex intervention and was not specified in more detail. The results of the studies included in this review indicate that ACP in patients with cancer is associated with improved psychological wellbeing, improved quality of life, less informational needs, a higher chance of preference sensitive care, less intensive care measures in the last phase of life and better knowledge regarding the rates for success of resuscitation.

Discussion The findings of this systematic review suggest that ACP in patients with cancer has positive patient oriented outcomes. However given the heterogeneous and often vague definitions of ACP the findings of the different studies are difficult to compare.

Conclusion High quality randomised trials are needed to corroborate current evidence regarding the effectiveness of ACP in oncology.

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