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P-85 An advance care planning (ACP) group medical visit increases acp discussions and documentation
  1. Hillary D Lum1,
  2. Rebecca L Sudore2,
  3. J Jones1,
  4. CR Levy1,
  5. RS Schwartz1 and
  6. JS Kutner1
  1. 1University of Colorado, Colorado, USA
  2. 2University of California, San Francisco, California, USA

Abstract

Background Group medical visits facilitate patient education and discussion. The impact of a group medical visit model focused on advance care planning (ACP) warrants exploration.

Aim To assess ACP conversations, readiness, and documentation after an ACP group medical visit model among older persons in primary care.

Methods Pilot study of a novel ACP group medical visit model in a geriatrics clinic. The model is two sessions co-facilitated by a geriatrician and social worker. The model emphasises collaborative learning to promote engagement in a patient-centred ACP process. Patient evaluations after group visits and ACP documentation at baseline and 3-month follow-up were collected.

Results Seventy-three patients participated in ten ACP group medical visit cohorts. Mean age was 77 years old (56% female, 82% white). Patients reported an increase in ACP conversations from 56% before the medical visits to 86% after. Following participation in the ACP group medical visits, patients reported high levels of readiness to talk with their doctor about: a) choosing medical decision makers (72%); b) health situations that would make life not worth living (72%); c) flexibility for decision makers (72%); and d) questions to help make medical decisions (75%). At 3 months, there were increased rates of documentation of advance directives (20% to 58%), medical decision makers (33% to 82%), and resuscitation preferences (22% to 35%).

Discussion An ACP group medical visit model increased ACP conversations, readiness for ACP behaviours, and documentation.

Conclusion The ACP group medical visit model warrants further evaluation of efficacy and potential for implementation.

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