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Advance care planning and longer survival in the terminally ill: a randomised controlled trial unexpected finding
  1. Mette Asbjoern Neergaard1,
  2. Marianne Hjorth Skorstengaard2,
  3. Trine Brogaard3,
  4. Elisabeth Bendstrup4,
  5. Anders Løkke4,
  6. Susanne Aagaard5,
  7. Henrik Wiggers5,
  8. Pernille Andreassen2 and
  9. Anders Bonde Jensen2
  1. 1 Palliative Care Unit, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
  2. 2 Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
  3. 3 Research Unit for General Practice, Aarhus University, Aarhus, Denmark
  4. 4 Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
  5. 5 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to Dr Mette Asbjoern Neergaard, Palliative Care Unit, Department of Oncology, Aarhus University Hospital, Aarhus 8200, Denmark; mettneer{at}rm.dk

https://doi.org/10.1136/bmjspcare-2019-001906

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    Introduction

    Advance care planning (ACP) can be a way to meet patients’ end-of-life preferences and increase awareness and quality of end-of-life care. In a recent publication, we investigated the effect of ACP in a randomised controlled trial of incurably ill patients with mixed diagnoses within the areas of cancer, lung and cardiac diseases.1 We found that ACP did not affect fulfilment of preferences concerning place of death and hospitalisation. However, a significantly higher percentage of patients died at home in the ACP group.1

    ACP may be perceived as a part of an early integration of palliative care, which has been shown to improve survival among cancer patients.2 However, no randomised studies are available on the effects of ACP on survival. As part of our explorative data analysis, we aimed to investigate the possible effects of ACP on survival among terminally ill patients with lung, heart and cancer diseases.

    Method

    The study was post hoc analysis to a randomised, controlled trial among terminally ill patients in Denmark, including both patients with malignant and non-malignant diseases. The primary aim of the randomised controlled trial (RCT) was to investigate if ACP among patients with lung, heart and cancer diseases affected fulfilment of preferred place of death in this patient group.1

    Data concerning the date …

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    Footnotes

    • Contributors MAN, MHS and ABJ made substantial contribution to the concept, design, analysis, interpretation of data and drafted the article. MAN, MHS, TB, EB, AL, SA, HW, PA and ABJ revised the article critically for important intellectual content and approved the version to be published.

    • Funding This work was supported by the Danish Cancer Society and the Danish foundation TrygFonden.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval According to the Central Denmark Region Committee on Health Research Ethics, this study does not need any ethics approval (j. no. 35/2013). The study was approved by the Danish Data Protection Agency (j. no. 1-16-02-367-14) and registered with ClinicalTrials.gov (NCT01944813).

    • Provenance and peer review Not commissioned; externally peer reviewed.