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Better preparation is required for proactive advance care planning
  1. Yi An Shih1,
  2. Wang Cheng2,3,
  3. Huang Xia4,
  4. Ali Ali5,
  5. Yujie Wang1,
  6. Lichuan Zhang1 and
  7. Qian Lu1
  1. 1 School of Nursing, Peking University, Beijing, China
  2. 2 Department of Rheumatology and Immunology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
  3. 3 Inner Mongolia Key Laboratory for Pathogenesis and Diagnosis of Rheumatic and Autoimmune Diseases, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
  4. 4 Department of General Medicine, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Chongqing, China
  5. 5 Sheffield Teaching Hospitals NIHR Biomedical Research Centre, Sheffield, UK
  1. Correspondence to Dr Qian Lu, School of Nursing, Peking University, Beijing 100871, China; luqian{at}

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To the Editor,

We were interested in Brooks, Hayhoe and Maccketty’s post on the BMJSPC blog titled ‘Advance care planning: a chance to be proactive not reactive’ (6 July 2020). The importance of being proactive rather than reactive in advance care planning (ACP) was confirmed in this study. The authors claim that they were able to evaluate the data of 61 patients who died at Cambridge University Hospital Trust between 2018 and 2019. However, the team found that just a minority of patients (13%) had discussed their prognosis with a healthcare professional during their terminal illness, and only 3% had made an early choice to refuse treatment.

Despite the positive evidence that ACP enhances patients’ life quality at the end of life, such conversations between patients and healthcare professionals are rare in clinical practice. A study of chronic respiratory disease showed that although many patients and healthcare professionals were interested in ACP, just about a third of patients reported such interactions.1 We also agree with Rietjens et al …

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  • Contributors YAS: conception, research design, drafting the manuscript and data analysis. WC and XH: acquisition of data, analysis and interpretation of data. LZ and YW: data analysis. QL and AA: editing and proofreading.

  • Funding This work was supported by the “National Natural Science Foundation of China (72174011)”.

  • Competing interests None declared.

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