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What do Canadians think of advanced care planning? Findings from an online opinion poll
  1. Ana A Teixeira1,
  2. Louise Hanvey2,
  3. Carolyn Tayler3,
  4. Doris Barwich3,4,
  5. Sharon Baxter2 and
  6. Daren K Heyland1,5,6
  7. On behalf of the Canadian Researchers at the End of Life Network (CARENET)
  1. 1Department of Medicine, Queen's University, Kingston, Ontario, Canada
  2. 2Canadian Hospice Palliative Care Association, Ottawa, Ontario, Canada
  3. 3Fraser Health Authority, Surrey, British Columbia, Canada
  4. 4Division of Palliative Care, Department of Medicine UBC, Surrey, British Columbia, Canada
  5. 5Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario
  6. 6Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada
  1. Correspondence to Dr Daren K Heyland, Department of Medicine, Queen's University, Kingston General Hospital, Angada 4, 76 Stuart Street, Kingston, Ontario, Canada K7L 2V7; dkh2{at}


Background Advance care planning (ACP) has the potential to increase patient-centred care, reduce caregiver burden, and reduce healthcare costs at the end of life. Current levels of public participation in ACP activities are unknown. The purpose of this study was to determine the level of engagement of average Canadians in ACP activities.

Methods Data come from an on-line opinion poll of a national sample of respondents who were asked five questions on ACP activities along with their sociodemographic characteristics.

Results Respondents were from all provinces of Canada, 52% were women, and 33% were between 45 years and 54 years of age. Of 1021 national sample respondents, 16% were aware of the term, ACP (95% CI 13% to 18%), 52% had discussions with their family or friends (95% CI 49% to 55%), and 10% had discussions with healthcare providers (95% CI 8% to 12%). Overall, 20% (95% CI 18% to 22%) of respondents had a written ACP and 47% (95% CI 44% to 50%) had designated a substitute decision maker. Being older was associated with significantly more engagement in ACP activities and there were significant differences in ACP engagement across Canada.

Conclusions Although only a small proportion of Canadians are aware of the formal term, ACP, a higher percentage of Canadians are actually engaged in ACP, through either having discussions or making decisions about end-of-life care. Older citizens are more likely to be engaged in ACP and there are geographic differences in the level of ACP engagement across Canada.

  • Advance Care Planning
  • Advance Directives
  • Regional Health Planning
  • Socioeconomic Factors
  • Intervention Studies

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