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O-120 White paper defining optimal advance care planning
  1. Judith AC Rietjens1,
  2. IJ Korfage1,
  3. Daisy JA Janssen2,3,
  4. Ralf J Jox4,
  5. M Drickamer5,
  6. Jane Seymour6 and
  7. Rebecca L Sudore7
  1. 1Department of Public Health, Erasmus University Medical Center, The Netherlands
  2. 2Department of Research & Education, CIRO+, Horn, The Netherlands
  3. 3Centre of Expertise for Palliative Care, Maastricht UMC+, Maastricht, The Netherlands
  4. 4Institute of Ethics, History and Theory of Medicine, University of Munich, Germany
  5. 5Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, Connecticut, USA
  6. 6Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, Division of Nursing, Queen’s Medical Centre, Nottingham, UK
  7. 7Division of Geriatrics, San Francisco VA Medical Center, University of California, USA


Background There is a lack of consensus regarding the definition of advance care planning (ACP), the people for whom it is most beneficial, how and by whom it should be conducted, its integration in health care, and what appropriate outcomes measures are. Further, there are considerable differences worldwide in the willingness of health care providers, patients and relatives to discuss issues related to disease progression and end-of-life care, and the integration of these discussions in the health care system.

Aim To draft a white paper about ACP that is based on scientific evidence and transcultural consensus building that describes a common understanding of the definition the key elements of ACP. This white paper is commissioned by the European Association for Palliative Care (EAPC).

Methods and expected results A three-round Delphi study will be conducted by a core group of 14 experts from 8 countries. The first round took place in June 2014 in a 2-day expert meeting. Five core domains were established: concept, content, system, measurements, and challenges/concerns. Subsequently, based on literature, a set of 50 recommendations related to these domains were drafted. These will be assessed in two rounds on its importance by a multidisciplinary expert panel (n = 100 from 16 countries). In addition, a research agenda for future ACP research will be constructed.

Conclusion The ACP white paper will provide a comprehensive overview of ACP based on evidence and consensus. It can serve as a framework for clinical practice, policy and research.

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