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OP38 With which patients do primary care providers start ACP conversations and does this lead to an increase in advance directives?
  1. A Van der Plas1,
  2. M De Wit - Rijnierse2,
  3. M Eliel3 and
  4. B Onwuteaka - Philipsen1
  1. 1VUmc, Amsterdam, Netherlands
  2. 2ZONH, Heerhugowaard, Netherlands
  3. 3Westfriesgasthuis, Hoorn, Netherlands


Background To improve uptake of ACP, primary care providers (PCP; general practitioners (GPs), community nurses, certified nursing assistants, practice nurses) were trained in ACP and received support during implementation.

Methods ACP was implemented in 10 GP-practices and 2 care homes. Before implementation a list was drawn up of all patients of 75 years or older in the GP practice or care home on 01-01-2017. On this list, PCP made a note of patients with whom they started a ACP conversation until 14 months after start of implementation. Also, questionnaires were sent to the patients before and 14 months after start of implementation. Now we present interim analyses, at the conference the final data will be available.

Results A total of 2292 older patients were enrolled with the GP practices or living in the nursing homes. Of those, 596 (26%) received an offer of ACP and/or had an ACP conversation. The conversation was started more often with older patients (mean age 81 versus 83 years); female patients (57% versus 64%), and patients with at least one diagnosis (88% versus 95%). Questionnaires show an increase in advance directives (31.1% versus 41.0%) after implementation, compared to before implementation.

Conclusions With a quarter of older patients an ACP conversation was started (ACP was offered and/or an ACP conversation was held). Advance directives are drawn up more often after implementation of ACP. Care providers make a selection in patients with whom they start the conversation.

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