Table 2

Characteristics of respondents who did or did not have an ACP conversation after implementation of ACP

No ACP
(n=308)*
ACP
(n=150)*
OR (95% CI)
Unadjusted (bivariate)
OR (95% CI)
Model†
Age, mean (SD)80.2 (4.3)82.3 (5.5)1.09 (1.05 to 1.14)1.10 (1.04 to 1.16)
Sex, female190 (63.1)96 (64.8)1.08 (0.72 to 1.63)
Country of birth, NL284 (92.2)145 (96.7)2.45 (0.92 to 6.56)
Marital status, married134 (44.7)50 (33.8)0.63 (0.42 to 0.95)
Level of education
 Lower secondary education or lower160 (52.0)79 (52.7)Reference
 Higher secondary education68 (22.1)35 (23.3)1.04 (0.64 to 1.70)
 Tertiary education80 (26.0)36 (24.0)0.91 (0.57 to 1.46)
Religious affiliation
 No specific religious affiliation or atheist168 (54.6)88 (58.7)Reference
 Protestant63 (20.5)29 (19.3)0.88 (0.53 to 1.46)
 Catholic42 (13.6)15 (10.0)0.68 (0.36 to 1.30)
 Other15 (4.9)6 (4.0)0.76 (0.29 to 2.04)
 Do not want to answer this question20 (6.5)12 (8.0)1.15 (0.54 to 2.45)
Diagnosis (more than one answer possible)
 Cancer17 (5.7)14 (9.7)1.77 (0.85 to 3.71)
 Rheumatism/arthrosis84 (28.3)42 (29.2)1.04 (0.67 to 1.62)
 COPD32 (10.8)12 (8.3)0.75 (0.38 to 1.51)
 Diabetes39 (13.1)18 (12.5)0.95 (0.52 to 1.72)
 Heart condition79 (26.6)36 (25.0)0.92 (0.58 to 1.45)
 Stroke/cerebrovascular accident13 (4.4)14 (9.7)2.35 (1.08 to 5.15)2.51 (0.92 to 6.83)
 Dementia4 (1.4)3 (2.1)1.56 (0.34 to 7.06)
 Depression16 (5.4)5 (3.5)0.63 (0.23 to 1.76)
 Multiple sclerosis00
 Amyotrophic lateral sclerosis00
 Other63 (21.2)38 (26.4)1.33 (0.84 to 2.12)
 None83 (28.0)27 (18.8)0.59 (0.36 to 0.97)
Do you have a clear idea about future health problems that you might face?
 Don’t know/no197 (65.0)80 (54.4)ReferenceReference
 Yes106 (35.0)67 (45.6)1.56 (1.04 to 2.33)1.25 (0.75 to 2.11)
Preferred timing of ACP, never (vs ever)17 (6.1)1 (0.8)0.12 (0.02 to 0.93)
If ever, preferred timing is
 Before someone is ill46 (17.6)43 (34.1)ReferenceReference
 At time of diagnosis of a possible life-threatening illness90 (34.5)39 (31.0)0.46 (0.26 to 0.81)0.63 (0.32 to 1.22)
 When it is clear that it is no longer possible to cure from the illness125 (47.9)44 (34.9)0.38 (0.22 to 0.65)0.52 (0.28 to 0.99)
Having had an ACP conversation at first measurement (before implementation), yes38 (12.3)63 (42.0)5.15 (3.22 to 8.23)3.85 (2.07 to 7.15)
Reasons not to engage in ACP
 My next of kin know what I want114 (37.0)61 (40.7)1.17 (0.78 to 1.74)
 I see no reason not to talk about it127 (41.2)59 (39.3)0.92 (0.62 to 1.38)
 I don’t want to think about the future or about getting (more) ill49 (15.9)11 (7.3)0.42 (0.21 to 0.83)
 My GP knows what I want12 (3.9)28 (18.7)5.67 (2.79 to 11.50)3.27 (1.17 to 9.12)
 I am healthy, there is no reason to do so10 (3.3)1 (0.7)0.20 (0.03 to 1.58)
 I am afraid I don’t get the opportunity to change preferences later3 (1.0)1 (0.7)0.68 (0.07 to 6.62)
 I don’t know what the future will bring8 (2.6)1 (0.7)0.25 (0.03 to 2.03)
 Other reasons7 (2.3)6 (4.0)1.79 (0.59 to 5.43)
  • Bold indicates a p-value < 0.05.

  • *Characteristics at pre-measurement are reported, if missing in pre-measurement then answer at post-measurement was used in country of birth, education and religion. Missing data: age no ACP n=9, ACP n=4; sex no ACP n=7, ACP n=2; marital status no ACP n=8, ACP n=2; diagnosis no ACP n=11, ACP n=6; idea about future health problems no ACP n=5, ACP n=3; preferred timing no ACP n=30, ACP n=23; reasons not to engage in ACP: missing answers were coded as ‘no’.

  • †Backward logistic multilevel regression procedure (to adjust for organisation), model with random intercept is reported, removal at p>0.10.

  • ACP, advance care planning; COPD, chronic obstructive pulmonary disease; GP, general practitioner; NL, the Netherlands.