TY - JOUR
T1 - Advance care planning in patients with suspected or proven COVID
T2 - are we meeting our own standards?
AU - Byambasuren, Oyungerel
AU - Myooran, Jananee
AU - Virk, Aishah
AU - Hanna, Rida
AU - Tanglay, Onur
AU - Younan, Sarah
AU - Moore, Nikk
AU - Middleton, Paul
AU - Chróinín, Danielle Ní
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2024/11
Y1 - 2024/11
N2 - Objective: Given the importance of advance care planning (ACP) in the context of a pandemic, we aimed to assess current adherence to local policy recommending ACP in all hospitalised adult patients with suspected or proven COVID-19 at Liverpool Hospital, Sydney, Australia. Design: A retrospective cohort study. Setting: A tertiary referral and teaching hospital. Participants: A select sample of adult patients admitted to Liverpool Hospital in 2019-2021 with suspected or proven COVID-19. Main outcome measures: Proportion of patients with documented ACP and format of ACP. Results: Amongst 209 patients with proven or suspected COVID-19 hospitalised between March 2019 through to September 2021, median frailty score was 3, the median Charlson Comorbidity Score was 4, median age of the patients was 71 years, and median length of hospital stay was 5 days (range 0-98 days). Almost all patients were tested for COVID-19 (n = 207, 99%) of which 15% (31) were positive. Fewer than a quarter of the patients had documented ACPs (50, 24%) and 17 patients had existing formal advance care directives. Patients who had ACP were older, more likely to be frail and more likely to have higher rates of comorbidity compared to those without ACP. ACP was more commonly discussed with family members (41/50) than patients (25/50) and others (5/50). Conclusion: Adherence to the local ACP policy mandating such discussions was low. This reinforces the need for prioritising ACP discussions, especially for unwell patients such as those with COVID, likely involving further input to improve awareness and rates of formal documentation.
AB - Objective: Given the importance of advance care planning (ACP) in the context of a pandemic, we aimed to assess current adherence to local policy recommending ACP in all hospitalised adult patients with suspected or proven COVID-19 at Liverpool Hospital, Sydney, Australia. Design: A retrospective cohort study. Setting: A tertiary referral and teaching hospital. Participants: A select sample of adult patients admitted to Liverpool Hospital in 2019-2021 with suspected or proven COVID-19. Main outcome measures: Proportion of patients with documented ACP and format of ACP. Results: Amongst 209 patients with proven or suspected COVID-19 hospitalised between March 2019 through to September 2021, median frailty score was 3, the median Charlson Comorbidity Score was 4, median age of the patients was 71 years, and median length of hospital stay was 5 days (range 0-98 days). Almost all patients were tested for COVID-19 (n = 207, 99%) of which 15% (31) were positive. Fewer than a quarter of the patients had documented ACPs (50, 24%) and 17 patients had existing formal advance care directives. Patients who had ACP were older, more likely to be frail and more likely to have higher rates of comorbidity compared to those without ACP. ACP was more commonly discussed with family members (41/50) than patients (25/50) and others (5/50). Conclusion: Adherence to the local ACP policy mandating such discussions was low. This reinforces the need for prioritising ACP discussions, especially for unwell patients such as those with COVID, likely involving further input to improve awareness and rates of formal documentation.
KW - advance care planning
KW - COVID-19
KW - end of life planning
KW - older people
KW - palliative care
UR - http://www.scopus.com/inward/record.url?scp=85178392833&partnerID=8YFLogxK
U2 - 10.1177/10499091231218476
DO - 10.1177/10499091231218476
M3 - Article
C2 - 38032286
AN - SCOPUS:85178392833
SN - 1049-9091
VL - 41
SP - 1358
EP - 1362
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
IS - 11
ER -