Palliatieve zorg

Koch, Lucas

doi:10.1007/s12445-011-0278-6

Cited by 1 publication

(2 citation statements)

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“…Before 2018, there was no clear ICPC code to record an ACP conversation in a patient's medical record. GPs were therefore advised to record ACP conversations under ICPC code A20 ( 26 , 27 ). The standard ICPC label of A20 was “request/conversation about euthanasia”.…”

Section: Methodsmentioning

confidence: 99%

“…The standard ICPC label of A20 was “request/conversation about euthanasia”. Since euthanasia can be discussed during an ACP conversation, the Dutch College of General Practitioners regarded A20 as the best available option to record all ACP conversations, including those where euthanasia was not discussed ( 26 , 27 ). In 2014, Ott and colleagues advised GPs to use A20 for recording wishes and decisions made during the ACP conversation, and to use ICPC code A58 (labeled as “ACP”) for recording an exploratory conversation about ACP ( 28 ).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Occurrence and Timing of Advance Care Planning in Persons With Dementia in General Practice: Analysis of Linked Electronic Health Records and Administrative Data

Azizi

Tilburgs²,

Hout

et al. 2022

Front. Public Health

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BackgroundAdvance care planning (ACP) is a process of communication in which patients and family caregivers discuss preferences for future care with the healthcare team. For persons with dementia, it is crucial to timely engage in ACP. Therefore, we study ACP in dementia using electronic health record data. This study aims to determine how often ACP conversations are recorded, analyze time from dementia diagnosis until the first recorded conversation and time from the first recorded conversation to death, and analyze which factors are associated with the timing of ACP.MethodsElectronic records of 15,493 persons with dementia in Dutch general practice between 2008 and 2016 were linked to national administrative databases. ACP conversations and indicators of health deficits to determine frailty were obtained from electronic records coded with the International Classification of Primary Care. Socio-demographic characteristics were derived from the national population registry managed by Statistics Netherlands. Date of death was derived from the Personal Records Database (2008–2018).ResultsACP was recorded as such as 22 (95% CI, 20–23) first conversations per 1,000 person-years of follow-up. The hazard ratio (HR) for the first conversation increased every year after dementia diagnosis, from 0.01 in the first year to 0.07 in the 7th and 8th year after diagnosis. Median time from a first conversation to death was 2.57 years (95% CI, 2.31–2.82). Migrant status [non-Western vs. Western (HR 0.31, 95% CI, 0.15–0.65)] was significantly associated with a longer time from dementia diagnosis to the first conversation. Being pre-frail (HR 2.06, 95% CI, 1.58–2.69) or frail (HR 1.40, 95% CI, 1.13–1.73) vs. non-frail was significantly associated with a shorter time from dementia diagnosis to the first ACP conversation.ConclusionACP conversations in Dutch general practice were rare for persons with dementia, or was rarely recorded as such. In particular among persons with a non-Western migration background and those who are non-frail, it started long after diagnosis. We advise further research into public health and practical strategies to engage persons with dementia with a non-Western migration background and non-frail persons early in the disease trajectory in ACP.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%