Perspectives on advance care planning for patients with hematologic malignancies: an international clinician questionnaire

Spring, J., McKinlay, J., Puxty, K. , Metaxa, V., Detsky, M., Mehta, S., Thyagu, S., McGuigan, K. and Munshi, L. (2021) Perspectives on advance care planning for patients with hematologic malignancies: an international clinician questionnaire. Annals of the American Thoracic Society, 18(9), pp. 1533-1539. (doi: 10.1513/AnnalsATS.202006-678OC) (PMID:33400904)

Abstract

Background: Critical illness is common in hematological malignancy (HM) patients. Advance care planning (ACP) can allow these patients to express their care preferences prior to life-threatening illnesses. The objective of this study was to evaluate physicians’ perspectives surrounding ACP in HM patients. Methods: We administered a survey to intensivists and hematologic oncologists who care for patients with HM across Canada and the United Kingdom. Potential respondents were identified from institutions that have a hematologic oncology program. The survey was disseminated electronically. Results: 111 physicians completed the survey with a response rate of 19% (39% across those who opened the email); 52% of respondents were intensivists and 48% hematologic oncologists. 15.5% of physicians reported that ACP happens routinely at their institution, while 8.3% of physicians stated that code status is routinely discussed. ACP discussions were most commonly reported at the onset of critical illness (84.3% of respondents), during disease recurrence (52.9% of respondents), or during transition to a strictly palliative approach (54.9% of respondents). Commonly cited barriers to ACP centred on physicians’ concern about the reaction of the patient or family. Conclusion: This study emphasizes the need for earlier and more frequent ACP discussions in this high-risk population with a variety of barriers identified.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Puxty, Dr Kathryn
• Authors: Spring, J., McKinlay, J., Puxty, K., Metaxa, V., Detsky, M., Mehta, S., Thyagu, S., McGuigan, K., and Munshi, L.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Annals of the American Thoracic Society
• Publisher: American Thoracic Society
• ISSN: 2329-6933
• ISSN (Online): 2325-6621
• Published Online: 05 January 2021
• Copyright Holders: Copyright © 2021 American Thoracic Society
• First Published: First published in Annals of the American Thoracic Society 18(9): 1533-1539
• Publisher Policy: Reproduced in accordance with the publisher copyright policy