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Medline ® Abstracts for References 1-3

of 'Advance care planning and advance directives'

Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel.
Sudore RL, Lum HD, You JJ, Hanson LC, Meier DE, Pantilat SZ, Matlock DD, Rietjens JAC, Korfage IJ, Ritchie CS, Kutner JS, Teno JM, Thomas J, McMahan RD, Heyland DK
J Pain Symptom Manage. 2017;53(5):821. Epub 2017 Jan 3.
CONTEXT: Despite increasing interest in advance care planning (ACP) and previous ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives.
OBJECTIVE: The aim of this study was to develop a consensus definition of ACP for adults.
METHODS: We convened a Delphi panel of multidisciplinary, international ACP experts consisting of 52 clinicians, researchers, and policy leaders from four countries and a patient/surrogate advisory committee. We conducted 10 rounds using a modified Delphi method and qualitatively analyzed panelists' input. Panelists identified several themes lacking consensus and iteratively discussed and developed a final consensus definition.
RESULTS: Panelists identified several tensions concerning ACP concepts such as whether the definition should focus on conversations vs. written advance directives; patients' values vs. treatment preferences; current shared decision making vs. future medical decisions; and who should be included in the process. The panel achieved a final consensus one-sentence definition and accompanying goals statement: "Advance care planning is a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal of advance care planning is to help ensure that people receive medical care that is consistent with their values, goals and preferences during serious and chronic illness." The panel also described strategies to best support adults in ACP.
CONCLUSIONS: A multidisciplinary Delphi panel developed a consensus definition for ACP for adults that can be used to inform implementation and measurement of ACP clinical, research, and policy initiatives.
Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA; San Francisco Veterans Affairs Medical Center, San Francisco, California, USA. Electronic address: rebecca.sudore@ucsf.edu.
Advance care planning: Beyond the living will.
Messinger-Rapport BJ, Baum EE, Smith ML
Cleve Clin J Med. 2009 May;76(5):276-85.
For a variety of reasons, the most commonly used advance directive documents (eg, the living will) may not be very useful in many situations that older adults encounter. The durable power of attorney for health care is a more versatile document. We advocate focusing less on "signing away" certain interventions and more on clarifying the goals of care in the ambulatory setting.
Cleveland Clinic Foundation, OH 44195, USA. rapporb@ccf.org
Respecting Choices. http://www.gundersenhealth.org/respecting-choices (Accessed on August 15, 2013).
no abstract available