• J Pain Symptom Manage · Oct 2021

    Association between subjective remaining life expectancy and advance care planning in older adults: a cross-sectional study.

    • Nienke Fleuren, DeplaMarja F I AMFIAAmsterdam UMC, Vrije Universiteit Amsterdam, Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., PasmanH Roeline WHRWAmsterdam UMC, Vrije Universiteit Amsterdam, Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., JanssenDaisy J ADJAMaastricht University, Care and Public Health Research Institute, Health Services Research, Maastricht, The Netherlands; CIRO, Research and Development, Horn, The Netherlands., Bregje D Onwuteaka-Philipsen, HertoghCees M P MCMPMAmsterdam UMC, Vrije Universiteit Amsterdam, Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., and Martijn Huisman.
    • Amsterdam UMC, Vrije Universiteit Amsterdam, Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. Electronic address: n.fleuren@amsterdamumc.nl.
    • J Pain Symptom Manage. 2021 Oct 1; 62 (4): 757-767.

    ContextAdvance care planning (ACP) becomes more relevant with deteriorating health or increasing age. People might be more inclined to engage in ACP as they feel that they are approaching end of life. The perception of approaching end of life could be quantified as subjective remaining life expectancy (SRLE).ObjectivesFirst, to describe the prevalence of ACP with health care providers or written directives ("formal engagement in ACP") and ACP with loved-ones ("informal engagement in ACP") among older persons in the general population in The Netherlands. Second, to assess the association between SRLE and engagement in ACP.MethodsCross-sectional study using data from the Longitudinal Aging Study Amsterdam (LASA) measurement wave of 2015-2016. Participants (n = 1585) were aged ≥ 57 years.ResultsMedian age was 69.4 years (IQR: 64.1-76.7), and median SRLE 25.9 years (17.7-36.0). Formal engagement in ACP was present in 32.6%, informal without formal engagement in 45.8%, and 21.6% was not engaged in ACP. For respondents with SRLE < 25 years, there was a nonstatistically significant association between SRLE and engagement in ACP (aOR: 0.97; 95% CI: 0.93-1.01; P= .088), and a statistically significant, small association with formal vs. informal engagement in ACP (aOR: 0.96; 0.93-0.99; P= .009). For respondents with SRLE ≥ 25 years there was no association between SRLE and engagement in ACP.ConclusionThe perception of approaching end of life is associated with higher prevalence of formal engagement in ACP, but only for those with SRLE < 25 years. For clinicians, asking patients after their SRLE might serve as a starting point to explore readiness for ACP.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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