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Impact of advance care planning on end-of-life management

Lunder, Urška; Červ, Branka; Kodba-Čeh, Hana

Current Opinion in Supportive and Palliative Care: December 2017 - Volume 11 - Issue 4 - p 293–298
doi: 10.1097/SPC.0000000000000306
END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston

Purpose of review The aim of this review is to critically appraise the recent evidence on different aspects of impact of advance care planning (ACP) in palliative care and to reflect on further implications on practice and research in the future.

Recent findings Evidence about various ACP impacts is rapidly growing and most common outcome measures are still advance directive completion, change in hospital admission rate and patients’ and families’ views and experiences with ACP. Mainly descriptive studies bring new information of ACP impact for specific groups of patients, their families, settings, countries, contexts, staff and healthcare system as such. It is not yet clear who and when would best conduct ACP, from general practitioners (GPs) to specialists in the hospitals and even lay-navigators for cancer patients; from early ACP conversations to critical ACP in acute events at the end-of-life. The need for ACP impacts high-quality evidence is becoming more urgent because latest future projections are showing higher palliative care needs than previously expected.

Summary Recent studies on various ACP impacts reveal variety of outcomes for different patient groups and settings, and are contributing to a wider picture of ACP situation around the world. However, high-quality evidence on ACP impact is still urgently expected in times of growing need for system-level changes for effective ACP implementation.

Research Department, University Clinic for Respiratory and Allergic Diseases Golnik, Golnik, Slovenia

Correspondence to Urška Lunder, Research Department, University Clinic for Respiratory and Allergic Diseases Golnik, Golnik 36, SI – 4204 Golnik, Slovenia. E-mail:

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