Information meetings on end-of-life care for older people by the general practitioner to stimulate advance care planning: a pre-post evaluation study

Abstract

Abstract Background To increase knowledge about options people have concerning end-of-life-care issues, General Practitioners (GPs) can organise meetings to inform their older patients. We evaluated these meetings, using the following research questions: How did the attendees experience the information meeting? Was there a rise in Advance Care Planning (ACP) behaviour after the information meeting? Was there a change in trust people have that physicians will provide good care at the end of life and that they will follow their end-of-life wishes after the information meetings? Methods Four GPs invited all patients of 75 years and older registered in their GP practices to the meeting via a written letter. Four meetings of 2 h took place in 2016. Meetings started with a presentation on end-of-life topics and ACP by the GP followed by time for questions. A pre-post evaluation study was done using written questionnaires distributed and filled in at the start of the meeting (T 0 ) at the end of the meeting (T 1 ) and 6 months after the meeting (T 2 ). Results In total 225 older people attended a meeting of which 154 (68%) filled in the questionnaire at T 0 and 145 (64%) filled in the questionnaire at T 1 . After six months, 90 of the 121 people who approved of being sent another questionnaire at T 2 , returned it (40%). The average age of the respondents was 80 years (T 0 ). The meetings were evaluated positively by the attendees (T 1 ). ACP issues (appointing a proxy, resuscitation, hospitalisation, euthanasia, treatment preferences under certain circumstances, preferred place of care and nursing home admittance) were discussed with a physician, a relative or both more often in the 6 months after having attended the meeting (T 2 ), compared to before (T 0 ). Compared to before the meeting (T 0 ), trust in the GP providing good end-of-life care and following end-of-life wishes was higher immediately after the meeting (T1), but not after 6 months (T 2 ). Conclusion Information meetings on end-of-life care by GPs have a positive influence on the occurrence of ACP, both with the physician and others. Although, this method especially reaches the older people that are already interested in the subject, this seems a relatively easy way to stimulate ACP.