Timing of advance care planning in patients with advanced cancer: Analysis of ACTION data

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-03-24 DOI:10.1016/j.pec.2025.108761

Tingting Zhu , Judith AC Rietjens , Johannes J.M. van Delden , Luc Deliens , Agnes van der Heide , Anna Thit Johnsen , Francesca Ingravallo , Urška Lunder , Nancy J. Preston , Jane Seymour , Ida J. Korfage

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Abstract

Objective

To explore the experiences of patients with advanced cancer regarding the timing of ACP.

Methods

This secondary analysis used data from the ACTION cluster-randomized clinical trial. 288 patients with advanced lung or colorectal cancer, WHO performance status 0–3, and with a minimum life expectancy of 3 months were included in this analysis.

Results

The mean time between patients’ cancer diagnosis and the first ACP conversation was 15.3 months (SD:19.4). The average duration from current cancer stage diagnosis to the first conversation was 8.9 months (SD:10.7). The timing of the conversation was perceived as “just right” by 217 (75.3 %) of the patients. Patients who perceived the timing as “too early” were more recently diagnosed with cancer (9.1 months) or with their current cancer stage (5.7 months) than those who did not. Patients perceiving the timing as “too late” had shorter estimated survival times.

Conclusion

Patients with advanced cancer may benefit from earlier ACP than what is currently typically initiated in clinical practice.

Practice implications

When initiating ACP conversations, several aspects should be considered, including patients’ gender, their socio-cultural environment, and their ability to perform daily activities, with or without limitations.

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.