THE IMPACT OF ADVANCE CARE PLANNING FOR RENAL PATIENTS

Abstract

Aim: To evaluate the impact of the introduction of ACP to the Austin Hospital renal unit. Background: Research indicates that renal patients are uninformed about care options and have limited knowledge about illness prognosis and trajectories. Accordingly, facilitated Advance Care Planning (ACP) was introduced to the renal unit at the Austin Hospital in 2010. Methods: Audit of medical records for (1) 58 patients who received ACP (2010- 2012) and (2) 58 age and gender matched control patients (2007-2009). Results: The rate of withdrawal from dialysis was significantly higher in the implementation group (IG) (P = 0.022), as was the involvement of the patient or family in the decision to withdraw dialysis (P = 0.001). Medical decisions to withdraw dialysis was equal between groups (P {>} 0.05) More ACP documents were completed in the IG (MEPOA = 67{%}, SOC = 27{%}, RTC = 17{%}) compared to the control group (MEPOA = 5{%}, SOC = 10{%}, RTC = 2{%}). Significantly more wishes were correctly documented in the IG (P {