Does advance care planning affect relatives’ healthcare-seeking behaviour?

Abstract

Background Relatives of terminally ill patients most often experience distress. Advance Care Planning (ACP) has been developed to plan end-of-life care and support patients and relatives. ACP has been shown to have a positive impact on relatives of terminally ill patients and may affect their healthcare-seeking behaviour. The aim of the study was to investigate associations between ACP and relatives’ contacts with general practitioners (GPs) and hospital admissions. Methods Based on a prior randomized controlled trial we conducted a prospective longitudinal study. Relatives of patients formerly randomized into one ACP conversation or control group were included. Information regarding relatives’ GP and hospital contacts was achieved through healthcare registries using personal Civil Registration numbers. The content, distribution, and median number of GP and hospital contacts were analyzed in two time windows: the caregiving period (from randomization until loss) and the bereavement period (from loss until six months after). Results No significant difference in the median number of GP or hospital contacts between the two groups was found. However, in the caregiving period, we found a significant difference in the distribution of GP contacts (p = 0.022); More relatives in the control group had no contact with their GP. Conclusion The prior ACP conversation did not affect the median number of GP or hospital contacts among relatives, but statistically significantly more relatives in the ACP group had a least one GP contact in the caregiving period. The study emphasizes the importance of performing ACP trials with outcomes in relation to relatives and patients.