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. 2023 Jul 30:10:23743735231188826.
doi: 10.1177/23743735231188826. eCollection 2023.

Advance Care Planning and Place of Death During the COVID-19 Pandemic: A Retrospective Analysis of Routinely Collected Data

Philippa McFarlane  1   2 , Katherine E Sleeman  2 , Catey Bunce  1 , Jonathan Koffman  3 , Martina Orlovic  1 , John Rosling  1 , Alastair Bearne  1 , Margaret Powell  1 , Julia Riley  1   4 , Joanne Droney  1   4
Affiliations

Advance Care Planning and Place of Death During the COVID-19 Pandemic: A Retrospective Analysis of Routinely Collected Data

Philippa McFarlane et al. J Patient Exp. .

Abstract

Increased advance care planning was endorsed at the start of the Coronavirus disease 2019 (COVID-19) pandemic with the aim of optimizing end-of-life care. This retrospective observational cohort study explores the impact of advanced care planning on place of death. 21,962 records from patients who died during the first year of the pandemic and who had an Electronic Palliative Care Coordination System record were included. 11,913 (54%) had a documented place of death. Of these 5,339 died at home and 2,378 died in hospital. 9,971 (45%) had both a documented place of death and a preferred place of death. Of these, 7,668 (77%) died in their preferred location. Documented elements of advance care planning, such as resuscitation status and ceiling of treatment decisions, were associated with an increased likelihood of dying in the preferred location, as were the number of times the record was viewed. During the COVID-19 pandemic, advanced care planning and the use of digital care coordination systems presented an opportunity for patients and healthcare staff to personalize care and influence end-of-life experiences.

Keywords: COVID-19; DNACPR; advance care planning; ceiling of treatment; communication; electronic palliative care coordination system; end-of-life; palliative care; place of death.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(A) Forest plot of odds ratios from forced Logistic Regression modeling on the determinants of dying in the preferred place of death. (B) Forest plot of odds ratios from forced logistic regression modeling on the determinants of dying in hospital. Full results including p values are presented in Appendix III.
See this image and copyright information in PMC

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