Prevalence of Advance Care Directives in the Community: A Telephone Survey of Three Australian States

White, Benjamin P., Willmott, Lindy, Tilse, Cheryl, Wilson, Jill, Ferguson, Michele, Aitken, Joanne, et al. (2019) Prevalence of advance care directives in the community: A telephone survey of three Australian States. Internal Medicine Journal, 49(10), pp. 1161-1267.

24 Pages Posted: 21 Mar 2019 Last revised: 31 Oct 2019

See all articles by Ben White

Ben White

Queensland University of Technology - Faculty of Law

Lindy Willmott

Queensland University of Technology - Faculty of Law

Cheryl Tilse

University of Queensland

Jill Wilson

University of Queensland

Michele Ferguson

affiliation not provided to SSRN

Joanne Aitken

affiliation not provided to SSRN

Jeffrey Dunn

affiliation not provided to SSRN

Deborah Lawson

University of Otago - Faculty of Law

Angela Pearce

affiliation not provided to SSRN

Rachel Feeney

University of Queensland

Date Written: February 20, 2019

Abstract

BACKGROUND: The community prevalence of advance care directives (ACDs) is low despite known benefits of advance care planning for patients, families and health professionals.

AIM: To determine the community prevalence of instructional and appointing ACDs in New South Wales, Victoria and Queensland and factors associated with completion of these documents.

METHODS: A telephone survey of adults living in New South Wales, Victoria and Queensland (n=1175) about completion of instructional ACDs (making their own decisions about future health care) and appointing ACDs (appointing another to decide). Quota sampling occurred based on population size by state, gender and age, with oversampling in smaller jurisdictions (Victoria and Queensland).

RESULTS: Overall response rate was 33%. Six per cent of respondents reported completing an instructional ACD while 12% reported completing an appointing ACD. Female gender, higher educational level, personal experience of a major health scare and being widowed were significant predictors of completing an instructional ACD. Older age, higher educational level and being widowed were significant predictors of completing an appointing ACD.

CONCLUSIONS: Despite long-standing efforts to increase advance care planning, community prevalence of ACDs remains low, particularly for instructional ACDs. This study found some different predictors for instructional ACDs compared with appointing ACDs, and also a potential role for experiential factors in triggering uptake. These findings suggest supplementing general community awareness campaigns with more nuanced and targeted efforts to improve ACD completion.

Keywords: advance care directives, advance care planning, end of life

Suggested Citation

White, Ben and Willmott, Lindy and Tilse, Cheryl and Wilson, Jill and Ferguson, Michele and Aitken, Joanne and Dunn, Jeffrey and Lawson, Deborah and Pearce, Angela and Feeney, Rachel, Prevalence of Advance Care Directives in the Community: A Telephone Survey of Three Australian States (February 20, 2019). White, Benjamin P., Willmott, Lindy, Tilse, Cheryl, Wilson, Jill, Ferguson, Michele, Aitken, Joanne, et al. (2019) Prevalence of advance care directives in the community: A telephone survey of three Australian States. Internal Medicine Journal, 49(10), pp. 1161-1267.. Available at SSRN: https://ssrn.com/abstract=3343948 or http://dx.doi.org/10.2139/ssrn.3343948

Ben White (Contact Author)

Queensland University of Technology - Faculty of Law ( email )

Level 4, C Block Gardens Point
2 George St
Brisbane, QLD 4000
Australia

HOME PAGE: http://staff.qut.edu.au/staff/whiteb/

Lindy Willmott

Queensland University of Technology - Faculty of Law ( email )

Level 4, C Block Gardens Point
2 George St
Brisbane, QLD 4000
Australia

HOME PAGE: http://staff.qut.edu.au/staff/willmott/

Cheryl Tilse

University of Queensland ( email )

St Lucia
Brisbane, Queensland 4072
Australia

Jill Wilson

University of Queensland ( email )

St Lucia
Brisbane, Queensland 4072
Australia

Michele Ferguson

affiliation not provided to SSRN

Joanne Aitken

affiliation not provided to SSRN

Jeffrey Dunn

affiliation not provided to SSRN

Deborah Lawson

University of Otago - Faculty of Law ( email )

PO Box 56
Dunedin North
Dunedin, 9016
New Zealand

Angela Pearce

affiliation not provided to SSRN

Rachel Feeney

University of Queensland ( email )

St Lucia
Brisbane, Queensland 4072
Australia

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