Prospective Multicentre Cross-Sectional Audit Among Older Australians Accessing Health and Residential Aged Care Services: Protocol for a National Advance Care Directive Prevalence Study

Detering, Karen M., Buck, Kimberly, Sellars, Marcus, Kelly, Helana, Sinclair, Craig, White, Ben, & Nolte, Linda (2019) Prospective multicentre cross-sectional audit among older Australians accessing health and residential aged care services: Protocol for a national advance care directive prevalence

10 Pages Posted: 26 Nov 2019

See all articles by Karen Detering

Karen Detering

Austin Health

Kim Buck

affiliation not provided to SSRN

Marcus Sellars

affiliation not provided to SSRN

Helana Kelly

affiliation not provided to SSRN

Craig Sinclair

University of New South Wales (UNSW) - ARC Centre of Excellence in Population Ageing Research (CEPAR)

Ben White

Queensland University of Technology - Faculty of Law

Linda Nolte

Austin Health

Date Written: October 28, 2019

Abstract

Introduction: Advance care planning (ACP), an ongoing communication and planning process, aims to clarify a person’s values and preferences, so these guide decision-making if the person becomes unable to make his or her own decisions. Ideally, ACP results in completion of advance care directives (ACD), documents completed by competent people outlining their values, treatment preferences and/or appointment of a substitute decision-maker (SDM). ACDs are most effective at the point of care, where they can be used to inform treatment decisions. Australian governments fund initiatives and have developed policy to increase ACD completion rates. However, little is known about the prevalence of ACDs at the point of care in Australian health services, making ACP evaluation efforts difficult. This study aims to determine the prevalence of ACDs in records of older people in Australian hospitals, aged care facilities and general practices.

Methods and analysis: This is a national multicentre cross-sectional prevalence study in selected aged care facilities, hospitals and general practices. Following a 2017 feasibility study, a new protocol incorporating key learnings was developed. Sites will be recruited via expression of interest process. Health records of people aged ≥65 years, admitted to or attending services on study day(s) will be audited by trained staff from sites. Site-level data will be collected during the expression of interest. The primary outcome is the presence of at least one ACD in the health record. Secondary outcomes include prevalence of other documented outcomes of ACP (by health practitioner(s)/family/SDM), assessment of ACD quality and content and concordance between the person’s documented preferences and any medical treatment orders. Individuals and sites characteristics where ACDs are present will be explored.

Ethics and dissemination: Protocol approval by Austin Health Human Research Ethics Committee, Melbourne, Australia (reference: HREC/18/Austin/109). Results will be disseminated via peer-reviewed journals and conferences. Participating sites and jurisdictions will receive individualised reports of findings.

Keywords: advanced care planning, advanced care directives, health, aged care, end-of-life care, end-of-life decision making

JEL Classification: I1, I18, I28

Suggested Citation

Detering, Karen and Buck, Kim and Sellars, Marcus and Kelly, Helana and Sinclair, Craig and White, Ben and Nolte, Linda, Prospective Multicentre Cross-Sectional Audit Among Older Australians Accessing Health and Residential Aged Care Services: Protocol for a National Advance Care Directive Prevalence Study (October 28, 2019). Detering, Karen M., Buck, Kimberly, Sellars, Marcus, Kelly, Helana, Sinclair, Craig, White, Ben, & Nolte, Linda (2019) Prospective multicentre cross-sectional audit among older Australians accessing health and residential aged care services: Protocol for a national advance care directive prevalence , Available at SSRN: https://ssrn.com/abstract=3486673

Karen Detering

Austin Health ( email )

145 Studley Rd
Heidelberg VIC 3084, Melbourne
Australia

Kim Buck

affiliation not provided to SSRN

Marcus Sellars

affiliation not provided to SSRN

Helana Kelly

affiliation not provided to SSRN

Craig Sinclair

University of New South Wales (UNSW) - ARC Centre of Excellence in Population Ageing Research (CEPAR) ( email )

Kensington
High St
Sydney, NSW 2052
Australia

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/

Linda Nolte

Austin Health ( email )

145 Studley Rd
Heidelberg VIC 3084, Melbourne
Australia

Here is the Coronavirus
related research on SSRN

Paper statistics

Downloads
2
Abstract Views
76
PlumX Metrics