Successful Advance Directives through Quality Disease Management

Area of Science:

• Medical Ethics
• Public Health Policy
• Healthcare Communication

Background:

• Advance care planning (ACP) is frequently discussed, with recent attention in prominent medical journals and policy documents.
• Public support for advance directives is high (60-90%), yet completion rates remain low (10-20%) across the US, Canada, and Australia.
• Despite widespread acknowledgment of ACP's value, a significant disconnect exists between public endorsement and practical implementation.

Purpose of the Study:

• To examine the discrepancy between public support for advance care planning and the low rates of completed advance directives.
• To identify the challenges in translating the conceptual agreement on advance care planning into tangible patient actions.
• To underscore the problem of low completion rates for advance care plans.

Main Methods:

• Literature review of recent articles and editorials in the New England Journal of Medicine.
• Analysis of policy documents, including 'Advance Care Planning in Canada: National Framework for Consultation' (Health Canada, 2010).
• Synthesis of public opinion data regarding support for advance care planning.

Main Results:

• High levels of public support for advance care planning are consistently reported.
• A substantial gap persists between public support and the actual completion of advance care plans.
• Expert commentary suggests that advance directives have been largely unsuccessful in practice.

Conclusions:

• There is a critical need to address the barriers preventing individuals from completing advance care plans.
• Effective strategies are required to bridge the gap between support for and utilization of advance care planning.
• The low completion rate of advance directives indicates a systemic issue requiring further investigation and intervention.